RESUMEN
During the period of 2010-2015 laparoscopic surgery was performed in 1263 patients: 1113 with endometrial cancer (588 hysterectomies, 509 hysterectomies with pelvic lymphadenectomy, among them 16 with sentinel lymph node (SLN) mapping with Indocyanine green (ICG)); 86 with cervical cancer (80 nerve-sparing radical hysterectomies (NSRH), among them 15 with SLN mapping, 6 radical vaginal trachelectomies with endovideoassisted lymphadenectomy); 64 with ovarian malignancies. The average operating time in the group of hysterectomies was 101 minutes, in the group of hysterectomies with pelvic lymphadenectomy - 184 minutes, in the group of NSRH - 230 minutes. Average blood loss was less than 50 ml. No intraoperative complications were registered. Asymptomatic lymph cysts were observed in 122 cases. Symptomatic lymph cysts requiring surgical treatment were registered in 9 cases. Inconsistencies of vaginal sutures after radical hysterectomy were in two cases, ureterovaginal fistulas - in two cases. During a 3-year follow-up period twelve recurrences were observed in endometrial cancer patients (12/443; 2,7%), four patients (0,9%) died from disease. After NSRH two local recurrences (2,5%) were registered in patients with cervical cancer, after radical trachelectomy -two local recurrences (33%). One patient became pregnant in the group of vaginal trachelectomies. Therefore laparoscopic approach in treatment of female genital malignacies allows performing an adequate volume of surgery with minimal risk of intra- and postoperative complications, favorable course of the rehabilitation period, and oncological safety.
Asunto(s)
Neoplasias Endometriales/cirugía , Laparoscopía , Neoplasias Ováricas/cirugía , Neoplasias del Cuello Uterino/cirugía , Cirugía Asistida por Video , Adulto , Anciano , Supervivencia sin Enfermedad , Neoplasias Endometriales/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/mortalidad , Estudios Retrospectivos , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidadRESUMEN
Cervical cancer is the most common cancer of the female reproductive system up to 20% of malignant tumors of the female genital organs. Surgery is the main method in treatment for local cervical cancer but postoperative complications often are associated with dysfunction of the pelvic organs. Some researchers focus their attention on the preservation of the pelvic innervation without loss of surgery's radicalism, which is represented in this survey. The paper presents the results of comparative analysis of 54 cases of surgical treatment for invasive cervical cancer.
Asunto(s)
Histerectomía/efectos adversos , Histerectomía/métodos , Laparoscopía , Plexo Lumbosacro/lesiones , Pelvis/inervación , Complicaciones Posoperatorias/prevención & control , Vejiga Urinaria/inervación , Trastornos Urinarios/prevención & control , Neoplasias del Cuello Uterino/cirugía , Adenocarcinoma/cirugía , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Ensayos Clínicos como Asunto , Investigación sobre la Eficacia Comparativa , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Escisión del Ganglio Linfático/efectos adversos , Ganglios Linfáticos/patología , Ganglios Linfáticos/cirugía , Metástasis Linfática , Persona de Mediana Edad , Clasificación del Tumor , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Tempo Operativo , Pelvis/lesiones , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Vejiga Urinaria/lesiones , Vejiga Urinaria/fisiopatología , Micción , Trastornos Urinarios/etiología , Neoplasias del Cuello Uterino/patologíaRESUMEN
Surgery is the main method in treatment for endometrial cancer. The complexity of treatment of endometrial cancer patients in elderly age is a result of a large number of comorbidities and, as a consequence, the potential possibility of a large number of intra--and postoperative complications. The article presents the international data and the analysis of own results of a use of laparoscopy in surgical treatment of these patients. A comparison with a group of operations performed by laparotomy is carried out as well as it is evaluated the main intra--and perioperative parameters and also complications, and immediate outcomes of patients treated at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology.
Asunto(s)
Neoplasias Endometriales/cirugía , Histerectomía/métodos , Laparoscopía , Adenocarcinoma de Células Claras/cirugía , Anciano , Anciano de 80 o más Años , Carcinoma Endometrioide/cirugía , Comorbilidad , Conversión a Cirugía Abierta/estadística & datos numéricos , Cistadenocarcinoma Seroso/cirugía , Neoplasias Endometriales/complicaciones , Neoplasias Endometriales/patología , Femenino , Humanos , Histerectomía/efectos adversos , Laparoscopía/estadística & datos numéricos , Laparotomía/estadística & datos numéricos , Estadificación de Neoplasias , Federación de Rusia , Resultado del TratamientoRESUMEN
We analyzed the international and our own experience of using different dyes in the identification of sentinel lymph nodes in oncogynecological practice. We evaluated the possibility of using indocyanine green (ICG) in the detection of sentinel lymph nodes in patients with endometrial and cervical cancer. The first results of the use of ICG at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology are presented.