A restrictive stoma policy after colorectal anastomosis in ovarian cancer based on ghost ileostomy use.

Background: The incidence of anastomotic leak after colorectal anastomosis in ovarian cancer has been reported to be much lower than that in colorectal cancer patients. Regarding the use of protective manoeuvres (diverting ileostomy) as suggested by clinical guidelines, the goal should be the implementation of a restrictive stoma policy for ovarian cancer patients, given the low rate of anastomotic leakage in this population.

Material And Methods: Patients who underwent cytoreduction surgery in a single centre (University Hospital La Fe, Valencia Spain) due to ovarian cancer between January 2010 and June 2023 were classified according to two groups: a non-restrictive stoma policy group (Group A) and a restrictive stoma policy group (Group B).

An Easy Learning Approach to a Complex Surgical Technique: A Step-by-Step Site-Relapse Lateral Extended Endopelvic Resection (LEER).

Lateral pelvic sidewall involvement by gynecological tumors has been considered traditionally an absolute contraindication to curative resection. Moreover, the involvement of the pelvic sidewall at the time of relapse in cervical cancer after primary or adjuvant pelvic radiation occurs in 8.3% of patients.

Optimal cytoreduction: is a CT's picture worth a surgeon's word?

Introduction: The presence of residual disease after cytoreductive surgery is subjectively determined by the surgeon at the end of the operation. Nevertheless, in up to 21-49% of CT scans, residual disease can be found. The aim of this study was to establish the relationship between post-surgical CT findings after optimal cytoreduction in patients with advanced ovarian cancer and oncological outcome.

Comparation between the Bricker ileal conduit vs double-barrelled wet colostomy after pelvic exenteration for gynaecological malignancies.

Background: After exhausting other therapeutic options, pelvic exenteration is performed in patients who suffer from relapsed gynaecologic tumours, with most of them requiring some sort of urinary diversion.

Material And Methods: The main objective of this study was to assess the short- and medium/long-term urinary complications associated with the Bricker ileal conduit versus double-barrelled wet colostomy after performing a pelvic exenteration for gynaecologic malignancies.

Results: A total of 61 pelvic exenterations were identified between November 2010 and April 2022; 29 Bricker ileal conduits and 20 double-barrelled wet colostomies were included in the urinary diversion analysis.

Ultrastaging protocol in sentinel lymph node for apparent early stage ovarian cancer.

Objective: The objective of the present study is to determine the role of sentinel lymph node (SLN) ultrastaging in apparent early-stage ovarian cancer.

Methods: We previously demonstrated the feasibility of SLN in early-stage ovarian cancer in a pilot study and in a clinical trial (NCT03452982). The SLN of the 30 patients involved in both were processed following an ultrastaging protocol.

Vesicovaginal Fistula Repair by Modified Martius Flap: A Step-by-Step Surgical Technique Video.

Background: Fistula repair in the perineal region represents a major challenge for surgeons. It is important for the medical community to facilitate and disclose these techniques.

Objective: The aim of this article was to show a stepwise approach for a direct repair and use of a Martius flap for a vesicovaginal fistula.

Indications and practice of diverting ileostomy after colorectal resection and anastomosis in ovarian cancer cytoreduction.

Objective: To determine the factors related with diverting ileostomy performance after colorectal resection and anastomosis, in advanced ovarian cancer cytoreductive surgery.

Methods: We have previously demonstrated the risk factors associated with anastomotic leak after colorectal anastomosis: Advanced age at surgery, low serum albumin level, additional bowel resections, manual anastomosis and distance of the anastomosis from the anal verge. However, use of diverting ileostomy is strongly variable and depends on individual surgeon preferences and training.

Protective Maneuver to Avoid Tumor Spillage during Laparoscopic Radical Hysterectomy: Vaginal Cuff Closure.

Objective: To demonstrate the feasibility of a protective maneuver to avoid tumor exposure during laparoscopic radical hysterectomy.

Design: This video illustrates the vaginal cuff closure technique in cervical cancer surgery.

Setting: The Oncologic Gynecology Department at the University Hospital La Fe.

