Nouvelles approches de la chirurgie « conventionnelledans les cancers du col utérin

Summary dical hysterectomy by laparotomy with resection of the proximal and distal parts of the parametria (type III according to the Piverʹs classification) is the most appropriate treatment of stage Ib 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.