Perioperative influences on infectious morbidity in radical hysterectomy

A series of 207 patients, who underwent radical hysterectomy with bilateral pelvic lymphadenectomy, is presented. Hospital charts were reviewed to determine perioperative influences on operative and postoperative morbidity. Performance of incidental appendectomy or prior conization did not affect infectious morbidity. Prophylactic antibiotics decreased the incidence of pelvic abscess and/or cellulitis. Use of "low-dose" heparin was associated with a significant increase in operative blood loss. One patient, reoperated on for bowel obstruction, died of pulmonary embolus. Ureteral fistulae occurred in 1.1% of patients not previously irradiated. Two bladder injuries and one ureteral injury were corrected intraoperatively; one postoperative ureterovaginal fistula was repaired surgically. Five-year survival for patients with stage 1B carcinoma of the cervix was 87%. Operative techniques are discussed.