Comparison of the Results of Radical Hysterectomy: Sequential Observations in Each Period

• Published in: Japanese journal of clinical oncology Vol. 32; no. 3; pp. 103 - 107
• Main Authors: Kobamatsu, Yoko, Yamamoto, Ritsu, Kaneuchi, Masanori, Mitamura, Takashi, Minobe, Shinichiro, Todo, Yukiharu, Takeda, Mahito, Okamoto, Kazuhira, Nomura, Eiji, Negishi, Hiroaki, Sakuragi, Noriaki, Fujimoto, Seiichiro
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2002; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Antibiotic Prophylaxis; Bacterial Infections - prevention & control; Drainage; Female; Humans; Hysterectomy - statistics & numerical data; Key words: radical hysterectomy – retroperitoneal infections – antibiotics – prophylaxis – retroperitoneal drainage; Lymph Node Excision - statistics & numerical data; Middle Aged; Observer Variation; Postoperative Complications - prevention & control; Retroperitoneal Space; Retrospective Studies; Uterine Cervical Neoplasms - surgery
• ISSN: 0368-2811; 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyf024

Background: The efficacy of drains and of antibiotics for prophylaxis of postoperative retroperitoneal infections following radical hysterectomy with systematic lymphadenectomy has not yet been adequately investigated. Methods: Patients who had just undergone radical hysterectomy were divided into three groups. We used a retroperitoneal drain transvaginally for Groups A (n = 54) and B (n = 55) and transabdominally for Group C (n = 103). Group A was administered a first- and Groups B and C a second- or third-generation cephem antibiotic as the prophylactic antibiotic. We compared the surgery time, blood loss, fever index and febrile morbidity in these three groups. Results: The average surgery time was Group A 344.2 ± 13.7 min (mean ± SE), Group B 425.6 ± 11.0 min and Group C 528.2 ± 10.9 min. A significant difference was observed among the groups (p < 0.05). In terms of blood loss during surgery, a significant increase (p < 0.05) occurred in Groups B (2400 ± 196 g) and C (2373 ± 130 g) compared with Group A (1820 ± 122 g). For fever index, Group A showed a value of 36.1 ± 2.7 dh, Group B 19.9 ± 2.4 dh and Group C 8.8 ± 1.5 dh. A significant difference was observed among the groups (p < 0.01). In terms of febrile morbidity, significant differences (p < 0.01, p < 0.0001) were observed between Groups B (14.6%) and C (8.7%) in comparison with Group A (44.4%), respectively. Conclusion: In radical hysterectomy with systematic lymphadenectomy, it may be preferable to choose transabdominal drains in the retroperitoneal space and second-generation cephem antibiotics for prophylaxis of postoperative retroperitoneal infections.