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[Complications following surgery and radiotherary in 108 patients with cervical cancer]
Objective:
To evaluate the most common complications following surgery and radiotherary of cervical cancer based on own experience and to compare them to the complications rates reported by other authors.
Material:
One hundred eight patients with invasive cervical cancer, staged (IB-IVB) are enrolled in the study. They all had been operated on in Varna between the period XI.2003-VI.2006 by the author.
Methods:
Surgical management includes radical hysterectomy class ll-IV, selective and total pelvic and paraaortic lymph node dissection. Radiotherapy is preoperative 30-52 Gy and adjuvant postoperative 52 Gy TGT Cisplatin-based neoadjuvant chemotherapy had been administered 3 courses at intervals of 21 days before surgery. Peritonization with two retroperitoneal drains in fossa obtoratoria had been performed in 91 patients. Seventeen patients were non-peritonized with abdominal drianage.
Results:
In the group of patients with peritonization and retroperitoneal drainage the incidence rates of fistulas,lymphocysts, ureteral strictures, urinary infections, ileus, radiation-induced proctitis are: 1,1%, 5,5%, 2,2%, 3,3%, 1,1% and 2,2%, respectively. In the group of patients without peritonization the incidence rates of same complications are: 5,9%, 17,6%, 0%, 0%, 29,4% and 11,8%, respectively.
Conclusion:
Pelvic peritonization and retroperitoneal drainage decreases significantly the early and late postoperative complications, especially the incidence rate of fistulas, lymphocysts, lymphedema, ileus, radiation- induced proctitis and proctosygmoiditis and makes them comparable to these complication rates,reported by other authors and centres. This method allows the patients to be discharged at the light postoperative day, optimizes the quality of life and the survival.