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EPV198/#424 Laparoscopic restaging surgery for gynaecological malignancies
  1. O Puga1,
  2. M Urzua1 and
  3. E Pertossi2
  1. 1Hospital Dr Sotero del Rio, Obstetric and Gynecology, Santiago, Chile
  2. 2Pontificia Universidad Catolica de Chile, Obstetric and Gynecology, Santiago, Chile


Objectives To evaluate the feasibility and safety of laparoscopically staging patients with previous incomplete staged gynaecological cancers

Methods Patients without presurgical evidence of metastatic disease were laparoscopically reassessed. The procedure involved para-aortic and pelvic lymph node dissection and omentectomy for ovarian, fallopian tube and endometrial carcinoma; exclusive pelvic lymph node dissection for cervical carcinoma, oophorectomy and omentectomy for borderline tumors. Medical records were reviewed.

Results We performed 51 laparoscopic restaging surgeries: 14 ovarian cancer, 15 endometrial cancer, 17 borderline ovarian tumors, 4 cervical cancers and one fallopian tube carcinoma. Mean age was 48 years (16–70). In 39 patients the first surgery was performed by laparotomy. The mean body mass index was 28 (20–40). Operative room time was 203 min (70–390) and mean postoperative hospital stay was 2 days. We performed 32 pelvic lymphadenectomies (average 15 lymph nodes), 30 para-aortic lymphadenectomies (8 lymph nodes), 27 omentectomies and 17 hysterectomies. Average estimated blood lost was 85 cc. There was one laparo-conversion for adhesions, one bowel injury, one cardiorespiratory arrest at recovery room and 2 lymphatics cystics. Lymph nodes and omentum were negative for metastasis. There were no patients up staged, in 9 endometrial and 9 ovarian cancers the complete negative restaging allowed us to decide that adjuvant therapy was not necessary. Five patients received adjuvant radiotherapy and 5 chemotherapy

Conclusions Laparoscopy is a feasibility technical option to perform restaging of gynaecological malignancies. Decreasing hospital stay, postoperative pain, few blood lost and low morbidity. Laparotomy for adhesions and risk of visceral injury may be anticipated.

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