Radical Hysterectomy with Pelvic Lymphadenectomy: Indications, Technique, and Complications

Abstract

Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA2 and IB1 carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (<1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.

Late Recurrence of Early Stage Cervical Cancer more than 3 Years after Radical Hysterectomy with Pelvic Node Dissection

“…According to 2 randomized controlled trials by the Gynecologic Oncology Group (GOG), protocol 92 and 109, adjuvant radiation (XRT) and adjuvant concurrent chemoradiation (CCRT) after RHND for early stage cervical cancer have been shown to improve oncological outcomes of patients with intermediate-and high-risk factors, respectively [1,2]. In addition, current improvements in surgical techniques, thromboembolic prophylaxis, antibiotic prophylaxis, and advances in postoperative care have all lowered morbidity from this procedure [3]. Therefore, the survival rates for patients with early stage cervical cancer after RHND are good, with 5-year overall survival (OS) rates varying from 80 to 95% [3,4].…”

“…In addition, current improvements in surgical techniques, thromboembolic prophylaxis, antibiotic prophylaxis, and advances in postoperative care have all lowered morbidity from this procedure [3]. Therefore, the survival rates for patients with early stage cervical cancer after RHND are good, with 5-year overall survival (OS) rates varying from 80 to 95% [3,4]. Nevertheless, 10-18% of patients experience disease recurrence [4][5][6].…”

Complicaciones asociadas a histerectomía radical con linfadenectomía pélvica en mujeres con cáncer de cérvix en el Instituto de Cancerología - Clínica Las Américas, Medellín, Colombia. Estudio de cohorte

“…La lesión vascular en nuestro estudio se presentó en el 1,5%, la cual se está por debajo de otros estudios como el de Bosze et al (12), que reportan una tasa de lesión vascular de 5,5%. Otras series reportan tasas entre 0,2 y 8,7% (13). No se presentaron lesiones en la vía urinaria, las cuales en la mayoría de series está reportada como una de las más frecuentes, con una tasa que se acerca al 3,5% (14).…”

Acupuncture for Preventing Complications after Radical Hysterectomy: A Randomized Controlled Clinical Trial

“…It can lead to lymphedema and infection subsequently due to interruption of efferent pelvic lymphatics [1]. But acupuncture could not reduce lymphocyst formation in this study protocol.…”