Laparoscopically Assisted Schauta Operation: Learning Experience at the Gynecologic Oncology Unit, Buenos Aires University Hospital
| Autor: | Javier Vidaurreta, Adriana Bermudez, J Sardi, Guillermo di Paola |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Uterine Cervical Neoplasms Gynecologic oncology Learning experience Hematoma Schauta operation Carcinoma Hysterectomy Vaginal medicine Humans Stage (cooking) Laparoscopy Abscess Lymph node Aged Hysterectomy medicine.diagnostic_test business.industry Obstetrics and Gynecology General Medicine Middle Aged medicine.disease University hospital Surgery medicine.anatomical_structure Oncology Lymph Node Excision Lymphadenectomy Female business |
| Zdroj: | Obstetrical & Gynecological Survey. 55:216-217 |
| ISSN: | 0029-7828 |
| DOI: | 10.1097/00006254-200004000-00015 |
| Popis: | Objectives. The aim of this study was to show the learning experience of the employment of laparoscopic lymphadenectomy followed by a Schauta operation to treat patients with cervical carcinoma at a university hospital and to evaluate the feasibility, complications, hospital stay, delay in return to work, and overall survival of this procedure. Methods. Between June 1, 1993, and December 30, 1997, 56 patients were selected. Surgical treatment began with a pelvic laparoscopic lymphadenectomy followed by a Schauta operation. Patients were staged according to FIGO criteria (Ia2, 10 cases; Ib1, 33 patients; Ib2, 8 cases; IIa, 3 cases; and IIb, 2 patients). Patients had a follow-up of 47 months. Overall survival was calculated with Kaplan–Meier tables. Results. The procedure was not completed in 9 pts, in 5 cases among the first 20 pts that were entered on the trial due to technical problems and in 4 due to extracervical spread of disease (2 with gross laparoscopically unresectable lymph node metastases, 1 with parametrial infiltration, and 1 with rectovaginal septum involvement). In the 47 pts in which the procedure could be completed, the laparoscopic approach was done in 102 min and the vaginal part in 165 min. There were 4 complications: 1 ureteral injury, 1 abscess of the ischiorectal fossa, 1 hematoma of the Schuchardt incision, and 1 case of leg edema. The mean number of resected nodes was 17. Among the 47 cases in which the surgical procedure was completed, overall survival was 100% for Stage Ia, 88% for Ib1, and 85% for Ib2 after a mean follow-up of 4 years. Four pts have relapsed and died; 3 were stage Ib1 and the other was stage Ib2. They had pelvic recurrences. Conclusions. This surgery is secure and has an excellent outcome, so it can be considered a valid approach for the treatment of patients with cervical carcinoma, but in our hands, 20 cases were needed to obtain the minimum skill needed to perform it. |
| Databáze: | OpenAIRE |
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