Clinical study for Patients with Cervical Cancer who had undergone Radical Hysterectomy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.

Effectiveness of the intraoperative chain cystourethrogram in "No-incision" bladder neck suspension / 대한비뇨기과학회지

"No-incision" bladder neck suspension, Gittes` operation, is a simple & effective technique among the various surgical technique. But occasionally patients was complained of long - term urinary retention and voiding difficulty after operation because or excessive traction of the nylon suture. We prevented them using chain cystourethrogram intraoperatively. This operation was performed under the spinal anesthesia which the patients can do the Valsalva maneuver during operation. Posterior urethrovesical angle was not significantly different between preoperative & intraoperative chain cystourethrogram. We corrected wide posterior urethrovesical angle to about 100 (mean angle of the normal range). Normal voiding after catheter removal & duration of admission was signiricantly decreased in intraoperative chain cystourethroram group(p<0.05). During 11 months follow-up, overall cure rate was 84.6% without long-term postoperatively voiding difficulty. We concluded that intraoperative chain cystourethrogram was useful methods for good results.

Causal analysis of the failure for the ureteroscopic extraction / 대한비뇨기과학회지

Ureteroscopic extraction has been used for the management of the ureteral stone. especially lower ureteral stone. During the last 2 years we performed ureteroscopy for removal of mid or distal ureteral stones in 63 patients. The causes of failure consisted of 4 unskillful instrumental manipulations, 4 migrations, of the stone. 3 failure of dilating ureter. 3 failures of access to the stone and 2. severe bleedings due to ureteral avulsion. The failure rate decreased from 33.3% for 30 procedures done during the first one year to 18.7 % for 33 procedures done in the next one year. We believe that the failure rate of ureteral stone removal will be consistently decreased with experience.