Nouvelles approches de la chirurgie << conventionnelle >> dans les cancers du col uterin

The radical hysterectomy by laparotomy with resection of the proximal and distal parts of the parametria (type III according to the Piver's classification) is the most appropriate treatment of stage lb and II cervical carcinoma. Nevertheless, a resection of a partial part of the parametria and conservative surgery (of the uterus and/or ovaries) are possible in selected cases of patients with good prognostic factors. The lymphadenectomy has a diagnostic, prognostic but probably also a therapeutic value. Para-aortic lymphadenectomy should be performed in patients with a bulky tumor. Pelvic exenteration with reconstructive surgery could be discussed in young patients with centro-pelvic recurrence of a cervical carcinoma. (C) 2000 Editions scientifiques et medicales Elsevier SAS.