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SF005/#192 Strategy for mis uterine manipulation in cervical carcinosarcoma
  1. M Simonsen1,
  2. B Migliavacca2,
  3. A Teixeira1,
  4. P Doria2,
  5. F Asanuma2,
  6. A Santiago2,
  7. A Ferreira1,
  8. M Lanoni1,
  9. I De andrade3,
  10. L Silva3,
  11. B Fernandes3,
  12. M De Mello Amaral3 and
  13. M Samora1
  1. 1Hospital 9 de Julho, Gynecologic Oncology, São Paulo, Brazil
  2. 2Hospital 9 de Julho, Gynecology, São Paulo, Brazil
  3. 3IAMSPE, Gynecology, São Paulo, Brazil


Introduction Uterine manipulation could be associated with worst outcomes even in endometrial cancer, as suggested recently. In this video we demonstrated simple techniques to overcome the potential tumor spillage during uterine manipulation.

Description LAGOH 57 yo had a low differentiated adenocarcinoma involving uterine isthmus with 5,1 x 6,4cm with endometrial, cervical and right parametrial involvement. Pathologic report suggested an endometrial origin of the tumor. We proposed to do a radical hysterectomy and retroperitoneal lymph node dissection Our team offered to the patient minimally invasive surgical approach and regarding the big dimension of the tumor’s cervical component we opted to avoid tumor spillage during uterine manipulation with the following measures: we used a big polypropylene graduated cylinder and fixed the device in the 4 cervical quadrants with stiches. For mobilizing uterine corpus, we used an hysterometer involved with bladder catheter placed in the uterus cavity. Radical hysterectomy, para-aortic lymph node dissection and pelvic lymph node debulking were performed uneventfully in 5h 10 min. Pathologic report accused carcinosarcoma with pelvic lymph nodes involvement, parametrial infiltration and free margins (FIGO IIIC). After 6 cycles of carboplatin/paclitaxel and adjuvant radiotherapy, LAGOH maintains one year of outpatient follow-up without evidence of recurrence.

Conclusion While data related with the impact of uterine manipulation in endometrial/uterine corpus cancer is still not available in multiple prospective trials, it is rational to develop strategies to optimize safety of the procedure.

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