scholarly journals Usefulness of Vascular Clips in Surgery for Gynecologic Cancer

2021 ◽  
Author(s):  
Kazuho Nakanishi ◽  
Takashi Yamada ◽  
Shunji Suzuki
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Pelvic Floor ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Pelvic Lymphadenectomy ◽  
Gynecological Surgery ◽  
Gynecologic Malignancies ◽  
Result Analysis ◽  
Titanium Clips

Abstract In gynecological surgery for cervical cancer and endometrial cancer with lymphadenectomy, many lymph vessels are ligated to prevent postoperative lymph leakage and lymphocele, and many blood vessels leading to the pelvic floor are ligated. Therefore, the labors required for ligation are very large. However, no studies have examined ligation methods in gynecologic cancer surgery. Therefore, we retrospectively examined gynecologic cancer patients who had been treated at our hospital by dividing them into a group using absorbent threads and a group using titanium clips. In addition, the surgical procedure was classified into three groups: a group with only pelvic lymphadenectomy, a group with pelvic and para-aortic lymphadenectomy, and a group with radical hysterectomy with pelvic lymphadenectomy. As a result, analysis of all cases clearly showed less complications and less time for surgery in the clip group. Furthermore, the analysis of RH + PLN group showed that surgery time was clearly shorter and less complications tended to occur in the clip group. In conclusion, by using this easily usable device, surgery for gynecologic malignancies will be more comfortable and safer.

scholarly journals Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christer Borgfeldt ◽  
Erik Holmberg ◽  
Janusz Marcickiewicz ◽  
Karin Stålberg ◽  
Bengt Tholander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Surgical Approach ◽  
Open Surgery ◽  
Gynecologic Cancer ◽  
Multivariable Analysis ◽  
Figo Stage

Abstract Background The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). Methods A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. Results In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. Conclusion The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.

scholarly journals Colorectal Cancer Risk in Women with Gynecologic Cancers—A Population Retrospective Cohort Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3127
Author(s):  
Szu-Chia Liao ◽  
Hong-Zen Yeh ◽  
Chi-Sen Chang ◽  
Wei-Chih Chen ◽  
Chih-Hsin Muo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Cohort Study ◽  
Cancer Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gynecologic Cancer ◽  
Ovarian Cancers ◽  
Increased Risk

We conducted a retrospective cohort study to evaluate the subsequent colorectal cancer (CRC) risk for women with gynecologic malignancy using insurance claims data of Taiwan. We identified patients who survived cervical cancer (N = 25,370), endometrial cancer (N = 8149) and ovarian cancer (N = 7933) newly diagnosed from 1998 to 2010, and randomly selected comparisons (N = 165,808) without cancer, matched by age and diagnosis date. By the end of 2011, the incidence and hazard ratio (HR) of CRC were estimated. We found that CRC incidence rates were 1.26-, 2.20-, and 1.61-fold higher in women with cervical, endometrial and ovarian cancers, respectively, than in comparisons (1.09/1000 person–years). The CRC incidence increased with age. Higher adjusted HRs of CRC appeared within 3 years for women with endometrial and ovarian cancers, but not until the 4th to 7th years of follow up for cervical cancer survivals. Cancer treatments could reduce CRC risks, but not significantly. However, ovarian cancer patients receiving surgery alone had an incidence of 3.33/1000 person–years for CRC with an adjusted HR of 3.79 (95% CI 1.11–12.9) compared to patients without any treatment. In conclusion, gynecologic cancer patients are at an increased risk of developing CRC, sooner for those with endometrial or ovarian cancer than those with cervical cancer.

scholarly journals Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology

2015 ◽  
Vol 25 (6) ◽  
pp. 1121-1127 ◽  
Author(s):  
Lesley B. Conrad ◽  
Pedro T. Ramirez ◽  
William Burke ◽  
R. Wendel Naumann ◽  
Kari L. Ring ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Single Port ◽  
Gynecologic Oncology ◽  
Pelvic Lymphadenectomy ◽  
Single Port Laparoscopy

ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

Outcomes of abandoned radical hysterectomy in patients with stages IB–IIA cervical cancer found to have positive nodes during the operation

2005 ◽  
Vol 15 (3) ◽  
pp. 498-502 ◽  
Author(s):  
P. Suprasert ◽  
J. Srisomboon ◽  
K. Charoenkwan ◽  
S. Siriaungul ◽  
S. Khunamornpong ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Disease Free Survival ◽  
Pelvic Lymphadenectomy ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Number Of Patients ◽  
Extended Field ◽  
Disease Free

The objective of this study was to evaluate the outcomes of stages IB–IIA cervical cancer patients whose radical hysterectomy (RH) was abandoned for positive pelvic nodes detected during the operation compared with those found to have positive nodes after the operation. Among 242 patients with planned RH and pelvic lymphadenectomy (RHPL) for stages IB–IIA cervical cancer, 23 (9.5%) had grossly positive nodes. RH was abandoned, and complete pelvic lymphadenectomy was performed. Of these 23 patients, 22 received adjuvant chemoradiation, and the remaining 1 received adjuvant radiation. Four patients with positive para-aortic nodes were additionally treated with extended-field irradiation. When compared with 35 patients whose positive nodes were detected after the operation, there were significant differences regarding number of positive nodes and number of patients receiving extended-field irradiation. Complications in both groups were not significantly different, but the 2-year disease-free survival was significantly lower in the abandoned RH group compared with that of the RHPL group (58.5% versus 93.5%, P = 0.01). In conclusion, the survival of stages IB–IIA cervical cancer patients whose RH was abandoned for grossly positive pelvic nodes was significantly worse than that of patients whose node metastasis was identified after the operation. This is because the abandoned RH group had worse prognostic factors.

Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country

2017 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
Erum S Khan ◽  
Sheikh Irfan ◽  
Natasha Khalid
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Developing Country ◽  
Gynecologic Oncology ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Site Infection ◽  
Tertiary Care Facility

ABSTRACT Introduction Surgical site infections (SSIs) are among the most common complications in surgical patients and have serious consequences for outcomes and costs. There is a dearth of information on risk factors for developing SSI in patients undergoing gynecologic cancer surgery, and this has not been studied using national data. Objectives The objectives of this study were to estimate the prevalence, preoperative and operative risk factors associated with the higher risk of SSIs in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Setting Department of Obstetrics and Gynaecology, Aga Khan University Hospitals, Karachi, Sindh, Pakistan. Materials and methods Retrospective record review of gynecologic oncology patients admitted for surgery from January 2015 to December 2015 was performed. Results A total of 100 patients met the inclusion criteria. Of these, 15 were identified with SSIs, which were all found to be of the superficial type. Approximately, 44, 40, and 7% were diagnosed with endometrial, ovarian, and cervical cancers respectively. The mean time from surgery to developing SSI was 12.9 days. Among endometrial cancer, 22.7% (10/44) had SSI compared with 7.5% (3/40) for ovarian cancer and 14.2% (1/7) for cervical cancer. The significant predictors of SSI were body mass index ≥35 (p-value <0.004), endometrial cancer diagnosis, the American Society of Anesthesiologists class more than 3, modified surgical complexity scoring system 3 to 4, and blood sugar levels more than 180 mg/dL within 48 hours after surgery in known diabetics. Conclusion About 15% of patients undergoing laparotomy for gynecologic malignancy developed SSIs. In this study, we identified several risk factors for developing SSI among gynecologic cancer patients. These findings may contribute toward identification of patients at risk for SSIs, and the development of strategies to reduce SSI rate and potentially reduce the cost of care in gynecologic cancer surgery. How to cite this article Khan ES, Irfan S, Khalid N. Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country. J South Asian Feder Menopause Soc 2017;5(1):23-27.

Outcome of cervical cancer patients with single-node compared with no nodal involvement treated with radical hysterectomy and pelvic lymphadenectomy

2013 ◽  
Vol 121 (1) ◽  
pp. 45-48
Author(s):  
Prapaporn Suprasert ◽  
Kittipat Charoenkwan ◽  
Sitthicha Siriaree ◽  
Chalong Cheewakriangkrai ◽  
Jaruwan Saeteng ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Nodal Involvement ◽  
Single Node

Survival Disparities by Hospital Volume Among American Women With Gynecologic Cancers

2017 ◽  
pp. 1-15
Author(s):  
Brandon-Luke L. Seagle ◽  
Anna E. Strohl ◽  
Monica Dandapani ◽  
Wilberto Nieves-Neira ◽  
Shohreh Shahabi
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hospital Volume ◽  
Cox Regression ◽  
Gynecologic Cancer ◽  
Stage Ii ◽  
American Women ◽  
Cancer Data ◽  
Cervical Cancers ◽  
Adjuvant Therapies

Purpose We describe survival disparities among women with uterine, ovarian, or cervical cancer by cancer-specific mean annual hospital volume. Methods National Cancer Database 1998-2011 uterine (n = 441,863), ovarian (n = 223,017), and cervical (n = 146,698) cancer data sets were used. Cancer-specific mean annual hospital volumes were calculated. Overall survival (OS) was plotted by hospital volume using restricted mean OS times from Cox regression. Results Uterine, ovarian, and cervical cancers were reported from 1,651, 1,633, and 1,600 hospitals, respectively. Median values of mean annual hospital volumes among hospitals were 8.6 (interquartile range [IQR], 2.6 to 20.8), 4.4 (IQR, 1.4 to 10.3), and 2.4 (IQR, 0.6 to 6.6) for uterine, ovarian, and cervical cancers, respectively. Increased hospital volume was associated with increased OS among women with stage III to IV high-grade serous ovarian cancer, stage II to IV squamous or adenocarcinoma cervical cancer, and stage I to IV endometrioid, clear cell, serous, or carcinosarcoma uterine cancers (all P < .03). Differential OS between women treated at higher- versus lower-volume cancer centers exceeded 5, 5, and 13 months among women with advanced endometrial, ovarian, or cervical cancer, respectively (all P < .001). Hospital volume was not associated with OS among patients with stage II to IV cervical cancer treated with brachytherapy ( P = .17). Use of adjuvant therapies decreased OS disparities by hospital volume among women with advanced ovarian or endometrial cancer. Conclusion Increased delivery of brachytherapy for treatment of cervical cancer may decrease survival disparities by hospital volume. Standardization of adjuvant therapies may diminish survival disparities by hospital volume among women with advanced ovarian or endometrial cancer. In addition, survival of American women with gynecologic cancer may be increased by centralization of care.

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