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Gynecologic cancer, minimally invasive surgery

Chyi-Long Lee, Soshi Kusunoki, Kuan-Gen Huang, Kai-Yun Wu, Chen-Yin Huang, Chih-Feng Yen
OBJECTIVE: To assess the long-term outcomes of laparoscopic staging surgery (LSS) in treating patients with endometrial carcinoma. MATERIALS AND METHODS: Patients with endometrial cancer who underwent LSS between June 1995 and June 2014 were prospectively registered. Perioperative data, complications, disease recurrence, and long-term survival were measured. RESULTS: The study included 287 consecutive patients [mean age (± standard deviation), 53±10...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Satoshi Tamauchi, Hiroaki Kajiyama, Jun Sakata, Ryuichiro Sekiya, Shiro Suzuki, Mika Mizuno, Fumi Utsumi, Kaoru Niimi, Tomomi Kotani, Kiyosumi Shibata, Fumitaka Kikkawa
AIM: Radical trachelectomy (RT) is a widely used fertility-sparing treatment for patients with early cervical cancer (CCA). RT, however, is an investigational treatment, and its gynecological and obstetric efficacy are being investigated. We retrospectively assessed the efficacy of abdominal RT (ART) as a fertility-sparing surgery. METHODS: From 2010 to 2014, patients with stage IA2-IB1 CCA (tumor ≤2 cm) who wished to preserve their fertility underwent ART. The major outcomes were mortality, recurrence, pregnancy complications, and obstetric outcome...
August 16, 2016: Journal of Obstetrics and Gynaecology Research
Gulden Menderes, Jonathan D Black, Masoud Azodi
No abstract text is available yet for this article.
September 2016: Expert Review of Anticancer Therapy
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama
Robotic surgery with the da Vinci Surgical System has been increasingly applied in a wide range of surgical specialties, especially in urology and gynecology; however, that in the field of upper GI tract has yet to be standard due to the lack of clear benefits in comparison with conventional minimally invasive surgery. We have been performing robotic gastrectomy and esophagectomy for operable patients with resectable upper GI malignancies since 2009, and demonstrated the potential advantage that use of the robot may reduce postoperative local complications including pancreatic fistula following gastrectomy and recurrent laryngeal nerve palsy after esophagectomy, even though there have been a couple of issues to be solved including longer duration of operation and higher cost...
July 12, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Jonathan A Cosin, Michelle A Brett Sutherland, Candace T Westgate, Hongbin Fang
BACKGROUND: Surgeons are increasingly faced with the challenge of caring for obese patients. Advanced laparoscopic procedures have been shown to be safe in women with high BMI, but conversion rates remain high. Because robotics holds many potential advantages over traditional laparoscopic surgery, we sought to evaluate the outcome of robotic-assisted gynecologic surgery in obese patients. METHODS: A retrospective chart review of obese female patients undergoing robotic gynecologic surgery between January 2008 and August 2010 was done...
June 22, 2016: Annals of Surgical Oncology
Xiuqin Wang, Wenjuan Liu, Zan Xu, Fumei Wang, Chuanfeng Zhang, Baosheng Wang, Kaiguo Wang, Jingui Yu
Gynecological laparoscopic surgery is minimally invasive compared with open surgical approaches, but postoperative pain is generally undermanaged. Pain management strategies related to the procedure-specific efficacy are needed. Many studies have shown that dexmedetomidine (DEX) has opioid-sparing properties. It is not clear whether DEX used alone for intravenous patient-controlled analgesia (PCA) could reduce postoperative pain after an invasive procedure. We hypothesized that DEX alone would reduce postoperative pain in women patients undergoing an elective gynecological laparoscopic procedure...
May 2016: Medicine (Baltimore)
Kemi M Doll, Emma L Barber, Jeannette T Bensen, Matthew C Revilla, Anna C Snavely, Antonia V Bennett, Bryce B Reeve, Paola A Gehrig
BACKGROUND: There are currently no assessments of the impact of surgical complications on health-related quality of life in gynecology and gynecologic oncology. This is despite complications being a central focus of surgical outcome measurement, and an increasing awareness of the need for patient-reported data when measuring surgical quality. OBJECTIVE: We sought to measure the impact of surgical complications on health-related quality of life at 1 month postoperatively, in women undergoing gynecologic and gynecologic oncology procedures...
