Acta Medica Medianae (Sep 2002)
COMPLICATIONS AT THE OPERATIVE TREATMENT OF THE INVASIVE CERVIX UTERI CARCINOMA
Abstract
In the period from 1997 to 2001 at the Clinic for Gynecology and Obstetrics of the Clinic Center, Nis, there were 140 treated patients suffering from the cervix uteri carcinoma in I-B and II-A stadiums according to the FIGO classification. In 16 (11,42%) patients there was modified radical hysterectomy (class 11) done while in 124 (88,57%) the Wertheim-Meigs hysterectomy (class III) done. Inter operative complications (lesions) were recorded in 8 (5,69%) patients, namely, urinary tract lesions in 4 (2,85%) while blood vessel ones in 3 (2,13%) patients. The obturator nerve is cut in 1 (0,71%) patient. Immediate postoperative complications were recorded in 56 (39,96%) patients. Most often they are infection-induced. Urinary infections were noticed in 25 (17,85%) patients, febrility in 22 (15,71%) and infections of the operative wound in 3 (2,14%) patients. Later complications of the operative cervix treatment were noticed in 37 (26,42%) patients. Their emergence depends on the fact whether the patient was radiated before or before and after the operation. Most often later complications emerge in the patients that undenvent, after the operation, brachytherapy and transcutaneous radiotherapy (27 or 19,28%); the least frequent were in only 3 (2,14%) of the operated patients. The most frequent later complications are those of the urinary tract (fistulas, cystitis) in 11 (7,83%) patients as well as changes upon the last part of the gastrointestinal tract, namely, hemorrhage colitis in 9 (9,28%), late ileus in 3 (2,14%) and rectovaginal fistula in 3 (2,14%) patients. Hydronephrosis was recorded in 7 (5,00%) patients. There were no lethal cases. All the patients are still living.
