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Abstract
The treatment for cervical cancer is a complex, multidisciplinary issue, which applies according to the stage of the disease. The surgical elective treatment of cervical cancer is represented by the radical abdominal hysterectomy. In time, many surgeons perfected this surgical technique; the ones who stood up for this idea were Thoma lonescu and Ernst Wertheim. There are many varieties of radical hysterectomies performed by using the abdominal method and some of them through vaginal and mixed way. Each method employed has advantages and disadvantages. At present, there are three classifications of radical hysterectomies which are used for the simplification of the surgical protocols: Piver-Rutledge-Smith classification which is the oldest, GCG-EORTC classification and Querlow and Morrow classification. The last is the most evolved and recent classification; its techniques can be adapted for conservative operations and for different types of surgical approaches: abdominal, vaginal, laparoscopic or robotic.
Abbreviations: GCG-EORTC = Gynecologic Cancer Group of the European Organization of Research and Treatment of Cancer; LEEP = loop electrosurgical excision procedure; I.O.B. = Institute of Oncology Bucharest; PRS = Piver-Rutledge-Smith
Keywords: radical hysterectomy, cervical cancer, surgical technique
Introduction
The treatment for cervical cancer is a complex, multidisciplinary one, which applies according to the stage of the disease. In the early stages, the treatment is represented by a simple intervention (LEEP or conization) having not only a diagnostic but also a therapeutic role, or by a simple total hysterectomy for women over 45, no longer willing to have children. In the advanced stages, the treatment is realized through neoadjuvant radiotherapy associated with the radical surgery [4]; as for the final stages, the treatment is no longer applied in a curative purpose, but a palliative one, the only therapeutic help being provided by an oncologist by radioand chemotherapy.
History
The surgical elective treatment of cervical cancer is represented by the radical abdominal hysterectomy. This operation combines two conceptions: the conception of the organ extended surgery and the conception of the lymphatic territory surgery applied according to principle. The pioneers of the principles of radicality for the cervical cancer are the Viennese surgeon Emst Wertheim and the Romanian surgeon Thoma lonescu, who have sustained their view in 1902, at the International Congress of Surgery and Gynecology in Rome. By...