October 2016: American Journal of Obstetrics and Gynecology
Sven Becker, Rudy Leon De Wilde
Complications are the limiting factors of all surgeries. More than performing the actual surgery, learning how to avoid complications before, during, and after surgery is the most important task of every surgeon. Severe complications can lead to patient death. Complications such as ureterovaginal fistulas, resulting from <2 s of inattentive preparation, can lead to years of hardship, suffering, accusation, and litigation. Excellent surgery is about performing the right surgery for the right patient without any complications...
August 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
David M Boruta
The preferred surgical approach for many gynecologic oncology procedures is now laparoscopy. Reduced morbidity, shorter hospitalization and a more rapid recovery have been associated with minimally invasive surgical approaches when compared to laparotomy. Incisional morbidity, including vascular and viscous injury, postoperative hernia, infection, and pain remain significant concerns. Use of fewer and smaller incisions during laparoscopy may be expected to further minimize these risks. Laparoendoscopic single-site surgery (LESS), or single incision laparoscopy, describes the use of one small skin incision to complete laparoscopic surgical procedures...
June 2016: Gynecologic Oncology
Kemi M Doll, Emma L Barber, Jeannette T Bensen, Anna C Snavely, Paola A Gehrig
OBJECTIVE: To report the changes in patient-reported quality of life for women undergoing gynecologic oncology surgeries. METHODS: In a prospective cohort study from 10/2013-10/2014, women were enrolled pre-operatively and completed comprehensive interviews at baseline, 1, 3, and 6months post-operatively. Measures included the disease-specific Functional Assessment of Cancer Therapy-General (FACT-GP), general Patient Reported Outcome Measure Information System (PROMIS) global health and validated measures of anxiety and depression...
May 2016: Gynecologic Oncology
Leslie Po, Patricia E Lee
OBJECTIVE: To study patients' perspectives regarding the risks and benefits of the use of power morcellation. DESIGN: Cross-sectional survey (Canadian Task Force classification II-3). SETTING: Academic tertiary referral hospital. PATIENTS: Women waiting in gynecology waiting rooms. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Of the 321 women invited, 310 (97%) responded to the survey; 19% of the participants had myomas requiring treatment, and the other 81% did not...
May 2016: Journal of Minimally Invasive Gynecology
Maria E J Leermakers, Noortje Pleunis, Dorry Boll, Ralph H Hermans, Nicole P M Ezendam, Johanna M A Pijnenborg
OBJECTIVES: Vulvar carcinoma is mainly treated surgically and has an overall good prognosis. Despite the development of minimally invasive surgical procedures in recent years, morbidity remains significant. The aim of the study was to determine the incidence and risk factors of erysipelas after surgical treatment for vulvar carcinoma. METHODS: This retrospective observational study was performed within the Comprehensive Cancer Centre South. The study included patients (N = 116) who underwent surgery for primary vulvar carcinoma between 2005 and 2012...
March 2016: International Journal of Gynecological Cancer
Giorgio Bogani, Antonino Ditto, Fabio Martinelli, Mauro Signorelli, Valentina Chiappa, Ilaria Sabatucci, Cono Scaffa, Domenica Lorusso, Francesco Raspagliesi
We reviewed the current evidence on the safety, effectiveness, and applicability of extraperitoneal robotic-assisted para-aortic lymphadenectomy (ExtRA-PAL) as the staging procedure of gynecologic malignancies. PubMed (MEDLINE), Scopus, Web of Science databases, and were searched for original studies reporting outcomes of ExtRA-PAL. Quality of the included studies and their level of recommendation were assessed using the Grading of Recommendations, Assessment, Development, and Evaluation and the American College of Obstetricians and Gynecologists guidelines, respectively...
May 2016: Journal of Minimally Invasive Gynecology
Anna Fagotti, Federica Perelli, Luigi Pedone, Giovanni Scambia
Minimally invasive surgery (MIS) currently is performed to stage and treat ovarian cancer at different stages of disease; however, the higher level of evidence from existing studies is IIB. Despite the absence of randomized controlled trials, MIS represents a safe and adequate procedure for treating and staging early ovarian cancer, and its use has increased significantly in clinical practice. Major concerns are related to minimizing tumor disruption or dissemination, removing the adnexal mass intact, adequate retroperitoneal staging, and fertility-sparing surgery for young patients...
