RESUMO
BACKGROUND: Total laparoscopic hysterectomy (TLH) is becoming more commonly used for gynaecological malignancies. AIMS: To describe our experience with TLH since its introduction to our tertiary referral centre for gynaecological cancer in 2003. METHODS: Retrospective analysis of the first 120 consecutive cases of TLH performed at our gynaecological cancer centre. Patients were divided into the first, second and third group of 40 patients. Operating time, estimated blood loss, hospital stay, conversion to laparotomy and intra- and postoperative morbidity were evaluated. RESULTS: The three groups were similar with regard to baseline characteristics. For the entire group the mean hospital stay was 2.4 +/- 1.4 days and eight of 120 patients (6.6%) required conversion to laparotomy. Operating time, estimated blood loss and intraoperative morbidity were similar among the three groups. Postoperative morbidity was highest (25%) in the middle one-third of the patients (P = 0.022). The percentage of pelvic lymph node dissections increased from 2.5% in the first one-third of patients to 27.5% in the final one-third of patients (P = 0.003). CONCLUSIONS: TLH can be established safely in a tertiary gynaecological cancer referral centre.
Assuntos
Competência Clínica , Neoplasias dos Genitais Femininos/cirurgia , Histerectomia/métodos , Laparoscopia/métodos , Adulto , Idoso , Austrália , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: During major abdomino-pelvic surgery, there is a risk of severe haemorrhage. When routine measures at haemostasis fail, the overlay autogenous tissue (OAT) patch may be useful to control bleeding. CASE: We present a case report of the use of the use of an OAT patch to control haemorrhage of the spleen incurred during tertiary cytoreduction. CONCLUSION: The OAT patch should be considered in situations where bleeding is unable to be controlled after routine measures have failed and in instances other than for vascular injury alone. This technique has implications for practice in a wide range of gynaecologic oncology surgery.