Radical hysterectomy (Wertheim's
hysterectomy) is the removal of the womb and
tissue either side of it (parametrium). It is a
much bigger operation than a standard
hysterectomy and is normally done in conjunction
with a lymphadenectomy. The operation is
performed for some women with cervical cancer
although it is occasionally performed by some
surgeons on women with a certain stage of
endometrial cancer.
Extended hysterectomy (modified
radical hysterectomy) is a term used to describe
a hysterectomy for endometrial cancer. Sometimes
it involves a traditional hysterectomy with
removal of the lymph glands and sometimes a
slightly wider excision to prevent cutting
through cancer during the operation.
This is a traditional
hysterectomy involving removal of the womb and
cervix. Some time it involves removal of both
ovaries and tubes (Bilateral Salpingo
Oophorectomy - BSO) and sometime not. It is
normal for the ovarias to be removed in most
endometrial cancers and sarcomas. In young women
with cervix cancers it is usual to leave the
ovaries behind.
Laparoscopic hysterectomy is the
removal of the womb and is being studied in
detail as a treatment for endometrial cancer.
There are a number of different types of
laparoscopic hysterectomy and these include
Laparascopic Supracervical Hysterectomy (LSH -
which has no place in any womb cancer),
Laparoscopically Assisted Vaginal Hysterectomy (LAVH),
Laparoscopic Hysterectomy (LH), Laparoscopic
Total Hysterectomy (LTH), Laparoscopic Radical
Hysterectomy (LRH), Laparoscopically Assisted
Radical Vaginal Hysterectomy (LARVH). The
differences in these types is beyond the scope
of this website.
Radical trachelectomy is a new operation
that involves removal of the cervix instead of a
radical hysterectomy. The aim of the operation
is to preserve fertility. Please click on the
above link for a site dedicated to
trachelectomy.
Cone biopsy is a treatment for
very early cervix cancer and pre-cancer of the
cervix. Loop diathermy, (LLETZ or LEEP) is also
a
treatment for pre-cancer of the cervix.
Click on the link for more details.
Lymphadenectomy is a surgical
treatment for some stages of cervix cancer. It
involves excision of the glands in the pelvis
(similar to the swollen glands in the neck when
you have a cold). For endometrial cancer this is
performed in some cases as is 'lymph node
sampling' when only some glands are removed to
determine if you need radiotherapy or not.
This involves daily treatment
under a radiotherapy machine for 5 to 6 weeks.
Side effect are much less now than they used to
be and are predominantly related to the bowel or
the bladder.
This involves a vaginal probe
inserted for a short period for 1 to 4 occasions
during treatment. It is used in a different
manner for both endometrial and cervix cancers.
Chemoradioatherapy is a
combination of both radiotherapy and
chemotherapy. It is the first line treatment for
some stages of cervical cancer.
Chometherapy is sometimes used
for high stage and recurrent endometrial cancer.
It is sometimes used for recurrent cervix cancer
and often used along with radiotherapy for some
cervix cancers.
Exenterations are operations for
some types of recurrent cervical cancer.
Sometimes, but less frequently, exenteration is
offered for endometrial cancer. These are
radical operations involving the removal of the
bladder (anterior exenteration), rectum
(posterior exenteration), or both (total
exenteration), along with the other pelvic
organs including the uterus if it has not yet
been removed. Sometimes a reconstruction is done
to the vagina and/or bladder. Sometimes a stoma
(bag onto the abdomen) is required for urine or
faeces.
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