[Surgical treatment of cervical and vaginal cancer by means of the synchronized extraperitoneal-vaginal radical operation and the neovagina technic using the peritoneum]. / Operativno lijecenje raka grlica materice i vagine sinhronizovanom ekstraperitonealnom vaginalnom radikalnom operacijom tehnikom neovagine pomocu peritoneuma.

In the period from 1976 to 1986 we operated 350 cases by the technique of combined extraperitoneal-vaginal radical synchronized hysterectomy in cases of uterus and vagina cancer. We analyzed 236 cases and compared them with the control group operated by the technique of Wertheim and modifications. There is a considerable difference in operative and post-operative complications. There are less complications in the examined group of patients operated by the technique of combined synchronized extraperitoneal-vaginal radical operation. We introduced the technique of partial neovagina formation at the place of the resected one, by means of the anterior and posterior plica peritoneum by which we are able to preserve the normal length of the vagina. By the means of this technique we operated 21 patients; out of that 15 were with cancer of the uterus cervix, 6 with vagina cancer, and in 3 of them, a complete vaginectomy was performed, and a complete neovagina made.

[Modification of extraperitoneal cesarean section in the prevention of infection]. / Modifikacija ekstraperitonealnog carskog reza kao zastita od infekcije.

The application of cesarean section is increasing, because the indications for it have been expanded. As the introduction of antibiotics has not been solved, the problem of abdominal cavity infections which is opening in the course of transperitoneal cesarean section. Therefore the requirement of repeated introduction of extraperitoneal cesarean section by which the abdominal cavity is not opened but the technique of operation is somewhat more complicated. In order to simplify the operation we have introduced the infiltration of physiological solution under the band of bladder because of easier separation from bladder, as this is the greatest problem in the operative procedure. The urachus is not cut but is released and mobilized in that way the bladder can be moved aside from the lower uterine segment, on which the cross section is done and in that way the possibility of damage of bladder and of the opening of peritoneal cavity is reduced. By this technique we operated 16 cases. The operative and postoperative course passed normally.