RESUMEN
OBJECTIVE: Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer. METHODS: The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. RESULTS: The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition). CONCLUSIONS: As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
Asunto(s)
Preservación de la Fertilidad , Oncología Quirúrgica , Traquelectomía , Neoplasias del Cuello Uterino , Brasil , Consenso , Femenino , Humanos , Estadificación de Neoplasias , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugíaRESUMEN
INTRODUÇÃO: Escalpelamento é trauma causado por avulsão parcial ou total do couro cabeludo, decorrente, principalmente, de contato acidental dos cabelos longos com motor de eixo rotativo. A alta rotação desses motores gera uma força que suga os cabelos da vítima, tracionando e arrancando o couro cabeludo de forma abrupta. MÉTODO: Foi realizado um estudo observacional transversal, retrospectivo, descritivo, incluindo 62 pacientes vítimas de escalpelamento tratados na Fundação Santa Casa de Misericórdia do Pará. RESULTADOS: Os pacientes mais acometidos foram crianças de 7 anos a 16 anos (56,4%), do gênero feminino (93,5%), sendo 59,7% estudantes e que, predominantemente, praticavam a religião católica (43,5%). CONCLUSÕES: Campanhas profiláticas sobre os riscos de se viajar e manter uma embarcação sem proteção no eixo do motor são fundamentais, uma vez que a tragédia do escalpelamento é causada principalmente pelos cabelos que se enrolam no eixo do motor.
BACKGROUND: Scalping is a trauma caused by partial or total avulsion of the scalp. It is primarily due to accidental contact of long hair with the rotary shaft of a motor. Rotary shafts suck in the victim's hair, causing traction and abruptly pulling the scalp off. METHODS: A longitudinal, observational, retrospective, and descriptive study of 62 scalping victim-patients treated at Fundação Santa Casa de Misericórdia do Pará was conducted. RESULTS: The most commonly affected patients were children between 7 and 16 years of age (56.4%) and women (93.5%); 59.7% were students and 43.5% were Catholics. CONCLUSIONS: Prophylactic campaigns about the risks of traveling in and maintaining a vessel without motor shaft protection are essential because scalping is primarily caused by hair twisting around the motor shaft.