scholarly journals LAPAROSCOPIC PELVIC EVISCERATION IN MALE AND FEMALE PATIENTS

2020 ◽  
pp. 15-23
Author(s):  
E. A. Galliamov ◽  
M. A. Agapov ◽  
R. G. Biktimirov ◽  
V. P. Sergeev ◽  
A. E. Sanzharov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Pelvic Exenteration ◽  
Locally Advanced ◽  
Pain Syndrome ◽  
Surgical Oncology ◽  
Complex Problem ◽  
Pelvic Tumors ◽  
Resection Line

Abstract: treatment of patients with primary and recurrent locally advanced pelvic tumors represents an extremely complex problem of surgical oncology.Aim: to evaluate perioperative and long-term postoperative results of laparoscopic pelvic exenteration technique.Material and methods: in the period from 2011 to 2018, 21 pelvic exenteration was performed with laparoscopic access, (mean age 59.79 ± 8.5), sex distribution: 17 women and 4 men. Nosology distribution: in 6 patients cervical cancer was verified, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had recurrence of vaginal cancers after previous uterine extirpation and 1 patient with ovarian neoplasm.Results: the volume of the exenteration was as follows: 9 total, 7 anterior and 5 posterior. In all cases, it was possible to achieve a negative margin of resection line (R0). The duration of the operation, the volume of blood loss, the frequency and nature of intra- and postoperative complications were evaluated.Conclusion: laparoscopic access is accompanied by a smaller amount of blood loss, decrease of frequency of early postoperative complications, contributes to more comfortable postoperative period with early activation, less severe pain syndrome and leads to a reduction in the duration of inpatient treatment.

scholarly journals Technique of the laparoscopic pelvic exenteration

2018 ◽  
Vol 46 (6) ◽  
pp. 631-639
Author(s):  
E. A. Galliamov ◽  
R. G. Biktimirov ◽  
V. P. Sergeev ◽  
L. N. Aminova ◽  
A. E. Sanzharov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
World Literature ◽  
Pelvic Exenteration ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Laparoscopic Technique ◽  
Negative Resection Margin ◽  
Invasive Approach

Background: Laparoscopic surgery has proved itself to be a “golden standard” for treatment of most abdominal and retroperitoneal cancers. Such a serious procedure as pelvic exenteration continues to be a complex surgical intervention usually performed through a  conventional laparotomic access. However, studies on minimally invasive approach for this intervention have becoming increasingly published in the world literature.Aim: To describe the laparoscopic pelvic exenteration technique of pelvic exenteration, as well as to assess short- and long-term results of these interventions.Materials and methods: From 2011 to 2018, 21 procedures of laparoscopic pelvic exenteration have been performed in 6  surgical centers (Moscow, Russia). Six (6) patients had previously confirmed cervical cancer, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had relapsing vaginal cancers after previous uterine extirpation, and 1 patient had an ovarian neoplasm.Results: The laparoscopic pelvic exenteration volumes were as follows: 9  total, 7 anterior and 5 posterior procedures. In 19 out of 21 cases, negative resection margin (R0) was possible. Median duration of the procedure was 254 minutes, median blood loss was 515 ml, and median postoperative hospital stay was 13 days. Postoperative complications were registered in 6 (28.6%) patients. The 3-year overall survival was 85.71%.Сonclusion: The choice of laparoscopic access can reduce blood loss, decrease the rates of early postoperative complications, contributes to a more comfortable postoperative period with early activation and less severe pain syndrome, and leads to a reduction in the duration of hospital stay. These results of the laparoscopic technique are comparable with those of laparoscopic and open pelvic exenteration published by other authors.

scholarly journals Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Brian R. Winters ◽  
Gary N. Mann ◽  
Otway Louie ◽  
Jonathan L. Wright
Keyword(s):  
Blood Loss ◽  
Open Surgery ◽  
Pelvic Exenteration ◽  
Locally Advanced ◽  
Descriptive Statistics ◽  
Initial Experience ◽  
Total Pelvic Exenteration ◽  
Surgical Morbidity ◽  
Pelvic Malignancies ◽  
Estimated Blood Loss

Total pelvic exenteration is a highly morbid procedure performed for locally advanced pelvic malignancies. We describe our experience with three patients who underwent robotic total pelvic exenteration with laparoscopic rectus flap and compare perioperative characteristics to our open experience. Demographic, tumor, operative, and perioperative factors were examined with descriptive statistics reported. Mean operative times were similar between the two groups. When compared to open total pelvic exenteration cases(n=9), median estimated blood loss, ICU stay, and hospital stay were all decreased. These data show robotic pelvic exenteration with laparoscopic rectus flap is technically feasible. The surgery was well tolerated with low blood loss and comparable operative times to the open surgery. Further study is needed to confirm the oncologic efficacy and the suggested improvement in surgical morbidity.

scholarly journals BIPOLAR VAGINAL HYSTERECTOMY IN THE FUTURE AND PRESENT

2018 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
A. I Slobodyanyuk ◽  
Anton A. Ishchenko ◽  
A. I Ishchenko ◽  
B. A Slobodyanyuk
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operation Time ◽  
Pain Syndrome ◽  
Bipolar Coagulation ◽  
Prospective Comparison ◽  
The Future

Vaginal hysterectomy seems to be the optimal access, but this method does not take a worthy place in operative gynecology. In this study, a prospective comparison of 2 different techniques of vaginal hysterectomy was performed in 125 patients with the use of vicryl ligatures and 215 patients using bipolar coagulation devices (Gyrus and Emed) in different clinics. In the analysis of immediate and remote results, in the group with electrosurgery, blood loss, operation time and pain syndrome at 4 and 48 hours were found to be statistically significantly less. Also, we did not discern any differences in the number of postoperative complications, which allows us to make conclusions regarding the safety and effectiveness of the use of modern bipolar coagulation devices by experienced surgeons.

