Kajanoja P, Räisänen I, Lehtovirta P
Ann Chir Gynaecol. 1985;74(2):94-7.
Wertheim radical hysterectomy combined with pelvic lymphadenectomy was performed at the Helsinki University Central Hospital on 132 women of whom 120 had cervical carcinoma from Stage IA to early IIB and 12 had endometrial carcinoma Stage II. None of the patients died or had severe complications during their hospitalisation. The left ureter was accidently transected in two patients and both were corrected immediately. Wound complications occurred in 16 patients (12%). The high incidence of wound complications is probably partly related to the low-dose heparin prophylaxis. The initial clinical staging was found to be correct in 85% of the cases. Five cases were under-staged. All ten patients cases of early Stage IIB were over-staged, none of whom had parametrial invasion. The predictive value of lymphangiography was low, 14% in histologically positive cases and 89% in negative cases of lymph node metastases. Lymphangiography proved to be only of value in facilitating complete lymph node dissection. Intra-operative lymphangiographic control revealed radio-positive nodes and lead to further dissection in 30 patients (24%).
赫尔辛基大学中心医院对132名女性实施了韦特海姆根治性子宫切除术联合盆腔淋巴结清扫术，其中120例为IA期至IIB期早期宫颈癌患者，12例为II期子宫内膜癌患者。所有患者在住院期间均未死亡或出现严重并发症。两名患者的左侧输尿管意外被切断，均立即进行了修复。16例患者（12%）出现伤口并发症。伤口并发症的高发生率可能部分与低剂量肝素预防有关。85%的病例初始临床分期正确。5例分期过低。所有10例IIB期早期患者分期过高，其中无一例有宫旁浸润。淋巴管造影的预测价值较低，在组织学阳性的淋巴结转移病例中为14%，在阴性病例中为89%。淋巴管造影仅在有助于彻底清扫淋巴结方面有价值。术中淋巴管造影控制显示放射性阳性淋巴结，并导致30例患者（24%）进一步清扫。
