Radical hysterectomy and pelvic lymphadenectomy
The advent of the twentieth century witnessed the initiation of radical abdominal surgery for the treatment of uterine cancers. Recognizing the pattern of direct infiltrative extension and nodal metastases, Wertheim  championed an extirpative procedure that included wide parametrial resections with ureteral mobilization, inclusion of an extended segment of the uterosacral ligaments, and excision of a generous portion of the vagina and sampling of suspicious pelvic nodes. Wertheim’s experience with 500 cases included an operative mortality of 18% which was predominantly attributable to the difficulties in managing postoperative infections. Because of the associated operative mortality and the evolving applications of radiotherapy, enthusiasm for the surgical treatment of cervical carcinoma was nearly dormant for several decades.
KeywordsCervical Cancer Obstet Gynecol Radical Hysterectomy Pelvic Lymphadenectomy Uterosacral Ligament
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