[Sequelae of radiosurgical treatment in patients having undergone Wertheim radical hysterectomy]. / Sulle sequele del trattamento radiochirurgico nelle pazienti operate di isterectomia radicale alla Wertheim.

The sequelae from therapeutic treatment in a series of 361 patients subjected to Wertheim's hysterectomy, 125 of whom had a lumbo-aortic lymphadenectomy, have been studied. All these patients underwent postoperative external beam irradiation and intracavitary radium or caesium. Twenty-six cases of functional vesical disturbance, 12 of iliac lymphocele, 24 of parametritis, 4 of bladder vaginal fistula, 35 of ureteral fistula, 16 of ureteral fibrosis, 6 of lymphedema of the lower limbs and 1 of rectal ulcer were found. In some types of sequelae, the most important cause was surgery, with greater evidence if the operation was more extensive. For other types of sequelae the most important cause was radiotherapy for dystrophy and fibrosis of the irradiated tissues, leading to occlusion of lymphatic vessels, and intestinal and ureteral fibrosis. Recovery was easier with better results if the causes of sequelae were prevalently from surgery. The clinical findings were later and recovery more difficult if the causes were prevalently from radiotherapy.