Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of Gynecology and Obstetrics in Novi Sad in the period 1993-2013/Radikalna histerektomija u hirurskom lecenju invazivnog karcinoma grlica materice na novosadskoj ginekolosko-akuserskoj klinici u periodu 1993-2013

• Published in: Medicinski pregled p. 227
• Main Authors: Durdevic, Srdan, Stojanovic, Sanja, Pantelic, Milos, Nikolic, Dragan, Nikolic, Marijana Basta, Kacanski, Mihaela Mocko
• Format: Journal Article
• Language: English
• Published: Drustvo Lekara Vojvodine 01-07-2015
• Subjects: Care and treatment; Cervical cancer; Hysterectomy; Medical research; Medicine, Experimental; Methods; Patient outcomes; Serbia
• ISSN: 0025-8105
• DOI: 10.2298/MPNS1508227D

Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients' age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number of removed lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer. Key words: Hysterectomy; Uterine Cervical Neoplasms; Endometrial Neoplasms; Neoplasm Invasiveness; Obstetrics and Gynecology Department, Hospital; Gynecologic Surgical Procedures; Neoplasm Staging; Carcinoma + pathology; Diagnosis; Postoperative Complications; Blood Loss, Surgical; Lymph Node Excision; Recurrence; Survival Rate Uvod. U toku 20-godisnjeg perioda (1993-2013.), kod 175 zena sa invazivnim karcinomom grlica materice uradena je radikalna histerektomija po metodi Verthajm-Megz na Klinici za ginekologiju i akuserstvo Klinickog centra Vojvodine u Novom Sadu. Indikaciju za radikalnu histerektomiju predstavljala je histopatoloska potvrda invazivnog karcinoma grlica materice u stadijumu IB 1-IIB prema International Federation of Gynecology and Obstetrics. Materijal i metode. Procena stadijuma i prosirenosti bolesti na okolne strukture vrsena je primenom sistema stadiranja International Federation of Gynecology and Obstetrics iz 2009. godine. Kriterijumi za iskljucivanje iz istrazivanja obuhvatili su sve druge stadijume bolesti: IA i stadijume preko IIB kao i odsustvo definitivne histopatoloske potvrde karcinoma grlica materice na definitivnom preparatu (primarni karcinom endometrijuma ili vagine koji je zahvatio grlic materice). Pre operacije insistirali smo na sprovodenju imidzing metoda dijagnostike karlice i abdomena, rendgenskom snimku pluca u dva pravca, elektrokardiogramu, internistickom i anestezioloskom pregledu. Rezultati. Uzrast pacijentkinja kretao se 24-79 godina (x : 46 god.), vreme trajanja operacije iznosilo je 120-300 minuta (x : 210 min.). U stadijumu IB 1 bilo je 64,6% operisanih, 14,8% u stadijumu IB 2, 9,1% u stadijumu IIA i 11,4% u stadijumu IIB. Gubitak krvi u toku operacije kretao se 50-800 ml (u proseku 300 ml), broj uklonjenih limfnih cvorova bio je 14-75 (x : 32). Zabelezili smo 6,8% intraoperativnih i 17,7% postoperativnih komplikacija. Recidiv bolesti evidentiran je kod 22 (12,5%) pacijentkinje, najcesce u paraaortalnoj grupi limfnih cvorova 3,4% i u predelu parametrijuma 2,8%, dok je ukupno petogodisnje prezivljavanje iznosilo 87% do 2008. godine. Zakljucak. Radikalna histerektomija po metodi Verthajm-Megz predstavlja osnovnu hirursku tehniku u lecenju pocetnih stadijuma invazivnog karcinoma grlica materice. Kljucne reci: Histerektomija; Karcinom grlica materice; Karcinom endometrijuma; Invazivnost karcinoma; Ginekolosko-akuserska klinika; Ginekoloske hirurske tehnike; Stadijumi neoplazmi; Karcinom + patologija; Dijagnoza; Postoperativne komplikacije; Gubitak krvi, hirurski; Ekscizija limfnih cvorova; Rekurentnost; Stopa prezivljavanja