Radical Hysterectomy for Carcinoma Cervix: A Clinical Analysis of 160 Cases

Background: In this study an attempt was made to study the following  Advantage and disadvantage of different approaches of radical Hysterectomy with special reference to abdominovaginal approach  Complications and side effects of the procedure with special reference to post CTRT (Chemo Therapy and Radio Therapy treated) cases Method: It is a prospective clinical study. It was conducted between December 1990 and August 2016 in different institutions of Silchar, Guwahati and Barpeta situated in ssam (North East India). It included 160 carcinoma cervix cases of stage Ia to stage IIb, operated by three different approaches of Radical Hysterectomy. Results: Maximum numbers of cases in the series were in stage IIa (51.25%). Most of the cases (50%) were performed by the Abdominovaginal approach wound gapping was the commonest (5%) complications followed by ureteric fistula (0.625%) secondary haemorrhage (2.50%) etc. Out of 90 cases in 5 years follow up there were 20 cases (12.50%) recurrences. Conclusion: Different approaches of radical hysterectomy have their own advantages. Abdominovaginal approach is more useful for stage II a carcinoma cervix where more liberal excision of vagina is helpful. It is also useful in obese patients, where abdominal approach is more difficult for vaginal dissection. In this method damage to the urinary bladder and its innervations is minimum which the reason for less post operative morbidity. Post CTRT cases are technically difficult but if performed carefully give similar result.