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Exenteration pelvic surgery

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https://www.readbyqxmd.com/read/28108013/detection-of-extra-regional-tumour-recurrence-with-18-f-fdg-pet-ct-in-patients-with-recurrent-gynaecological-malignancies-being-considered-for-radical-salvage-surgery
#1
H Brar, T May, N Tau, D Langer, P MacCrostie, K Han, U Metser
AIM: To compare the detection rate of extra-regional metastases in patients with recurrent gynaecological malignancies being considered for radical salvage surgery with combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) compared to conventional imaging. MATERIALS AND METHODS: A retrospective review was performed of all patients in a provincial database with recurrent gynaecological malignancies being considered for pelvic exenteration that underwent restaging with CT/PET between March 2011 and October 2014...
January 17, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#2
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28095995/pelvic-floor-reconstruction-by-modified-rectus-abdominis-myoperitoneal-mram-flap-after-pelvic-exenterations
#3
D Cibula, M Zikan, D Fischerova, R Kocian, A Germanova, A Burgetova, L Dusek, Z Fartáková, M Schneiderová, K Nemejcová, J Slama
OBJECTIVE: To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. METHODS: Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16)...
January 14, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28078119/surgical-outcomes-of-post-chemoradiotherapy-unresectable-locally-advanced-rectal-cancers-improve-with-interim-chemotherapy-is-folfirinox-better-than-capox
#4
Vikas Ostwal, Reena Engineer, Anant Ramaswamy, Arvind Sahu, Saurabh Zanwar, Suprita Arya, Supriya Chopra, Munita Bal, Prachi Patil, Ashwin Desouza, Avanish Saklani
BACKGROUND: Role of chemotherapy in patients who continue to have unresectable disease after pre-operative chemo-radiotherapy (CRT) remains largely unaddressed. METHODS: Patients with LA rectal cancer from January 2013 to June 2015 were evaluated. Post-CRT, patients, who were deemed unresectable, were considered for further interim chemotherapy (i-CT). RESULTS: Seventy six patients (15%) with median age of 38.5 years received i-CT after CRT...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28070552/long-term-survival-after-anterior-pelvic-exenteration-and-total-vaginectomy-for-recurrent-endometrial-carcinoma-with-metastatic-inguinal-nodes-at-the-time-of-surgery
#5
Benjamin Margolis, Sun Woo Kim, Dennis S Chi
•Pelvic exenteration can be used in patients with multifocal recurrence.•Ability to achieve negative margins remains a necessity for pelvic exenteration.•Individualized treatments are essential for those with recurrent malignancy.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28027809/-laparoscopic-anterior-pelvic-exenteration-in-a-patient-with-locally-advanced-melanoma
#6
David Isla-Ortiz, Gonzalo Montalvo-Esquivel, Roberto Eduardo Herrera-Goepfert, Ángel Herrera-Gómez, Rosa Angélica Salcedo-Hernández
BACKGROUND: Pelvic exenteration is one of the most mutilating surgical procedures with high post-operative morbidity. The laparoscopic technique aims to reduce perioperative complications and reduce post-surgical recovery. OBJECTIVE: We present the first case of laparoscopic anterior exenteration for locally advanced melanoma, held at the National Cancer Institute and published in Mexico. CASE REPORT: Patient 60 years of age diagnosed with invasive vulvar melanoma with bladder extension upon whom laparoscopic anterior pelvic exenteration with external urinary reconstruction was performed...
December 24, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27990753/triangle-of-marcille-the-anatomical-gateway-to-lateral-pelvic-exenteration
#7
Peter Lee, Katherine E Francis, Michael J Solomon, George Ramsey-Stewart, Kirk K S Austin, Cherry Koh
BACKGROUND: To perform more radical surgery for complex pelvic malignancies and recurrent colorectal cancer, the surgeon must increasingly operate outside the conventional anatomical planes. Published in 1963 the 'Triangle of Marcille' (lumbosacral triangle) remained primarily of intellectual interest being found lateral to the traditional operating field. However, with the advancement of complex colorectal and gynaecological surgery it now provides a schema to assist surgeons in becoming acquainted with a complex and poorly understood anatomical region...
December 18, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27957822/laparoscopic-assisted-abdominoperineal-resection-combined-with-en-bloc-prostatectomy-using-the-trans-sacral-approach-for-locally-invasive-rectal-cancer-a-case-report
#8
Jo Tashiro, Shigeki Yamaguchi, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara
Laparoscopic-assisted abdominoperineal resection and en-bloc prostatectomy using the trans-sacral approach for locally invasive rectal cancer that invades only the prostate is useful in order to avoid total pelvic exenteration. The patient was a 63-year-old man with cT4b (prostate) N1M0, stage IIIC rectal cancer. Curative resection was performed. Histopathological findings did not indicate definitive invasion into the prostate gland. The patient was discharged from the hospital on postoperative day 32 with an anastomotic leak and a ureteral catheter...
