Perceptions of obesity and cancer risk in female bariatric surgery candidates: highlighting the need for physician action for unsuspectingly obese and high risk patients.

Objectives: To determine: 1) whether obese women perceive themselves to be obese or at risk for malignancy, 2) perceived impact of obesity on cancer risks, 3) compliance with cancer screening, and 4) rates of menstrual dysfunction.

Methods: Surveys were administered to female patients presenting for bariatric weight loss surgery. Demographics, gynecologic history, perception of cancer risk, and screening history were collected/analyzed.

Vulvar necrotizing soft tissue infection: A review of a multi-disciplinary surgical emergency and management in the modern era.

► Mortality from necrotizing soft tissue infections of the vulva is 14% in this study. ► Multi-disciplinary care may contribute to the lower mortality in this case series.

It's not just for laparoscopy anymore: use of insufflation under ultrasound and fluoroscopic guidance by Interventional Radiologists for percutaneous placement of intraperitoneal chemotherapy catheters.

Objectives: While intraperitoneal (IP) chemotherapy has shown significant survival benefits, the ability to successfully deliver IP chemotherapy has been limited. In GOG 172, surgically-placed IP catheters had a reported complication rate of 34%. In addition, IP catheters have to be placed surgically.

The revolving door: hospital readmissions of gynecologic oncology patients.

Objective: Rehospitalization within 30 days of discharge was identified by the Obama Administration as a target for reducing health care spending. We examined readmissions to our gynecologic oncology service to determine: 1) rates of readmission, 2) indication for readmissions, 3) whether the admission was planned, and 4) costs.

Methods: IRB approval was obtained for this 5-year retrospective review (2004-2008).

Pre-operative gynecologic evaluation of bariatric surgery patients: improving cancer detection in a high-risk population.

Background: Obesity is strongly associated with endometrial and breast cancers; further, obese women are less likely to undergo recommended cancer screening. The objective was to determine the preoperative practices of bariatric surgeons with regard to gynecologic assessment and cancer screening.

Study Design: A 28-question survey was mailed to 1,503 US bariatric surgeons to assess self-reported perceptions of gynecologic cancer screening, preoperative evaluation of female patients, and gynecologic oncology awareness and knowledge.

Minimally invasive comprehensive surgical staging for endometrial cancer: Robotics or laparoscopy?

Objective: To compare outcomes between robotic versus laparoscopic hysterectomy and lymphadenectomy in patients with endometrial cancer.

Methods: A cohort study was performed by prospectively identifying all patients with clinical stage I or occult stage II endometrial cancer who underwent robotic hysterectomy and lymphadenectomy from 2006-2008 and retrospectively comparing data using the same surgeons' laparoscopic hysterectomy and lymphadenectomy cases from 1998-2005, prior to our robotic experience. Patient demographics, operative times, complications, conversion rates, pathologic results, and length of stay were analyzed.