[Complications of radical hysterectomy during management of stage Ib and IIa cervix uteri cancer. Experience with 145 patients].

Perioperative morbidity and mortality were studied in 145 patients who underwent radical hysterectomy wit pelvic lymphadenectomy, as treatment of choice for cervical cancer, stages Ib and IIa at The Oncology Service on The General Hospital of México, SSA, with special emphasis in urinary complications when superior bladder arteries were preserved, (99 cases) or not, (46 cases). There was no operative death. There were 20, (13.7%) intraoperative complications: 10 (6.8%) injuries to hypogastric plexus; 5 (3.4%) ureteral sections and 2 (1.3%) injuries to iliac veins. Thirty nine patients, (26.8%) developed postoperative complications, (1 to 30 days): Bladder dysfunction, 30 (20.6%); wound infection, 5 (3.4%); ureterovaginal fistula, 3 (2.0%) and vesicovaginal fistula, 3 (2.0%). After 30 days, we observed 5 complications, (3.4%): ureterovaginal fistula, 3 (2.0); bowel obstruction, 1 (0.6%) and lymphocyst, 1 (0.6%). Surgical time was an hour longer, (4.15 hs vs. 3.15 hs) and bleeding increased a little bit, (1,125 c.c. vs. 980 c.c.) when superior bladder arteries were preserved. However, in these cases, there were less postoperative complications, (29/99, 29.2% vs. 19/46, 41.3%; P < 0.05), including ureterovaginal fistula, (1/99, 1.0% vs. 5/46, 10.8%).