December 13, 2016: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/27760707/survival-after-pelvic-exenteration-for-uterine-malignancy-a-national-cancer-data-base-study
#9
Brandon-Luke L Seagle, Megan Dayno, Anna E Strohl, Stephen Graves, Wilberto Nieves-Neira, Shohreh Shahabi
OBJECTIVE: To determine overall survival (OS) and factors associated with OS after pelvic exenteration for uterine cancer. METHODS: Women with uterine cancer who underwent exenteration (n=1160) were identified from the 1998-2011 National Cancer Data Base. Kaplan-Meier and multivariate Cox proportional-hazards survival analyses were performed to test for associations of potential explanatory variables with OS. Analyzed confounders included age, comorbidity score, insurance status, income, distance from home to treatment center, stage, distant and nodal metastasis, tumor size, surgical margin status, exenteration type, and treatment with radiation and/or chemotherapy...
December 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27749474/palliative-pelvic-exenteration-clinical-outcomes-and-quality-of-life
#10
Aaron J Quyn, Michael J Solomon, Peter M Lee, Tim Badgery-Parker, Lindy M Masya, Jane M Young
BACKGROUND: Locally advanced pelvic malignancy can be associated with disabling symptoms and reduced quality of life. If resectable with clear margins, a pelvic exenteration can offer long-term survival and improved quality of life. Its role in the palliation of symptoms has been described; however, the clinical outcomes and surgical indication are poorly defined. OBJECTIVE: This study describes the clinical and quality-of-life outcomes after palliative pelvic exenteration for advanced pelvic malignancy...
November 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27689067/cytoreductive-surgery-for-men-with-metastatic-prostate-cancer
#11
Nikolas Katelaris, Declan Murphy, Nathan Lawrentschuk, Athos Katelaris, Daniel Moon
BACKGROUND: Cytoreductive surgery for metastatic prostate cancer is an emerging area of interest with a potential upside that includes local control, delayed initiation of hormone therapy, and possibly improved cancer specific survival. In order for radical prostatectomy to be an effective treatment option for men in this group, the benefits must outweigh the surgical morbidity. The aim of this study was to present a case series and assess the literature feasibility of cytoreductive surgery for men with metastatic prostate cancer...
September 2016: Prostate International
https://www.readbyqxmd.com/read/27678502/effects-of-neoadjuvant-chemotherapy-plus-radical-surgery-as-front-line-treatment-strategy-in-patients-affected-by-figo-stage-iii-cervical-cancer
#12
Violante Di Donato, Michele Carlo Schiavi, Ilary Ruscito, Virginia Sibilla Visentin, Innocenza Palaia, Claudia Marchetti, Margherita Fischetti, Marco Monti, Ludovico Muzii, Pierluigi Benedetti Panici
BACKGROUND: To assess the clinical efficacy and prognostic outcome of neoadjuvant chemotherapy (NACT) plus radical surgery (RS) as front line treatment in patients with FIGO stage III cervical cancer (CC). METHODS: In this retrospective study, 52 FIGO stage III CC patients treated from 2005 to 2015 were included. All patients received platinum-based chemotherapy. Patients reporting clinical response or stable disease after NACT underwent to RS and bilateral systematic pelvic lymphadenectomy with or without aortic lymphadenectomy or anterior exenteration...
December 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27614445/state-of-the-art-treatment-and-novel-agents-in-local-and-distant-recurrences-of-cervical-cancer
#13
Clemens B Tempfer, Matthias W Beckmann
Depending on the stage at initial presentation, cervical cancer will recur in 25-61% of women. Typical manifestations of recurrent cervical cancer include the central pelvis and the pelvic side walls as well as retroperitoneal lymph node basins in the pelvis and the para-aortic region, and - more rarely - supraclavicular lymph nodes. There are no typical symptoms of recurrent cervical cancer. Women with suspected recurrence after cervical cancer based on gynecological examination or organ-specific symptoms must undergo imaging studies and - if technically feasible - biopsy with histological verification, especially in cases of distant metastases, in order to rule out a second primary...
2016: Oncology Research and Treatment
https://www.readbyqxmd.com/read/27505111/outcomes-of-pelvic-exenteration-with-en-bloc-partial-or-complete-pubic-bone-excision-for-locally-advanced-primary-or-recurrent-pelvic-cancer
#14
Kirk K S Austin, Andrew J Herd, Michael J Solomon, Ken Ly, Peter J Lee
INTRODUCTION: Neoplasms infiltrating the pubic bone have until recently been considered a contraindication to surgery. Paucity of existing published data in regard to surgical techniques and outcomes exist. OBJECTIVE: This study aims to address outcomes of our recently published technique for en bloc composite pubic bone excision during pelvic exenteration. DESIGN: A prospective database was reviewed to identify patients who underwent a partial or complete pubic bone composite excision over a 12-year period...
