Uvodnik
PERITONIZATION AND DRAINAGE IN RADICAL HYSTERECTOMY AND PELVIC LYMPHADENECTOMY – AN OBSOLETE TECHNIQUE
Herman Haller
Stanislav Rupčić
Alemka Brnčić-Fischer
Maja Krašević
Miroslav Stamatović
Nebojša Sindik
Ozren Mamula
Sažetak
Retrospectively the effect of pelvic peritoneum closure with drainage in relation to peritoneum nonclosure without drainage on the occurence of postoperative complications after a radical hysterectomy and pelvic lymphadenectomy in patients with cancer of the uterus cervix in stage Ib / IIa is analyzed. Methods. The two observed groups represent also two periods: the first from 1986 to 1994, when the peritoneum of 111 patients was closed with individual sutures and vaginal drainage, and the second from 1995–2001 when in 112 patients the peritoneum was left open and without drainage. Results. In the first group there were 33.3% of postoperative complications, while in the second one the percentage was considerably lower, only 12.5%. All considered complications occured more frequently in the first observed group in relation to the second: temperature 12.6% vs. 3.6%, complications of the abdominal wound healing 8.1% vs. 3.6%, com-plications of the vaginal cuff healing 9.0% vs. 3.6% and the ureterovaginal fistulas 3.6% vs. 1.8%. The adjuvant therapy with radiotherapy was considerably more frequent in the first group; the five-years survival was a bit higher in the second group, but without statistically significant difference. The observed groups did not differ with regard to the age or length of stay in hospital, but the postoperative stay longer than 22 days was higher in the first group, particularly in patients who were more radically operated (Piver III). At the same time a higher number of radical operations was carried out in the first observed group. Conclusion. Non-closing of the peritoneum and no drainage use after radical hysterectomy and pelvic lymphadenectomy considerably decrease the occurence of postoperative complications in cervical cancer patients. The described surgical technique should be included in standard intraoperative procedures.
Ključne riječi
hysterectomy; radical hysterectomy; cervical cancer; operative complications
Hrčak ID:
9586
URI
Datum izdavanja:
31.3.2005.
Posjeta: 1.794 *