In this study, perioperative outcomes and survival data in patients with early cervical cancer operated with three surgical methods: robot-assisted, laparoscopic and open, are to be analyzed. From January 2006 to May 2010, 294 patients with T1в1 cervical cancer were studied retrospectively. Robot-assisted radical hysterectomy (RARH) was performed in 73 (24.8%) of them, laparoscopic-assisted radical vaginal hysterectomy (LARVH) in 46 (15.6%) and, in 175, (59.5%), abdominal radical hysterectomy (ARH). Mean hospital stay of patients with RARH and LARVH was 4.1± 0.7 and 4.8±0.5, respectively, and of those with ARH, 9.6± 1.0 days (p=0.001). Mean operative time was 152.2± 26.5 min for the robotic group as it was significantly shorter in comparison with the laparoscopic group (232.1±61.7 min) and laparotomy group (168.2±31.1 min) (p=0.001). The application of Cox regression analysis found that the regional lymph node metastases were of significant value for diseasefree survival (DSF), and the nodal status and recurrence presence-for overall survival (OS). Type of surgical procedure did not influence DSF, as well as OS. RARH has been established to be a safe procedure with proven advantages in regard to operative time and hospital stay. The absence of significant differences in DSF and OS is a substantial reason to continue, from an oncologic point of view, the application of this method on patients with T1в1 cervical cancer.
Touch imprint cytology is a simple and quick method of intraoperative screening of SLNs for the presence of metastases in patients with breast cancer. Results may be improved by an appropriate enlargement of the surface sampled and the use of rapid CK-IHC on the touch preparations.
A 68-year-old female presented to the Gynecologic Oncology Clinic with a right-lower quadrant abdominal mass 3 × 4 cm in diameter palpable on pelvic examination. Her routine laboratory tests were normal. Transvaginal ultrasonography revealed a cystic mass in the right adnexa 3.9 cm in diameter, which was thought to arise in the ovary. At the time of laparoscopy, a 3 × 4 cm tumor arising from the distal end of the appendix was noted. A laparoscopic appendectomy with tumor removal was performed. Histologic examination of the surgical specimen revealed a mucocele of the appendix (AM). Although rare, this tumor should be considered in the differential diagnosis of a right adnexal mass. These tumors can be identified laparoscopically and removed by minimally invasive surgery.
Introduction A 29-year-old patient with cervical ectopic pregnancy (CEP) presented as "suspected" cervical mass, and irregular vaginal bleeding was directed to a gynecologic oncologist for consultation. During the examination a massive bleeding occurred. After an unsuccessful attempt to stop the bleeding with a balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed. The predisposing factors, the differential diagnostic possibilities and the clinical approaches in CEP are discussed. Total abdominal hysterectomy is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding. KEYWORDS cervical ectopic pregnancy; massive bleeding, hysterectomy Recently the rate of cervical pregnancy has increased, which can be explained by the most frequent use of assisted reproductive techniques and transvaginal ultrasound examination [4, 5]. Despite the diagnostic possibilities of the contemporary
Summary
Total mesorectal excision (TME) is a standard surgical procedure for rectal cancer. Robotic surgery has the potential to minimize the disadvantages of laparoscopic rectal resection. Circumferential margin and macroscopic quality assessment of the resected specimen are the major prognostic factors for local recurrence of the disease. The aim of this study was to research the macroscopic assessment of the quality of TME after robotic-assisted rectal resections for rectal cancer performed in a single center. Data was prospectively collected about macroscopic assessment of the quality of TME in thirteen patients after robotic-assisted rectal resections for rectal cancer between 09.04.2014 and 31.12.2016. After all robotic TMEs, a pathologist made macroscopic assessment of the completeness of the mesorectal excision. The quality of TME was complete in 12 cases and nearly complete in one case. The circumferential and distal resection margins were negative in all cases. The mean number of harvested lymph nodes was nine. This study indicated that using robotic surgery for rectal cancer does not lead to worsening the quality of TME. Further studies in this field are necessary.
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