Seven cases of surgery of pancreatic tumors during pregnancy have been reported in the literature. Six of the cases resulted in live term births. The patient discussed herein, a 37-year-old para 2-0-0-2 white female, had surgery for the removal of a pancreatic mass at 20 2/7 weeks' gestation. No intraoperative complications occurred, and both mother and fetus appeared to have done well. The postoperative course was complicated by pseudomembranous enterocolitis caused by C. difficile, which was treated with antibiotics. Despite treatment, diarrhea continued, and the patient was readmitted to the hospital for hydration and further antibiotics at 27 weeks. Three days after admission, the fetus was noted to have poor biophysical testing and a caesarean delivery was performed. The infant was found to have a large intracerebral hemorrhage, which most likely occurred antenatally, and life support was discontinued shortly after birth. We conclude from this that surgery for a pancreatic mass in pregnancy should be approached cautiously, and the risk to both the mother and fetus should be considered.
Endometrial cancer remains the most common gynecologic malignancy in the Unites States and Western Europe. It has been estimated that in 2014, about 52, 630 new cases of endometrial cancer was diagnosed and about 8,590 died from the disease. Prior to 1988, endometrial cancer was staged clinically. Since that time surgical staging has been adopted. With the advancement in technology, the vast majority of cases are being staged and treated surgically via minimally invasive approaches. Conventional laparoscopy has been a major advancement in staging and treatment of uterine cancers. However, technical challenges such as 2-D imaging, rigid instruments, and lack of precision and surgeon fatigue did not translate into widespread adoption of this technique. With the advent of computer-enhanced robotic telesurgery, this has dramatically changed the surgical management and staging of endometrial cancer.
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