[The Wertheim-Meigs radical hysterectomy in surgical treatment of cervical carcinoma].

INTRODUCTION

Wertheim from Vienna was the first to introduce the technique of radical hysterectomy into surgical practice in treatment of uterine cervix carcinoma associated with partial lymphadenectomy (1989). In concern to the level of surgical extensiveness, radical hysterectomy can be divided into 5 classes (after Piver-Rutledge).

MATERIAL AND METHODS

At the Department of Obstetrics and Gynaecology in Novi Sad 55 patients with invasive cervical cancer (FIGO st. IB1-IIB) underwent surgery during the period from 1991 to 2001. All patients underwent radical hysterectomy after Wertheim-Meigs technique. The aim of this study was to present operative techniques of radical hysterectomy and complications following surgery.

RESULTS

Distribution by stage of the disease was as follows: IB1 = 39 (70.9%), IB2 = 6 (10.9%), IIA = 7 (12.7%) and IIB = 3 (5.5%). On average, there were 15 lymph nodes removed, out of which 9 (16.4%) cases were positive. Postoperative complications were recorded in 19 (34.5%) patients, whereas the incidence of urinary fistulas and intrahospital mortality rate have been reduced to the minimum (0%). Recurrence was evident in 3 (5.4%) patients and 5-year survival rate was 92.3% (in patients operated up to 1997).

DISCUSSION AND CONCLUSION

In relation to previously published results of treatment at the Department, there is an evident increase in the number of stage I patients and a decrease in stage II patients, as well as a reduced incidence of postoperative urinary fistulas, total number of complications, but an increase in the 5-year survival rate.