January 2016: Current Treatment Options in Oncology
Frédéric Guyon, Gloria Cordeiro Vidal, Guillaume Babin, Eberhard Stoeckle, Denis Querleu
Minimally invasive surgery has demonstrated benefits that include improved pain control, decreased infection risk, and faster surgical recovery and return to work. Morcellation is an integral part of making laparoscopic surgery possible for the removal of large uterine leiomyomata, and the development of power morcellation has increased efficiency during these procedures. Morcellation may expose patients to increased morbidity in certain circumstances. This is particularly true in cases of unrecognized malignancy, where intra-abdominal dissemination of cancer may worsen the prognosis (overall survival and disease free survival)...
January 2016: Bulletin du Cancer
Audrey Tieko Tsunoda, Carlos Eduardo Mattos da Cunha Andrade, Marcelo Andrade Vieira, Ricardo dos Reis
Cervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertility-preserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity...
September 2015: Revista do Colégio Brasileiro de Cirurgiões
Satoru Sagae, Bradley J Monk, Eric Pujade-Lauraine, David K Gaffney, Kailash Narayan, Sang Young Ryu, Mary McCormack, Marie Plante, Antonio Casado, Alexander Reuss, Adriana Chávez-Blanco, Henry Kitchener, Byung-Ho Nam, Anuja Jhingran, Sarah Temkin, Linda Mileshkin, Els Berns, Suzy Scholl, Corinne Doll, Nadeem R Abu-Rustum, Fabrice Lecuru, William Small
OBJECTIVE: Cervical cancer is responsible for more than a quarter of a million deaths globally each year, mostly in developing countries, making therapeutic advances in all health care settings a top priority. The Gynecologic Cancer InterGroup (GCIG) is a worldwide collaboration of leading national research groups that develops and promotes multinational trials in gynecologic cancer. In recognition of the pressing need for action, the GCIG convened an international meeting with expert representation from the GCIG groups and selected large sites in low- and middle-income countries...
January 2016: International Journal of Gynecological Cancer
Tae-Wook Kong, Suk-Joon Chang, Xianling Piao, Jiheum Paek, Yonghee Lee, Eun Ju Lee, Mison Chun, Hee-Sug Ryu
AIM: This study investigates the pattern of disease recurrence and identifies the clinicopathologic prognostic factors for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB and IIA cervical carcinoma treated with laparoscopic/robotic radical hysterectomy (LRH/RRH). METHODS: We conducted a retrospective analysis of 128 patients with FIGO stage IB and IIA cervical cancer. Preoperative examination did not uncover definitive evidence of parametrial invasion or lymph node metastasis in any of the patients; therefore, all patients underwent LRH/RRH with retroperitoneal lymphadenectomy between April 2006 and December 2013...
January 2016: Journal of Obstetrics and Gynaecology Research
Megumi Yanokura, Kouji Banno, Miho Iida, Haruko Irie, Kiyoko Umene, Kenta Masuda, Yusuke Kobayashi, Eiichiro Tominaga, Daisuke Aoki
Endometrial cancer is a common malignant gynecological tumor, but there are few biomarkers that are useful for early and accurate diagnosis and few treatments other than surgery. However, use of microRNAs (miRNAs) that induces gene downregulation in cells may permit effective and minimally invasive diagnosis and treatment. In endometrial cancer cells, expression levels of miRNAs including miR-185, miR-210 and miR-423 are upregulated and those of miR-let7e, miR-30c and miR-221 are downregulated compared to normal tissues, and these miRNAs are involved in carcinogenesis, invasion and metastasis...
2015: EXCLI journal
Teuta Shemshedini, Tana S Pradhan, Tarah L Pua, Sean S Tedjarati
In the United States, the epidemic of obesity is readily apparent in women diagnosed with endometrial cancer, the most common gynecologic malignancy. Overall, the benefits of minimally invasive surgery and its oncologic outcomes are similar among laparoscopy and robotic approaches. However, in stratifying obese patients by BMI, more data is needed on morbidly obese patients and their candidacy for robotic surgery along with the technical challenges of staging procedures. Cost analysis studies targeted specifically to the obese and morbidly obese patient is needed to further justify efforts at promoting robotic surgery in this patient population...
June 2015: Journal of Robotic Surgery
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