[Radical hysterectomy with pelvic lymphadenectomy for the treatment of invasive IB and IIA cervical cancer: review of 153 cases]. / Histerectomía radical con linfadenectomía pélvica para el tratamiento de cáncer cervical invasor IB y IIA: revisión de 153 casos.

One hundred and fifty three patients with carcinoma of the cervix, stages IB and IIA, were treated with radical hysterectomy and pelvic lymphadenectomy, during the period from October 1978 to December, 1989; 85.6% were at stages IB and 14.4% at IIA. The most frequent histological type was the epidermoid one in 91.5%. Average age was 48 years; 94 patients out of 107 (87.8%) were followed up during five years at least. Total survival at five years, was 75.7%; with positive lymphatic nodes, 50% and with negative nodes, 77.2%. In 17.6% of the cases post-operative radiotherapy was required. Late morbidity was most frequent as vesical dysfunction (17.6%); there were vesicovaginal fistulae (1.3%); and operative mortality was 0.6%). The present study confirms that this type of surgery is justified, as to survival and morbi-mortality, and it allows a histopathological evaluation that shows risk factors, as to recurrence.

[Cervical isthmus myomatosis]. / Miomatosis istmico-cervical.

Ten patients with isthmico-cervical leiomyoma as the only one localization, were surgically treated, from Jan, 1989 to May, 1990. It was 2.8% of all treated myomatosis. Average age was 42.4 years, with gestation of 1.1 per patients. Nine cases were treated by the abdominal via. One case presented with a recurrence. These cases represent a technico-surgical difficulty, due to tumor localization and size, as well as an ample knowledge about pelvic structures, in order to avoid digestive tract lesions, urinary and vascular. The present series confirms that this type of surgery is justified considering morbi-mortality, so it would be possible a definite histopathological evaluation.

[Usefulness of endometrial curettage during cervical conization]. / Utilidad del legrado endometrial durante la conización cervical.

In order to determine the value of uterine curettage at the time of cervical conization, as well as morbidity for it, 318 patients were studied. The patients were sent because of abnormal Papanicolaous's test. The established diagnostic procedures were cervical biopsy directed by Schiller's test and/or colposcopy and cervical cone. In 151 cases cervical cone was done without endometrial curettage, and in 167 endometrial curettage was used simultaneously to cervical conization. The results show that curettage plus cervical conization had a morbidity of 9.6%, statistically significant (p less than 0.05) as compared with cervical conization (4%). Furthermore, there was an RR 2.7 times of greater risk with the first procedure, morbidity increased and it did not contribute to a more complete diagnosis.

[Nongynecological surgical procedures performed by an oncological gynecology service]. / Procedimientos quirúrgicos no ginecológicos, realizados por un servicio de ginecología oncológica.

From March, 1987 to July 1990, 1,568 surgical procedures, were done at Oncological Gynecology Service; 206 of them (13.1%) were considered as "non-gynecological" surgical procedures; 182 (88.3%) were secondary to a malignity diagnosis, being the most frequent one ovarian carcinoma (54.4%). As to benign lesions, 11.7% caused "non gynecological" surgery, most frequent were severe pelvic adhesions, 41.6%, and severe endometriosis, 25%. "Non-gynecological" surgical procedure carried out most frequently was pelvic lymphadenectomy. Morbidity was 3.8%, and mortality, 0.48% due to acute myocardial infarction. The acceptance for oncologic gynecologist is justified in this series, based on survival and morbi-mortality, which permits the participation in a multidisciplinary team.