Our Experience of Laparoscopic Anterior Exenteration in Locally Advanced Cervical Carcinoma.

Autor:	Puntambekar S; Galaxy Care Laparoscopy Institute, Pune, India. Electronic address: shase63@gmail.com., Sharma V; Galaxy Care Laparoscopy Institute, Pune, India., Jamkar AV; Maharashtra University of Health Science, Nashik, India., Gadkari Y; Galaxy Care Laparoscopy Institute, Pune, India., Joshi G; Galaxy Care Laparoscopy Institute, Pune, India., Puntambekar S; Galaxy Care Laparoscopy Institute, Pune, India., Parikh H; Galaxy Care Laparoscopy Institute, Pune, India., Vatsal S; Galaxy Care Laparoscopy Institute, Pune, India.
Jazyk:	angličtina
Zdroj:	Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2016 Mar-Apr; Vol. 23 (3), pp. 396-403. Date of Electronic Publication: 2015 Dec 23.
DOI:	10.1016/j.jmig.2015.12.005
Abstrakt:	Study Objective: To show the feasibility, technique, and results of laparoscopic anterior exenteration in selected patients. Design: A retrospective cohort study. Setting: Galaxy Care Laparoscopy Institute, Pune, India. Patients: Seventy-four of 85 patients who underwent laparoscopic anterior exenteration for stage IVA carcinoma of the cervix from January 2005 to January 2015 were analyzed; the median follow-up was 30 months. Contrast-enhanced computed tomographic imaging of the abdomen and pelvis was performed for all patients. Interventions: The same surgeon and team performed all the operations for uniformity in 10 operative steps. Measurements and Main Results: The mean operative time was 180 minutes, and the mean blood loss was 160 mL. The mean hospital stay was 6 days. The average number of lymph nodes removed was 21.4. Surgical margins were negative in all patients. Forty-two patients had positive lymph nodes. Chemoradiation was given to those with positive lymph nodes. Perioperative complications occurred in 15 (20.27%) patients including deep vein thrombosis, urinary tract infection, ureterosigmoid leak (n = 2/74), and so on. Positron emission tomographic imaging and computed tomographic scanning were performed at 6 months after surgery and 6 months after adjuvant therapy in those with positive lymph nodes. There was no immediate postoperative mortality. The overall survival rate at 5 years was 25%. Conclusion: Laparoscopic anterior exenteration is feasible in cases of advanced carcinoma of the cervix. Results have shown that in selected patients this procedure is associated with good long-term survival. (Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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