September 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27460130/laparoscopic-total-pelvic-exenteration-using-transanal-minimal-invasive-surgery-technique-with-en-bloc-bilateral-lymph-node-dissection-for-advanced-rectal-cancer
#15
Kengo Hayashi, Masanori Kotake, Daiki Kakiuchi, Sho Yamada, Masahiro Hada, Yosuke Kato, Chikashi Hiranuma, Kaeko Oyama, Takuo Hara
A 59-year-old man presenting with fecal occult blood visited our hospital. He was diagnosed with advanced lower rectal cancer, which was contiguous with the prostate and the left seminal vesicle. There were no metastatic lesions with lymph nodes or other organs. We performed laparoscopic total pelvic exenteration (LTPE) using transanal minimal invasive surgery technique with bilateral en bloc lateral lymph node dissection for advanced primary rectal cancer after neoadjuvant chemoradiotherapy. The total operative time was 760 min, and the estimated blood loss was 200 ml...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27434623/evidence-for-the-use-of-robotically-assisted-surgery-in-gynecologic-cancers
#16
Charlotte Ngô, Caroline Cornou, Léa Rossi, Anne-Sophie Bats, Chérazade Bensaid, Albane Frati, Claude Nos, Fabrice Lécuru
PURPOSE OF REVIEW: Robotically assisted laparoscopy has been introduced in the armamentarium of gynaecologic oncology surgeons. A lot of studies compared robotic surgery and laparotomy when the real issue is to demonstrate the interest and added value of robotically assisted laparoscopy versus standard laparoscopy. In this review, we will describe the most meaningful indications and advantages of robotically assisted laparoscopy in gynaecologic oncology. RECENT FINDINGS: The learning curve for advanced procedures in robot-assisted laparoscopy is shorter and easier than with the standard laparoscopy, especially for beginners...
September 2016: Current Opinion in Oncology
https://www.readbyqxmd.com/read/27343313/posterior-pelvic-exenteration-and-retrograde-total-hysterectomy-in-patients-with-locally-advanced-ovarian-cancer-clinical-and-functional-outcome
#17
Roberto Berretta, Federico Marchesi, Lavinia Volpi, Giulio Ricotta, Michela Monica, Giulio Sozzi, Maurizio Di Serio, Daniele Mautone
OBJECTIVE: To evaluate clinical outcomes and postoperative quality of life in patients affected by locally advanced ovarian cancer who underwent pelvic posterior exenteration with Hudson-Delle Piane radical retrograde hysterectomy. MATERIALS AND METHODS: Our study was done on a retrospective cohort using data from 22 patients who underwent surgery between 2010 and 2014 at the Gynecological Oncologic Center of Parma, Parma, Italy. RESULTS: Residual disease after surgery (Sugarbacker index) was absent (CC-0) in 68% of cases...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27336750/-perineal-hernia-hernia-repair-using-rectus-abdominis-muscle-flap
#18
M Bocková, J Hoch, L Frajer
UNLABELLED: Perineal hernia is defined as a protrusion of intra-abdominal viscera through a defect in the pelvic floor. Primary hernias are extremely rare; secondary (postoperative) hernias following pelvic surgery, especially abdominoperineal resection or pelvic exenteration, are more common. Impaired perineal wound healing and neoadjuvant chemoradiotherapy in cancer patients are defined as main risk factors. A growing incidence of this complication is expected in connection with an increasing use of laparoscopic approaches and ELAPE...
December 0: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27317102/urological-reconstruction-after-pelvic-oncological-surgery-a-single-institution-experience
#19
Yu Guang Tan, Grace Tan, David Tan, Claramae S Chia, Dun Yong Ang, Melissa C C Teo
BACKGROUND: In locally advanced pelvic malignancies, there is often involvement of urological organs, necessitating resection and reconstruction, which can be associated with significant complications. METHODS: We retrospectively reviewed 20 patients undergoing urological reconstructions during pelvic oncological surgeries from January 2004 to December 2013. All patients had imaging-proven involvement of at least one urological organ preoperatively. Primary outcome was urological complication rate...
June 14, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27273808/versatility-of-pedicled-anterolateral-thigh-flap-in-gynecologic-reconstruction-after-vulvar-cancer-extirpative-surgery
#20
Stefano Gentileschi, Maria Servillo, Giorgia Garganese, Fragomeni Simona, Giovanni Scambia, Marzia Salgarello
OBJECTIVE: Ablative surgery for vulvar cancer can involve the resection of perineum, vagina, urethra, groins, mons pubis, and abdominal wall creating complex defects. In our opinion, ALT flap is an ideal flap for reconstruction, because of low incidence of complications, long pedicle outside the radiotherapy field, capability of carrying fascia and muscle, possibility of sensate reconstruction, and low donor site morbidity. The purpose of this report is to describe our experience with ALT flap for reconstruction after vulvar cancer extirpative surgery, discussing our indications for complex defects and focusing on its versatility...
June 8, 2016: Microsurgery
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