Radical hysterectomy and vaginectomy with sigmoid vaginoplasty for stage I vaginal carcinoma

Abstract

Radical hysterectomy and vaginectomy with sigmoid vaginoplasty was a reasonable option for patients with stage I vaginal carcinoma who wished to retain sexual function after surgery.

Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors

“…Due to the anatomy of the region and the close proximity of the vagina to critical pelvic structures such as the bladder, urethra and rectum, surgery has a limited role in the management of vaginal carcinoma [1,6,[42][43][44][45][46][47]. The standard treatment is radiotherapy, which utilizes external beam radiation [EBRT] and/or brachytherapy [BT] techniques [6,22,[48][49][50][51][52][53][54][55][56][57][58][59][60][61].…”

“…Nowadays, surgery can be taken into consideration in accurately selected cases of: (i) stage I disease confined to the upper posterior vagina; (ii) stage IV disease with recto-vaginal or vesico-vaginal fistula; (iii) central recurrence after radiotherapy [1,6,42,44,45,47,[69][70][71]. As far as the patients with stage I disease are concerned, surgery consists of radical hysterectomy, upper vaginectomy and pelvic lymphadenectomy if the uterus is still in situ, and radical upper vaginectomy and pelvic lymphadenectomy if the uterus has been previously removed.…”

“…In any case, vaginal resection must achieve a clearance of at least 1 cm. Vertical rectus abdominis myocutaneous flap and, more recently, sigmoid colon have been used for vaginal reconstruction [42,43,47,72]. Ling et al [42] performed a laparoscopic radical hysterectomy with vaginectomy and sigmoid vaginoplasty in four women with stage I disease located at the upper third or two thirds of the vagina.…”

“…There were no intra-operative and post-operative complications, and all women were free of disease with a satisfactory sexual life after mean follow-up of 46 months. Yin et al [47] described five cases of carcinoma of the upper third of the vagina treated with radical hysterectomy, vaginectomy, pelvic lymphadenectomy, and sigmoid vaginoplasty. All patients recovered well after surgery, no recurrence or delayed complications occurred during a mean follow-up of 22.8 months, and all patients were satisfied with their sexuality.…”

A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia

“…These techniques are generally used after exenterative procedures to both create a vagina and fill up the empty pelvis. Recently, a laparoscopic treatment of a vaginal carcinoma with vaginoplasty using a sigmoid segment was reported in 5 patients with good results [5]. However, this complex approach requires a large bowel resection with potential serious complications.…”