[The management of cervical cancer cases in pregnancy and puerperium]. / Postepowanie w przypadkach raka szyjki macicy w czasie ciazy i pologu.

UNLABELLED: Cervical cancer in women during pregnancy and puerperium is a serious diagnostic and therapeutic problem. Twelve multiparas with confirmed cervical cancer during pregnancy, delivery and puerperium were examined. The mean age of the group was 35. In two of them cervical cancer was diagnosed in the second trimester, in 5 in the third trimester and in 5 in puerperium. Clinical stage according to FIGO was as follow: Ib--9 patients, IIa--2 patients, III--1 patient. In two patients operated in the second trimester--extended hysterectomy was performed. In four women cesarean section with extended hysterectomy and lymphadenectomy was performed. Only one patient in third trimester had cesarean section and in the same time unradical hysterectomy because of bleeding. In two patients in puerperium extended hysterectomy was performed (Meigs operation). Three patients underwent only radiotherapy. All patients who were operated on underwent subsequent radiotherapy. CONCLUSIONS: Cervical cancer during pregnancy and puerperium is diagnosed very late, usually in advanced stage. It is connected with lack of clinical and cytological examination of women before pregnancy. Principles of treatment of cervical cancer in pregnancy and puerperium do not differ from those applicable in other patients.

[Wound healing after vulvar surgery]. / Gojenie sie ran po operacjach sromu.

Vulvular wounds healing is an important problem in vulvar surgery. Prolonged healing worsens patients quality of live, and is related to prolonged hospitalization and use of antibiotics. The aim of this report is to analyse factors, which may influence vulvular wounds healing. It was found that extended vulvar surgery and advanced age of patients are the negative factors in vulvar wound healing. Antibioticotherapy, drainage and diseases like diabetes mellitus, hypertension and obesity don't affect the vulvular wounds healing.

[The place of second-look laparoscopy in monitoring treatment of advanced malignant ovarian neoplasms]. / Miejsce second-look laparoskopii w monitorowaniu leczenia zaawansowanych postaci nowotworów zlosliwych jajnika.

The role of second-look laparotomy in management of advanced ovarian cancer is still controversial. One of the arguments against this method is the risk of this wide operation. Replacement of second-look laparotomy by laparoscopy maybe the way to minimize that risk. The aim of this report is the comparison of second-look laparotomy and laparoscopy. The prospectively gathered material consists of 56 women with ovarian cancer, 17 of them were qualified for second-look procedures. Laparoscopy was the first step in this procedure. In 5 patient the residual malignancy in abdominal cavity was found. In 11 there were no evidence of the disease, and in 1 case laparoscopic inspection was impossible. When the laparoscopy was negative or impossible the second-look laparotomy was performed. Only in one case after negative laparoscopy the evidence of malignancy during laparotomy was found. In our opinion: 1) Positive second-look laparoscopy is equivalent to laparotomy and permits to avoid it. 2) The negative second-look laparoscopy with its contemporary technique still requires the subsequent laparotomy.

Primary invasive vaginal carcinoma treated with radiotherapy: analysis of prognostic factors.

Between 1965 and 1988, 125 patients with primary invasive vaginal carcinoma were treated with radiation therapy at the Center of Oncology in Kraków. Twenty-two superficial stage I patients received radium or cesium intracavitary radiation alone. The remaining 11 patients with stage I disease whose lesions were either large or thick and 77 patients with stages II and III were treated with a combination of external irradiation followed by intracavitary brachytherapy. Fifteen patients with stage IVA received external irradiation only. Five-year NED survival was achieved in 42.4% of patients. In the Cox multivariate analysis three variable were independently related to beneficial survival: grade G1 + G2, stage I + II, and age below 60 years. Of 66 patients who died of vaginal cancer, locoregional failure was found in 51 (77.3%), locoregional and distant in 5 (7.6%), and distant only in 10 (15.1%) patients. Late radiation morbidity occurred in 16 (12.8%) patients.