RADICAL HYSTERECTOMY FOR CERVICAL-CANCER - THE EFFECT OF SHORTER LENGTH OF STAY ON OUTCOME

BACKGROUND The surgical treatment for limited cervical cancer (radical hysterectomy and pelvic lymph node dissection) has remained essential ly the same for 40 years, but economic pressures have resulted in shor ter length of hospital stay, and precautions against infectious diseas es have resulted in less use of blood products. PURPOSE To determine i f recent changes in hospital practices have affected outcomes, and if obese patients are at greater risk of complications. METHODS Retrospec tive review of 100 surgical cases grouped by time period (1981 through 1987 and 1988 through 1993) and by patient weight (< 80 kg and greate r than or equal to 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). The rate of posto perative complications decreased significantly (P < .01), and the 5-ye ar survival rate remained 91%. Obese patients received more blood tran sfusions than did nonobese patients (2.6 vs 1.6 units; P = .02), but t heir mean operative time and hospital stay did not significantly diffe r. The rate of postoperative and long-term complications did not diffe r significantly between the two weight groups. CONCLUSIONS Surgical tr eatment of limited cervical carcinoma continues to be safe and effecti ve.