Sentinel lymph node technique in early-stage ovarian cancer (SENTOV): a phase II clinical trial.

Objective: Early-stage ovarian cancer might represent an ideal disease scenario for sentinel lymph node application. Nevertheless, the published experience seems to be limited. Our objective was to assess the feasibility and safety concerns of sentinel lymph node biopsy in patients with clinical stage I-II ovarian cancer.

Comparative study of three different managements after colorectal anastomosis in ovarian cancer: conservative management, diverting ileostomy, and ghost ileostomy.

Objective: Anastomotic leak remains the main concern after colorectal anastomosis in ovarian cancer. Our objective was to compare the use of three different management approaches after colorectal resection and anastomosis in patients with ovarian cancer.

Methods: Between January 2010 and June 2018, a total of 133 patients with International Federation of Gynecology and Obstetrics (FIGO) stage II-IV ovarian cancer who underwent colorectal resection and anastomosis were included.

Port site resection after laparoscopy in advance ovarian cancer surgery: Time to abandon?

Introduction: The use of laparoscopy in the treatment and management of advanced ovarian cancer is increasing among the gynaecologic oncologists. The development of port site metastases after laparoscopy is a concern and a matter of debate due to theoretical iatrogenic disease spread. Port site resection (PSR) has been proposed as an option to avoid this scenario.

Obstetric complications as a challenge after radical trachelectomy: a review of the literature.

Cervical cancer is the fourth most frequent cancer in women worldwide and the ninth cause of death in women between 30 and 49 years of age. Increase in early detection and diagnosis has allowed the implementation of more conservative management strategies. The radical trachelectomy (RT) is considered the treatment of choice for patients with early stage cervical cancer that desire fertility preservation, without compromising oncologic outcomes.

Risk factors for anastomotic leakage after colorectal resection in ovarian cancer surgery: A multi-centre study.

Objective: To determine pre-/intraoperative risk factors for anastomotic leak after modified posterior pelvic exenteration (MPE) or colorectal resection in ovarian cancer and to create a practical instrument for predicting anastomotic leak risk.

Background: In advanced ovarian cancer surgery, there is rather limited published evidence, drawn from a small sample, providing information about risk factors for anastomotic leak.

Methods: Eight hospitals participated in this retrospective study.

Clinical application of the sentinel lymph node technique in early ovarian cancer: a pilot study.

Introduction: There is limited evidence favoring the use of the sentinel lymph node technique in ovarian cancer, and no standardized approach has been studied. The objective of the present pilot study is to determine the feasibility of the sentinel lymph node technique by applying a clinical algorithm.

Methods: Patients with confirmed ovarian cancer were included.

Repeatable Interindividual Variation in Hypoxia Tolerance in the Gulf Killifish, Fundulus grandis.

The capacity of fishes to tolerate low oxygen (hypoxia) through behavioral and physiological adjustments varies among species in a fashion that correlates with oxygen availability in their natural habitats. Less is known about variation in hypoxia tolerance within a species, but it is expressly this interindividual variation that will determine which individuals will survive during severe hypoxia. Here, we measured aquatic surface respiration (ASR) and loss of equilibrium (LOE), two common indexes of hypoxia tolerance of fishes, in gulf killifish, Fundulus grandis, subjected to multiple trials of a highly reproducible hypoxia protocol over a period of 6-8 wk.

Ghost Ileostomy in Advanced Ovarian Cancer: A Reliable Option.

Objective: Diverting ileostomy (DI) has been proposed to reduce the incidence and consequences anastomotic leakage after bowel resection. In colorectal cancer treatment, ghost ileostomy (GI) has been proposed as an alternative to DI. Our objective was to report the results of GI associated with colorectal resection in the treatment of ovarian cancer.

Radical peritonectomy in advanced ovarian cancer.

In order to reach cytoreduction in advanced ovarian cancer, peritonectomy and diaphragmatic stripping are procedures required to remove the disease in the upper abdomen. Diaphragm involvement is estimated in up to 40% of cases. Nevertheless, in some of these patients, the tumour volume may constitute a limitation of the technique due to the association with abdominal wall involvement, bulky tumour at the Morrison's pouch or liver infiltration.