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Slow-transit constipation after radical hysterectomy type III
1Department of Gynecology and Obstetrics, University of Cologne, Kerperner Strasse 34, 50931 Cologne, Germany. Marc.Possover@medizin.uni-koeln.de
Background:
This study investigated ways to reduce the rate of slow-transit constipation after radical hysterectomy type III.
Methods:
A prospective study was conducted involving 59 consecutive patients with cervical cancer stage IB1-IIIA at high risk for parametrial or lymph node involvement who were treated between May 1996 and March 1999 by laparoscopically assisted radical vaginal hysterectomy type III.
Results:
During laparoscopic transection of the cardinal ligament, particular attention was focused on conservation of the pelvic splanchnic nerves. After vaginal removal of the uterus, a vaginal sacrocolporectopexy was performed transvaginally. Nerve preservation and pexy of the rectum allowed a significant reduction of postoperative constipation, as compared with classic radical hysterectomy without conservation of the splanchnic pelvic nerves and without sacrocolporectopexy.
Conclusion:
Refinements in the preparation of the parasympathetic nerves during radical pelvic surgery and refixation of the terminal rectum helps to prevent postoperative constipation.