Removal of the Retained Cervical Stump:Clinical Analysis of 18 Cases

Objective The purpose of this study was to explore the cause of the removal of retained cervical stump because of the pathological changes of retained cervical stump or cavitas pelvis after previous subtotal hysterectomy.Methods This was a retrospective review of 18 trachelectomy patients at Dafeng Hospital between January 2004 and January 2010.Results Of 18 patients with a history of sbtotal hysterectomy,2 patients subsequently required trachelectomy because of recurrence of leiomyoma,3 because of squamous carcinoma,2 because of endometriosis,5 because of cancer in situ and 6 because of tumor of the ovary associated with serious cervical erosion.The main clinical manifestations were abdominal distension,uroschesis,irregular vaginal bleeding,vaginal exudate and contact bleeding,pelvic mass.During operation,one patient's bladder was injured and another patient's small intestine was injured because of the extensive adherence between small intestine and abdominal wall.They were all discovered during the process of operation and then repaired successfully.All patients recovered and discharged as scheduled.Conclusion The operative indications of supracervical hysterectomy must be mastered strictly:the diagnosis of malignant tumor located in the uterus and cervix should not be missed before and during operation;the secondary injury should be prevented during operation;closed follow-up should be performed after operation and as a result the pathological changes of retained cervical stump could be discovered and treated promptly.