Complications of radical oncogynecological operations

Czech version

Authors: Luboš Minář ¹; Vít Weinberger ¹; P. Kysela ²
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc. ¹; Chirurgická klinika LF MU a FN, Brno, přednosta prof. MUDr. Z. Kala, CSc. ²
Published in: Ceska Gynekol 2010; 75(4): 346-352

Overview

Objective:
Information sheet about the most frequently complications of radical oncogynecological operations.

Design:
Literature review with case reports.

Setting:
Department of Gynaecology and Obstetrics, Faculty of Medicine, Masaryk’s University and Faculty Hospital, Brno.

Methods:
Literature review about complications of radical oncogynecological operations with illustrative case reports.

Conclusions:
Radical oncogynecological operations, due to their size, associated with a higher morbidity compared with traditional gynecological surgery. The literature states morbidity parameters between 25‑45% depending on the center of erudition and range of out performance. Basic division of surgical complications is on perioperative complications and postoperative complications, which are further divided into early and late.

The most frequently intraoperative complication is large blood loss requiring the application of blood substitutes. Less common complications are injury to the urinary bladder, ureter, rarely bowel or neural structures, especially nerve obturatorius. Among early postoperative complications are dominated urological complications, particularly urinary bladder hypotonia, another important group are the vascular complications, ie trombembolia and bleeding. Between late postoperative complications is possible to define several basic groups, ie urology, intestinal, lymphovascular and complications associated with laparotomy wound suture.

Prevention of complications should be based on several basic assumptions. These include adequate erudition and composition of the operating team, perfect knowledge of anatomical conditions in the pelvic retroperitoneum, the paraaortic, the paracaval and inguinal area, implementation radicality adequate performance in relation to the extent of the disease and developing new surgical techniques (eg nerve sparing surgery). Absolute necessity is also the possibility of interdisciplinary cooperation with other surgical disciplines, which is important both in terms of preventing complications, and for their event. subsequent solutions.

Key words:
intraoperative and postoperative complications, blood loss, injury to the urinary bladder and ureter, urinary fistula, thromboembolic complications, lymphedema, lymphocyst, hemangioma.

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