Role of Intraoperative Ultrasound to Extend the Application of Minimally Invasive Surgery for Treatment of Recurrent Gynecologic Cancer

Mascilini, F.; Quagliozzi, Lorena; Moro, Francesca; Moruzzi, Maria Cristina; Gallotta, Valerio; Alletti, Salvatore Gueli; Scambia, Giovanni; Testa, Antonia Carla; Fagotti, Anna

doi:10.1016/j.jmig.2017.12.023

Cited by 14 publications

(13 citation statements)

References 26 publications

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“…Intraoperative ultrasound has been shown previously to have clinical relevance in more complicated cases, such as in women with gynecological malignancy recurrence undergoing minimally invasive surgery. In these cases, diffuse adhesions together with the lack of tactile feedback could impede the identification of the lesion. In the present case, frozen‐section analysis of the ovarian masses was in agreement with final pathology; however, the lymph node was positive for ovarian low‐grade serous carcinoma, influencing clinical decisions and the patient's prognosis.…”

supporting

confidence: 56%

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Intraoperative ultrasound diagnosis of metastatic lymph node in serous borderline ovarian tumor

Blasis

Tortorella

Macchi

et al. 2019

Ultrasound in Obstet & Gyne

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supporting

confidence: 56%

“…Intraoperative ultrasound represents a feasible and commonly available diagnostic instrument able to guide surgical procedures, and its role in gynecology is now emerging. Ultrasound is also able to evaluate accurately the morphology of lymph nodes, allowing identification of changes in their inner structure.…”

mentioning

confidence: 99%

Intraoperative ultrasound diagnosis of metastatic lymph node in serous borderline ovarian tumor

Blasis

Tortorella

Macchi

et al. 2019

Ultrasound in Obstet & Gyne

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“…Previous research has demonstrated that intraoperative ultrasound, using a transvaginal probe, represents a valid tool to facilitate complete tumor excision in recurrent borderline tumors and to detect location and extent of metastatic disease in gynecological cancer patients. In the present case, real‐time laparoscopic ultrasound imaging was effective in evaluation of the ovary for incision placement.…”

mentioning

confidence: 65%

Intraoperative ultrasound through laparoscopic probe in fertility‐sparing surgery for borderline ovarian tumor recurrence

Mascilini

Quagliozzi

Bolomini

et al. 2019

Ultrasound in Obstet & Gyne

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“…5 The adoption of this technique allows a precise and readily available method to specifically identify hidden disease and to avoid unnecessary invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasound-Guided Excision of Cardiophrenic Lymph Nodes in an Advanced Ovarian Cancer Patient

Moro¹,

Uccella²,

Testa³

et al. 2018

Int J Gynecol Cancer

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ObjectiveOvarian cancer is commonly diagnosed at an advanced stage. Complete macroscopic eradication of the disease is associated with improved prognosis. In this setting, the surgical resection of enlarged cardiophrenic lymph nodes (CPLNs) can help to achieve cytoreduction to no gross residual disease. During surgery, CPLN removal is usually performed either via video-assisted thoracic surgery or through a large transdiaphragmatic or subxiphoid incision. In the present case, we propose the use of an intraoperative transdiaphragmatic ultrasound to confirm preoperative imaging and to obtain a precise localization of the suspicious CPLNs.MethodsA 50-year-old woman without peritoneal carcinomatosis was diagnosed with bilateral ovarian cancer and enlarged inguinal, pelvic, aortic, and cardiophrenic nodes. She underwent primary debulking surgery, including radical hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritoneal biopsies, and bulky nodes resection, at the iliac, inguinal, and lumboaortic regions.ResultsAfter obtaining complete abdominal cytoreduction, an intraoperative ultrasound scan was performed. Two enlarged CPLNs were ultrasonographically visualized using a convex contact probe through a transhepatic window, and their exact location was identified. After complete mobilization of the right liver, the right diaphragm was incised, proximal to the site of the lymphadenopathies. The 2 lymph nodes were identified, grasped, and removed by transdiaphragmatic approach. Absence of other residual disease was confirmed by thoracic inspection, palpation, and by a subsequent intraoperative ultrasound control. At final histology, CPLNs were positive for infiltration of high-grade serous ovarian carcinoma.ConclusionsIntraoperative transdiaphragmatic ultrasound represents a possible approach to localize suspicious CPLNs and to guide their surgical eradication.

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Role of Intraoperative Ultrasound to Extend the Application of Minimally Invasive Surgery for Treatment of Recurrent Gynecologic Cancer

Cited by 14 publications

References 26 publications

Intraoperative ultrasound diagnosis of metastatic lymph node in serous borderline ovarian tumor

Intraoperative ultrasound diagnosis of metastatic lymph node in serous borderline ovarian tumor

Intraoperative ultrasound through laparoscopic probe in fertility‐sparing surgery for borderline ovarian tumor recurrence

Intraoperative Ultrasound-Guided Excision of Cardiophrenic Lymph Nodes in an Advanced Ovarian Cancer Patient

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