Clinical outcome of Laparoscopic and Robot-assisted Radical Cystectomy for Bladder Cancer in a Retrospective Study

2021 ◽  
Author(s):  
YuChen Bai ◽  
Shuai Wang ◽  
Wei Zheng ◽  
Jing Quan ◽  
Fei Wei ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Long Term Outcome ◽  
Estimated Blood Loss

Abstract Background: With the rapid development of surgical technics and instruments, more and more bladder cancer patients are being treated by laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) .The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent cystectomy by these two surgical approaches. Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage Ta/T1/Tis to T3 who underwent RARC and LRC. Perioperative outcomes, recurrence, and overall survival (OS) were analyzed. Results: From March 2010 to December 2019, there were total of 218 patients, which including 82(38%) patients with LRC and 136(62%) patients with RARC. No perioperative death was observed in both groups. Tumor recurrence, death from any causes, and cancer-specific death occurred in 77, 55, and 39 patients respectively. The 5-year DFS, OS, and CSS rates for all included patients were 55.4%, 62.4%, and 66.4%, respectively. There were no significantly statistically differences between the RARC group and the LRC group for number of lymph nodes harvested, positive lymph node rate, positive margin rate and postoperative pathological stage (all P>0.05). Patients undergoing RARC had lower median estimated blood loss (180mL vs. 250 mL; P 0.015) and 90-days postoperative complications (30.8% vs. 46.3%; P 0.013) than LRC.Conclusions: For selected patients with RARC and LRC, both were safe and effective with a low complication rate and similar long-term outcome compared two groups. Moreover, the robotic approach resulted in lower median estimated blood loss and better outcome in postoperative complications.

scholarly journals Analysis of the surgery experience in correction of genitals prolapse realised in the kaliningrad regional centre of endo video surgery

2003 ◽  
Vol 52 (3) ◽  
pp. 38-42
Author(s):  
O. V. Sednev
Keyword(s):  
Postoperative Complications ◽  
Pain Syndrome ◽  
Comparative Assessment ◽  
Point Of View ◽  
Prolapse Surgery ◽  
Frequency Pattern ◽  
Regional Centre ◽  
Relapse Pattern

The present work contains the analysis of the follow-upgenitals prolapse surgery carried out with the 56 patients in the Kaliningrad regional centre of endo video surgery within the 1998 - 2002. In process of the analysis we have made a comparative assessment of long-term effectiveness of a number of the operations practiced in our centre. We have shown the evolution frequency pattern of such postoperative complications as dysuria and pain syndrome due to the fixed structures tention, as well as prolapse relapse pattern depending on the applied correction technology. We have also shown lack of their dependance on the degree of prolapse evidence. In addition the author has outlined his point of view on the ways of decreasing the amount of relapses in the follow-upgenitals prolapse.

scholarly journals Chemoembolization with HepaSpheres as a stage of comprehensive treatment for malignant pelvic tumors

2019 ◽  
Vol 14 (4) ◽  
pp. 35-42
Author(s):  
A. G. Kedrova ◽  
D. P. Lebedev ◽  
D. A. Astakhov ◽  
V. V. Kosyy ◽  
F. G. Zabozlaev ◽  
...  
Keyword(s):  
Morphological Study ◽  
Therapeutic Agent ◽  
Malignant Tumors ◽  
Locally Advanced ◽  
Treatment Method ◽  
Comprehensive Treatment ◽  
Antitumor Effects ◽  
Pelvic Tumors ◽  
Biological Compatibility

Genital bleeding poses a serious threat to patients with progressive locally advanced malignant tumors. Surgical treatment is often impossible in these patients; therefore, to achieve reliable hemostasis, the patients should undergo embolization of vessels feeding the tumor. Good results have been achieved by selective catheterization of pelvic arteries using chemoembolization with HepaSphere microspheres (Biosphere Medical, France) delivering the therapeutic agent to the tumor. Hydrophilicity of microspheres loaded with cytostatics and their biological compatibility with tissues ensure long-term therapeutic effect by controlling tumor growth. Pronounced hemostatic and antitumor effects of this treatment method have been confirmed by a morphological study. This study analyzes 38 patients that underwent chemoembolization with HepaSpheres loaded with doxorubicin or irinotecan, which allowed surgery and further treatment.

scholarly journals Multivisceral Resection of Advanced Pelvic Tumors: From Planning to Implementation

2020 ◽  
Vol 33 (05) ◽  
pp. 268-278
Author(s):  
R. Mirnezami ◽  
A. Mirnezami
Keyword(s):  
Pelvic Exenteration ◽  
Tumor Staging ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Multivisceral Resection ◽  
Current State ◽  
Pelvic Tumors ◽  
Patient Optimization ◽  
Exenterative Surgery

AbstractPelvic exenteration involves radical multivisceral resection for locally advanced and recurrent pelvic tumors. Advances in tumor staging, oncological therapies, preoperative patient optimization, surgical techniques, and critical care medicine have permitted the safe expansion of pelvic exenterative surgery at specialist units. It is now understood that in carefully selected patients, 5-year survival can exceed 60% following pelvic exenteration, and that very low mortality figures and an optimum postexenteration quality of life are possible. In the present review, we provide a contemporary summary of the current state of the art in pelvic exenterative surgery following all key phases of the treatment pipeline from patient staging and tumor assessment, to treatment planning and surgery.

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