Radical hysterectomy for cervical cancer: the effect of shorter length of stay on outcome
Alexander W. Kennedy, MDAddress reprint requests to A.W.K., Department of Gynecology, A81, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Gert Peterson, RN
Laurie J. Tuason, MS
Jerome L. Belinson, MD
Kenneth D. Webster, MD
The surgical treatment for limited cervical cancer (radical hysterectomy and pelvic lymph node dissection) has remained essentially the same for 40 years, but economic pressures have resulted in shorter length of hospital stay, and precautions against infectious diseases have resulted in less use of blood productsPURPOSE
To determine if recent changes in hospital practices have affected outcomes, and if obese patients are at greater risk of complications.METHODS
Retrospective review of 100 surgical cases grouped by time period (1981 through 1987 and 1988 through 1993) and by patient weight (< 80 kg and ≥ 80 kg).RESULTS
Comparing the two time periods, the mean operative time remained the same (199 minutes), but use of blood products declined (mean 2.1 vs 1.5 units; P < .01), as did the mean length of hospital stay (10.6 vs 7.4 days, P < .01). The rate of postoperative complications decreased significantly (P < .01), and the 5-year survival rate remained 91%. Obese patients received more blood transfusions than did nonobese patients (2.6 vs 1.6 units; P = .02), but their mean operative time and hospital stay did not significantly differ. The rate of postoperative and long-term complications did not differ significantly between the two weight groups.CONCLUSIONS
Surgical treatment of limited cervical carcinoma continues to be safe and effective.