Carcinoma of the Cervix After Supravaginal Hysterectomy

Abstract

1.Carcinoma of the cervix after supravaginal hysterectomy behaves similarly to the same disease when the fundus is retained. 2.Its response to treatment is no worse than that of “cervix” cancer in general, and in some clinics is better. 3.Approximately 40 per cent of “stump” cancers recognized three years after subtotal hysterectomy, or within six months of the appearance of the first symptoms, were living and well five years after treatment. 4.Subtotal hysterectomy appears to improve the chance of cure if performed before carcinoma of the cervix has been acquired. 5.The probable development of vesicovaginal fistulas is greater than when the fundus is present. Fistulas are more often due to the disease than the result of treatment. 6.Meticulous examination of the cervix should be made a part of every gynecologic examination. Areas which are abnormal should be removed for histologic study. These principles are no less important when removal of the fundus is contemplated. 7.Complete hysterectomy is an excellent manner of dealing with disease of the cervix when the fundus is to be removed. However, in the hands of those whose experience is limited, supravaginal hysterectomy, combined with trachelectomy, is satisfactory and less hazardous. 1.Carcinoma of the cervix after supravaginal hysterectomy behaves similarly to the same disease when the fundus is retained. 2.Its response to treatment is no worse than that of “cervix” cancer in general, and in some clinics is better. 3.Approximately 40 per cent of “stump” cancers recognized three years after subtotal hysterectomy, or within six months of the appearance of the first symptoms, were living and well five years after treatment. 4.Subtotal hysterectomy appears to improve the chance of cure if performed before carcinoma of the cervix has been acquired. 5.The probable development of vesicovaginal fistulas is greater than when the fundus is present. Fistulas are more often due to the disease than the result of treatment. 6.Meticulous examination of the cervix should be made a part of every gynecologic examination. Areas which are abnormal should be removed for histologic study. These principles are no less important when removal of the fundus is contemplated. 7.Complete hysterectomy is an excellent manner of dealing with disease of the cervix when the fundus is to be removed. However, in the hands of those whose experience is limited, supravaginal hysterectomy, combined with trachelectomy, is satisfactory and less hazardous.