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Uterine carcinosarcomas are aggressive gynaecological cancers comprising less than 5% of uterine malignancies. We present the case of a woman in her 70s with a complicated history of advanced anal carcinoma treated with pelvic radiotherapy and multiple laparotomies, who was referred to gynae-oncology following MRI surveillance imaging showing evidence of endometrial carcinoma and para-aortic lymphadenopathy. Successful surgical excision required multidisciplinary teamwork between gynae-oncology, colorectal and urology surgeons. The patient underwent midline laparotomy, with adhesiolysis, ileum resection and side to side anastomosis, posterior exenteration, left kidney mobilisation and suspension, para-aortic lymph node debulking and left ureteric stent insertion. Significant challenge was posed by the extensive adhesions from previous laparotomies and the debulking of the para-aortic lymph nodes around the renal vessels. This case demonstrates the importance of a multidisciplinary approach in complex pelvic surgery and the vitality of good communication between colleagues in achieving effective patient care.

Gastric cancer is one of the commonest malignancies worldwide and is the fourth leading cause of cancer-related death. Commonly presenting at an advanced stage, the prognosis of gastric cancer is dismally poor, with an overall five-year survival of around 15%.  Here, I present one typical case, Mr AB, who was diagnosed with stage T3N1M0 gastric adenocarcinoma and underwent total gastrectomy with D2 lymphadenectomy and perioperative chemotherapy. This report will go on to examine the evidence base surrounding the management of non-early resectable gastric cancer relevant to Mr AB’s case, in particular D1 versus D2 lymphadenectomy and neoadjuvant chemo-radiotherapy.

surgery much less reported in literature. The aim of this study was to evaluate the frequency of nonfunctional complications associated to radical procedures and to determine if there is any risk factor associated with their appearance. Methodology A retrospective study was conducted including consecutive patients diagnosed with early-stage cervical cancer who underwent radical hysterectomy or radical trachelectomy at La Paz University Hospital from January 2005 to December 2019. Data from intraoperative complications, short-term (<30 days after surgery) and long-term (>30 days after surgery) complications were retrospectively collected. A multivariable analysis was performed in order to identify possible predictors of surgical complications. Results A total of 111 patients were included. Intraoperative complications occurred in 13 (11.7%) women. Multivariable analysis showed there was a greater risk of intraoperative complications if microscopic parametrial involvement was present (at postoperative analysis). 41 (36.9%) patients had any short-term postoperative complication, being urological complications the most frequent ones. 33 (29.7%) patients had any long-term complication, where lymphedema was the most frequent one (20 patients, 18%). Conclusion Urological complications are the most frequent ones in radical uterine procedures, especially bladder disfunction. However, other complications such as ureteral injury, fistula or lymphedema, are less frequent but also important due to their impact in the quality of life of patients. We found that parametrial involvement in postoperative pathological analysis was associated with higher intraoperative complications, being the most important factor impacting the presence of bladder dysfunction.