The 'problem' radical hysterectomy

This is a study of 243 radical hysterectomy and pelvic lymphadenectomy procedures performed for gynecologic malignancy. The term 'problem' radical hysterectomy was applied to those patients with 1 of the following conditions: recent cervical conization (within 21 days), previous total or supravaginal hysterectomy, pregnancy, or previous pelvic radiation. There were 88 patients in these categories. 155 Patients had none of these predisposing problems which might influence operative or postoperative complications. There were 2 deaths (0.82%). There was no statistically significant difference in operative injuries to the bladder, ureters, or rectum or in the mean operative time and mean blood loss across the categories. However, there was a statistically significant difference across the categories in postoperative complications, both major and minor. The greatest incidence of such complications occurred in patients who had previous radiation therapy and the 2nd greatest incidence was in patients who had recent cervical conization. Pregnant patients had the least number of complications.