Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection: A randomized study

Massimo Franchi, Fabio Ghezzi, Flavia Zanaboni, Claudio Scarabelli, Paolo Beretta, Nicoletta Donadello

Research output: Contribution to journalArticle

Abstract

Objective: To compare closure and nonclosure of the peritoneum at radical abdominal hysterectomy and pelvic node dissection with respect to postoperative morbidity. Methods: Women with uterine cancer who underwent radical abdominal hysterectomy and node dissection type II or III of Piver- Rutledge were assigned randomly to have a standard closure of pelvic and parietal peritoneum and placement of a T-shaped suction drain or to have the peritoneum left open but the vagina closed and two abdominal drains placed. Adjuvant radiotherapy was given to patients with risk factors. The postoperative incidence of lymphocysts (within 8 weeks from the operation and after 1 year) and infection-related and non-infection-related complications were analyzed. Results: One hundred twenty subjects were enrolled, of whom 59 had peritoneal closure and 61 did not. Both groups were similar with regard to age, weight, nodes removed, nodal metastases, operative time, type of surgery, need for transfusion, and incidence of postoperative radiotherapy. The median follow-up was 36 months (range 11-72). Eleven patients died, four because of treatment-related complications. The amount of drainage was significantly higher in the closed group than in the unclosed group (median 740 mL, range 50-5980 versus median 340 mL, range 40-4000; P <.005). The incidence of asymptomatic lymphocysts was similar in the closed and open groups at 2 weeks (17 of 59 versus 15 of 6, respectively), at 8 weeks (eight of 56 versus ten of 61, respectively), and after 1 year (one of 21 versus four of 22, respectively). No difference was found between closed and open groups in terms of symptomatic lymphocysts (one of 59 versus two of 61, respectively), wound and pelvic infection (seven of 59 versus 11 of 61, respectively), febrile morbidity (two of 59 versus one of 61, respectively), and obstruction (zero of 59 versus one of 61, respectively). Conclusion: Nonclosure of the peritoneum at radical abdominal hysterectomy and node dissection is not hazardous and is not associated with an increased incidence of infection- or adhesion-related complications.

Original languageEnglish
Pages (from-to)622-627
Number of pages6
JournalObstetrics and Gynecology
Volume90
Issue number4 I
DOIs
Publication statusPublished - Oct 1997

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Peritoneum
Hysterectomy
Dissection
Incidence
Pelvic Infection
Morbidity
Uterine Neoplasms
Adjuvant Radiotherapy
Suction
Vagina
Wound Infection
Operative Time
Infection
Drainage
Fever
Radiotherapy
Neoplasm Metastasis
Weights and Measures
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection : A randomized study. / Franchi, Massimo; Ghezzi, Fabio; Zanaboni, Flavia; Scarabelli, Claudio; Beretta, Paolo; Donadello, Nicoletta.

In: Obstetrics and Gynecology, Vol. 90, No. 4 I, 10.1997, p. 622-627.

Research output: Contribution to journalArticle

Franchi, M, Ghezzi, F, Zanaboni, F, Scarabelli, C, Beretta, P & Donadello, N 1997, 'Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection: A randomized study', Obstetrics and Gynecology, vol. 90, no. 4 I, pp. 622-627. https://doi.org/10.1016/S0029-7844(97)00359-1
Franchi, Massimo ; Ghezzi, Fabio ; Zanaboni, Flavia ; Scarabelli, Claudio ; Beretta, Paolo ; Donadello, Nicoletta. / Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection : A randomized study. In: Obstetrics and Gynecology. 1997 ; Vol. 90, No. 4 I. pp. 622-627.
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abstract = "Objective: To compare closure and nonclosure of the peritoneum at radical abdominal hysterectomy and pelvic node dissection with respect to postoperative morbidity. Methods: Women with uterine cancer who underwent radical abdominal hysterectomy and node dissection type II or III of Piver- Rutledge were assigned randomly to have a standard closure of pelvic and parietal peritoneum and placement of a T-shaped suction drain or to have the peritoneum left open but the vagina closed and two abdominal drains placed. Adjuvant radiotherapy was given to patients with risk factors. The postoperative incidence of lymphocysts (within 8 weeks from the operation and after 1 year) and infection-related and non-infection-related complications were analyzed. Results: One hundred twenty subjects were enrolled, of whom 59 had peritoneal closure and 61 did not. Both groups were similar with regard to age, weight, nodes removed, nodal metastases, operative time, type of surgery, need for transfusion, and incidence of postoperative radiotherapy. The median follow-up was 36 months (range 11-72). Eleven patients died, four because of treatment-related complications. The amount of drainage was significantly higher in the closed group than in the unclosed group (median 740 mL, range 50-5980 versus median 340 mL, range 40-4000; P <.005). The incidence of asymptomatic lymphocysts was similar in the closed and open groups at 2 weeks (17 of 59 versus 15 of 6, respectively), at 8 weeks (eight of 56 versus ten of 61, respectively), and after 1 year (one of 21 versus four of 22, respectively). No difference was found between closed and open groups in terms of symptomatic lymphocysts (one of 59 versus two of 61, respectively), wound and pelvic infection (seven of 59 versus 11 of 61, respectively), febrile morbidity (two of 59 versus one of 61, respectively), and obstruction (zero of 59 versus one of 61, respectively). Conclusion: Nonclosure of the peritoneum at radical abdominal hysterectomy and node dissection is not hazardous and is not associated with an increased incidence of infection- or adhesion-related complications.",
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T1 - Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection

T2 - A randomized study

AU - Franchi, Massimo

AU - Ghezzi, Fabio

AU - Zanaboni, Flavia

AU - Scarabelli, Claudio

AU - Beretta, Paolo

AU - Donadello, Nicoletta

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N2 - Objective: To compare closure and nonclosure of the peritoneum at radical abdominal hysterectomy and pelvic node dissection with respect to postoperative morbidity. Methods: Women with uterine cancer who underwent radical abdominal hysterectomy and node dissection type II or III of Piver- Rutledge were assigned randomly to have a standard closure of pelvic and parietal peritoneum and placement of a T-shaped suction drain or to have the peritoneum left open but the vagina closed and two abdominal drains placed. Adjuvant radiotherapy was given to patients with risk factors. The postoperative incidence of lymphocysts (within 8 weeks from the operation and after 1 year) and infection-related and non-infection-related complications were analyzed. Results: One hundred twenty subjects were enrolled, of whom 59 had peritoneal closure and 61 did not. Both groups were similar with regard to age, weight, nodes removed, nodal metastases, operative time, type of surgery, need for transfusion, and incidence of postoperative radiotherapy. The median follow-up was 36 months (range 11-72). Eleven patients died, four because of treatment-related complications. The amount of drainage was significantly higher in the closed group than in the unclosed group (median 740 mL, range 50-5980 versus median 340 mL, range 40-4000; P <.005). The incidence of asymptomatic lymphocysts was similar in the closed and open groups at 2 weeks (17 of 59 versus 15 of 6, respectively), at 8 weeks (eight of 56 versus ten of 61, respectively), and after 1 year (one of 21 versus four of 22, respectively). No difference was found between closed and open groups in terms of symptomatic lymphocysts (one of 59 versus two of 61, respectively), wound and pelvic infection (seven of 59 versus 11 of 61, respectively), febrile morbidity (two of 59 versus one of 61, respectively), and obstruction (zero of 59 versus one of 61, respectively). Conclusion: Nonclosure of the peritoneum at radical abdominal hysterectomy and node dissection is not hazardous and is not associated with an increased incidence of infection- or adhesion-related complications.

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