hysterectomy in patients with large isthmoceles has not been well documented. Moreover, while desmoid tumors have been described as an extremely rare finding within a CSD, we could only find a single case report in which an ETT was found in someone with a CSD. We reviewed the literature surrounding CSDs in the context of our patient's clinical course. We concluded that: 1) high suspicion of CSD is warranted in a patient with unexplained amenorrhea and prior cesareans; 2) during hysterectomy, performing adhesiolysis by starting at the vesicocervical tissue and progressing superiorly may be helpful in the case of significant adhesive disease; and 3) is possible that ETT is related to CSD but further research is needed to examine this relationship.

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Measurements/Results: Of the 55 patients, at least one SLN was identified in 53 patients (96.4%), and bilateral SLNs were identified in 41 patients (77.3%). A total of 390 SLN was harvested, and the average SLN count of each pelvis was 4.0, distributed in the iliac vascular lymphatic region, obturator region and paracervical region. After pathological examination of these 53 patients, 12 showed lymph node metastasis with 10 occurring in the detected SLNs and the other two in the non-SLNs. The new method showed accuracy of 96.3% (51/53), a sensitivity of 80% (10/12), a false negative rate of 16.7% (2/12), and negative predictive value of 95.4% (41/43). Adverse reactions were not observed in any cases. Conclusions: With high overall and bilateral detection rates, carbon nanoparticles provide a feasible and efficient method in SLN mapping of cervical cancer.