Document Detail

Reasons for improper simple hysterectomy in patients with invasive cervical cancer in the northern region of Thailand.
MedLine Citation:
PMID:  10932978     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the reasons for improper simple hysterectomy in the presence of invasive cervical cancer. METHODS: The medical records of 70 patients who had undergone simple hysterectomy in the presence of invasive cervical cancer and were referred to Chiang Mai University Hospital between January 1991 and December 1998 were reviewed. RESULTS: Approximately half of the patients presented with abnormal vaginal bleeding. Failure to perform a Papanicolaou smear before the operation accounted for 35.4%. Normal pelvic examination in which no gross invasive tumor was observed accounted for 59%. The most common indications for inappropriate operation was cervical dysplasia. The reasons for inappropriate simple hysterectomy included lack of preoperative cervical cytology (22.8%), incomplete evaluation of cervical dysplasia or microinvasion on biopsy (21.4%), false-negative cervical cytology (18.6%), failure to perform an endocervical curettage following conization (8.6%), emergency hysterectomy (8.6%), failure to perform indicated conization (5.6%), errors in colposcopic examination (4.3%), incomplete evaluation of an abnormal cervical cytology (1.4%), failure to perform endocervical currettage following loop conization (1.4%), failure to review slide (1.4%), failure to check the pathology report (1.4%), failure to biopsy a gross cervical lesion, and skipped lesion in upper part of the endocervix (1.4%). One case of invasive disease was missed for unknown reason. CONCLUSION: Most cases of inappropriate hysterectomy resulted from deviation from guideline for cervical cancer detection. Preoperative Papanicolaou smear and strict adherence to the well-established diagnostic protocol for patients with an abnormal smear are advised to prevent such occurrence.
J Srisomboon; A Pantusart; C Phongnarisorn; P Suprasert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  26     ISSN:  1341-8076     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-08-17     Completed Date:  2000-08-17     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  175-80     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand.
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MeSH Terms
False Negative Reactions
Hysterectomy / methods*
Middle Aged
Neoplasm Invasiveness*
Neoplasm Recurrence, Local*
Treatment Failure
Uterine Cervical Dysplasia / pathology
Uterine Cervical Neoplasms / diagnosis*,  pathology,  surgery*
Vaginal Smears

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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