RESUMO
Resumen El cáncer de vulva representa el 2% al 5% de todos los cánceres ginecológicos a nivel mundial, dentro de los cuales, el más frecuente es el carcinoma escamocelular seguido por el melanoma. La cirugía es la piedra angular en el tratamiento de la neoplasia vulvar, y la evaluación del estado ganglionar es un poderoso predictor de supervivencia. La linfadenectomía inguinofemoral hace parte de las estrategias de tratamiento. La aproximación quirúrgica mínimamente invasiva por video endoscopia (VEIL) es una alternativa a la vía abierta que disminuye la morbilidad postoperatoria como dehiscencia de la herida quirúrgica, linfocele, linfedema, infección y deterioro psicosexual. A continuación, se describe la técnica quirúrgica VEIL como abordaje novedoso en Colombia para el manejo de la neoplasia vulvar.
Abstract Vulvar cancer represents 2% to 5% of all gynecological cancers worldwide, of which the most common is squamous cell carcinoma followed by melanoma. Surgery is the cornerstone in the treatment of vulvar neoplasia, and evaluation of lymph node status is a powerful predictor of survival. Inguinofemoral lymphadenectomy is part of the treatment strategies. The minimally invasive surgical approach by video endoscopy (VEIL) is an alternative to the open approach that reduces postoperative morbidity such as dehiscence of the surgical wound, lymphocele, lymphedema, infection, and psychosexual deterioration. The following describes the surgical technique of VEIL, as a novel approach in Colombia for the management of this cancer.
Assuntos
Humanos , Feminino , Terapêutica , Ferida Cirúrgica , Excisão de Linfonodo , Linfonodos , Neoplasias Vulvares , Carcinoma de Células EscamosasRESUMO
Acute compartment syndrome of the hand is a potentially devastating and infrequent condition observed after trauma, arterial injury, or prolonged compression of the upper limb. We present the case of a patient diagnosed with compartment syndrome of the hand after laparoscopic surgery for epithelial ovarian cancer. The patient is a 42-year-old woman with incidental finding of high-grade ovarian serous carcinoma after an emergency surgery. On imaging evaluation, the patient was found to have evidence of residual retroperitoneal adenopathy and was taken to the operating room for a staging procedure by laparoscopy. In the immediate postoperative period, she developed compartment syndrome of the right hand that required multiple fasciotomies and multidisciplinary management by plastic surgery, orthopedics, and rehabilitation medicine. The patient was discharged from the hospital 7 days after laparoscopic surgery to undergo rehabilitation. Three months after surgery, she is continuing to recover, with near complete recovery of hand function. The patient has completed a total of 3 cycles of chemotherapy with carboplatin/paclitaxel. Compartment syndrome of the hand is an uncommon event, but it can generate major functional deficits and even death if it is not diagnosed and treated in a timely manner. Strict criteria for patient positioning in laparoscopy surgery may avoid or reduce this complication. To date, this is the first case reporting such complications associated with laparoscopic gynecologic surgery.
