M Possover1, A Schneider. 1. Department of Gynecology and Obstetrics, University of Cologne, Kerperner Strasse 34, 50931 Cologne, Germany. Marc.Possover@medizin.uni-koeln.de
Abstract
BACKGROUND: This study investigated ways to reduce the rate of slow-transit constipation after radical hysterectomy type III. METHODS: A prospective study was conducted involving 59 consecutive patients with cervical cancer stage IB1-IIIA at high risk for parametrial or lymph node involvement who were treated between May 1996 and March 1999 by laparoscopically assisted radical vaginal hysterectomy type III. RESULTS: During laparoscopic transection of the cardinal ligament, particular attention was focused on conservation of the pelvic splanchnic nerves. After vaginal removal of the uterus, a vaginal sacrocolporectopexy was performed transvaginally. Nerve preservation and pexy of the rectum allowed a significant reduction of postoperative constipation, as compared with classic radical hysterectomy without conservation of the splanchnic pelvic nerves and without sacrocolporectopexy. CONCLUSION: Refinements in the preparation of the parasympathetic nerves during radical pelvic surgery and refixation of the terminal rectum helps to prevent postoperative constipation.
BACKGROUND: This study investigated ways to reduce the rate of slow-transit constipation after radical hysterectomy type III. METHODS: A prospective study was conducted involving 59 consecutive patients with cervical cancer stage IB1-IIIA at high risk for parametrial or lymph node involvement who were treated between May 1996 and March 1999 by laparoscopically assisted radical vaginal hysterectomy type III. RESULTS: During laparoscopic transection of the cardinal ligament, particular attention was focused on conservation of the pelvic splanchnic nerves. After vaginal removal of the uterus, a vaginal sacrocolporectopexy was performed transvaginally. Nerve preservation and pexy of the rectum allowed a significant reduction of postoperative constipation, as compared with classic radical hysterectomy without conservation of the splanchnic pelvic nerves and without sacrocolporectopexy. CONCLUSION: Refinements in the preparation of the parasympathetic nerves during radical pelvic surgery and refixation of the terminal rectum helps to prevent postoperative constipation.
Authors: Boris Gabriel; Joseph Nassif; Pantelis Trompoukis; Ana Maria Lima; Sonia Barata; Gerlinde Lang-Avérous; Arnaud Wattiez Journal: Int Urogynecol J Date: 2011-07-06 Impact factor: 2.894