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The role of vaginal hysterectomy in the treatment of endometrial carcinoma
  1. R. J. LellÉ*,
  2. G. W. Morley* and
  3. W. A. Peters
  1. * Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, Michigan and
  2. Puget Sound Oncology Consortium, Seattle, Washington, USA
  1. Address for correspondence: Dr G. W. Morley, Department of Obstetrics and Gynecology, University of Michigan Medical Center, Room D2255, MPB 0718, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0718, USA.


Between 1964 and 1991, vaginal hysterectomy was performed in 60 patients with clinical stage I endometrial carcinoma, who were not considered candidates for the conventional surgical approach. Of these patients, 66.7% were obese with a median weight of 235 pounds. Other risk factors included hypertension (63%), diabetes mellitus (34%), cardiac disease (28%) and pulmonary disease (12%). Operative mortality was 0%. The complication rate was 14%, with four patients requiring transfusions and four patients developing vaginal cuff cellulitis. Forty per cent of patients received adjuvant pre- or postoperative radiation therapy. Crude survival at 5 and 10 years was 91.1% and 87.1%, respectively. However, only one patient died from disease 6 years after primary treatment. Although we consider surgical staging as the standard of care for the treatment of endometrial cancer, vaginal hysterectomy has a definite place in the management of patients with good prognostic criteria who are at high operative risk for the standard surgical approach.

  • complications
  • endometrial cancer
  • risk factors
  • survival
  • vaginal hysterectomy.

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