[Radical hysterectomy. Operative complications]

The Authors carried out a retrospective examination of data relating to 241 patients undergoing radical hysterectomy with pelvic lymphadenectomy between 1970 and 1991. The basic aim of the study was to identify and quantify complications correlated to radical hysterectomy using the Wertheim-Meigs method. Surgery was performed in 223 cases due to cervical cancer, in 13 cases due to endometrial cancer, in 3 cases due to vaginal cancer and in 2 due to ovarian cancer with secondary extension to the uterus. Complications were subdivided into intraoperative and postoperative. Intraoperative complications involved the urinary tract in 4.5% and other apparatus (intestinal and nervous lesions, hemorrhage due to vascular damage) in 8.7% of cases. Postoperative complications were classified as follows: 35.2% involving the urinary tract (fistula 20.3% and vesical dysfunction 14.9%) and 8% involving other organs or systems (infections, neuropathy, pelvic lymphocele, pathologies of intestinal canalization, etc.). Lastly, the Authors examined the individual complications of radical hysterectomy, focusing attention in particular on vesicourethral dyskinesia, in the light of the physiopathological mechanisms reported in the literature. The mean rate of complications in the series examined here was substantially comparable to that reported by other Authors.