Wertheim’s Operation. Problems and achievments

Abstract

Aim. Analysis of modern modification of Wertheim’s operation and its results in Bukovina region for last 10 years.Methods. Analysis of literature in internet. Data about morbidity and mortality of cancer colli uteri in Chernivtsi Oncology Center.Results. An original description of the technique of radical hysterectomy for cervical cancer by Wertheim is presented. Modifications of the Wertheim operation with various classifications of interventions are considered. In first class of this classification are included extra fascial hysterectomies without resection of tissues, lymph nodules and fascia of pelvis which directly contradicts the principles of Wertheim's operation. The results of radical laparoscopic hysterectomy for cervical cancer are discussed. In 2019 trials, there was an almost three-fold excess of relapses after laparoscopic hysterectomies compared to open operations. The issues of the epidemiology of cervical cancer in Ukraine and Bukovina are considered. The incidence of cervical cancer in the Chernivtsi region was about 70 patients per year, or 8.4 per 100,000 population (data from 2016-2018). Cervical cancer mortality was from 40 to 43 people annually or 4.3-4.7 per 100,000 population. Wertheim’s operation is performed annually in 26-34 women and is practically not accompanied by complications and mortality.Conclusion. Wertheim’s operation is safe and unique method for treatment of cervical cancer.