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Japanese Journal of Clinical Oncology 32:103-107 (2002)
© 2002 Foundation for Promotion of Cancer Research

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

Yoko Kobamatsu, Ritsu Yamamoto, Masanori Kaneuchi, Takashi Mitamura, Shinichiro Minobe, Yukiharu Todo, Mahito Takeda, Kazuhira Okamoto, Eiji Nomura, Hiroaki Negishi, Noriaki Sakuragi and Seiichiro Fujimoto+

Gynecology, Reproductive and Developmental Medicine, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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.

+ For reprints and all correspondence: Ritsu Yamamoto, Gynecology, Reproductive and Developmental Medicine, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan. E-mail: rityam@med.hokudai.ac.jp


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