High rate of positive vaginal discharge cytology at the time of colpotomy in gynecologic cancer patients

Imai, Ken; Chikazawa, Kenro; Ito, Takaki; Kuwata, Tomoyuki; Konno, Ryo

doi:10.1016/j.tjog.2021.09.034

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…They concluded that laparoscopic intracorporeal colpotomy would increase the risk of tumor spread but that closing the upper vagina before colpotomy could effectively prevent tumor cell diffusion. Imai et al compared the positive rates of vaginal discharge cytology at the time of colpotomy during open and laparoscopic colpotomy in gynecologic cancer patients, and the results showed that all patients in cervical cancer were tested positive for vaginal discharge cytology irrespective of having undergone laparotomy or laparoscopy without uterine manipulator 37 . Based on these reports, new colpotomy procedures have been gradually adopted.…”

Section: Discussionmentioning

confidence: 99%

“…Imai et al compared the positive rates of vaginal discharge cytology at the time of colpotomy during open and laparoscopic colpotomy in gynecologic cancer patients, and the results showed that all patients in cervical cancer were tested positive for vaginal discharge cytology irrespective of having undergone laparotomy or laparoscopy without uterine manipulator. 37 Based on these reports, new colpotomy procedures have been gradually adopted. Boyraz et al 38 used an EndoGIA surgical stapler (Medtronic, Istanbul, Turkey) in vaginal closure, which places a high financial burden on patients.…”

Section: Discussionmentioning

confidence: 99%

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Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Huo

Huang

et al. 2022

J of Obstet and Gynaecol

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Aim:The purpose of this study was to investigate the surgical techniques and clinical feasibility of nonuterine manipulator and enclosed colpotomy to avoid cancer cell spillages in laparoscopic radical trachelectomy (LRT) for patients with early-stage cervical cancer. Methods: We performed the newly optimized surgical techniques of round ligament suspension and vaginal purse-string suture in LRT in 12 patients with early-stage cervical cancer from May 2019 to October 2020. Surgical information and postoperative results were recorded. Results: All 12 patients successfully underwent LRT with round ligament suspension and vaginal pursestring suture, and no conversion to laparotomy was required. The median operation time was 268.5 min (range 200-320 min), including 5 min of round ligament suspension, and the median blood loss was 20 mL (range 5-50 mL). The median number of pelvic lymph nodes removed was 27 (range 19-35), and median amounts of paracervical tissue was 24 mm (range 21-26 mm) and vaginal tissue was 18 mm (range 16-26 mm). No intraoperative complication or serious postoperative complications were reported. Conclusion: Round ligament suspension and vaginal purse-string suture techniques are feasible and effective in LRT. They can replace uterine manipulator and unprotected colpotomy with satisfactory perioperative outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Huo

Huang

et al. 2022

J of Obstet and Gynaecol

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“…Further, morcellating the intra-abdominal cavity is a risk factor for cancer cell spillage. [ 20 21 ] For malignant conditions, especially cervical cancer, there is a risk of recurrence in laparoscopic hysterectomy. [ 20 ] The route of lymph node removal was indicated as a risk factor for recurrence,[ 22 ] and laparoscopic surgery for malignant diseases is associated with several other complications, including urinary dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Perineal and Vaginal Lacerations and Vaginal Removal in Total Laparoscopic Hysterectomy

Chikazawa

Imai

et al. 2022

Gynecology and Minimally Invasive Therapy

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Objectives: This study aimed to identify risk factors associated with perineal and vaginal lacerations related to vaginal removal during total laparoscopic hysterectomy (TLH). Materials and Methods: We retrospectively assessed 134 patients who underwent TLH, of whom 44 (32.8%) had vaginal lacerations. Results: Univariate analysis revealed that for patients with myomas and adenomyosis, gonadotropin-releasing hormone agonist use and myomas with a transverse diameter of ≥5 cm were significant risk factors, while multiparity (vaginal delivery) was a protective factor for perineal and vaginal lacerations. Moreover, multivariate analysis indicated that multiparity was the only statistically significant protective factor. For cervical intraepithelial neoplasia, endometrial cancer, and endometrial hyperplasia, only a uterine transverse diameter of ≥5 cm was a significant risk factor for perineal or vaginal lacerations. Conclusion: For patients with large myomas, multiple vaginal delivery was a protective factor, and in patients with normal-sized uteri, a uterine transverse diameter of ≥5 cm was a risk factor for perineal or vaginal lacerations.

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Survival after laparoscopic radical surgery for stage IA–IIB cervical cancer: 1316 consecutive cases from a national laparoscopic training center in China

et al. 2022

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High rate of positive vaginal discharge cytology at the time of colpotomy in gynecologic cancer patients

Cited by 4 publications

References 5 publications

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

Risk Factors Associated with Perineal and Vaginal Lacerations and Vaginal Removal in Total Laparoscopic Hysterectomy

Survival after laparoscopic radical surgery for stage IA–IIB cervical cancer: 1316 consecutive cases from a national laparoscopic training center in China

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