ROBOTİK RADİKAL PARAMETREKTOMİ, PELVİKLENFADENEKTOMİ, VAJEN 1/3 ÜST KISMININ ÇIKARILMASI:OLGU SUNUMU

Amaç: “Robotik radikal parametrektomi (RRP)+pelvik lenfadenektomi (PND)+vajen 1/3 üst kısmının çıkarılması” ameliyatı uygulanan olgunun sunumu. Olgu Sunumu: Basit histerektomi sonrası invazif servikal kanser tespit edilen 61 yaşındaki hasta kliniğimize başvurdu. Hastaya “eksik cerrahi uygulanmış serviks kanseri” tanısıyla “RRP+PND+Vajen 1/3 üst kısmının çıkarılması” ameliyatı önerildi ve sonrasında başarıyla uygulandı. ‹ntra-operatif veya post-operatif komplikasyon olmadı. Sonuçlar: Konsol süresi 277 dakika olan ameliyatta toplam 35 adet pelvik lenf nodu çıkarıldı. Lenf nodlarında, parametriumlarda, vajen manşetinde metastaz saptanmadı. Hastaya per-op veya post-op kan transfüzyonu gerekmedi. Hastanın üriner sistem kateteri rezidü- el idrarın 90 cc gelmesi üzerine post-op 14. gün çekildi. Robotik radikal parametrektomi uygulanabilirlik ve güvenlik açı- sından diğer yöntemlerle karşılaştırıldığında efektif bir alternatif olarak görünmektedir. Occult serviks kanserlerinde radikal parametrektomi yapılan vakaların % 78-80’inde radyoterapinin gerekliliği önlenmektedir. Yaptığımız literatür araştırmasında, “RRP+PND+Vajen 1/3 üst kısmının çıkarılması” ameliyatının daha önce ülkemizden yayınlanmamış olduğunu ve literatürde de bu konudaki yayınların kısıtlı olduğunu tespit ettik.

ROBOTİK RADİKAL PARAMETREKTOMİ, PELVİKLENFADENEKTOMİ, VAJEN 1/3 ÜST KISMININ ÇIKARILMASI:OLGU SUNUMU

Objective: To present a case treated by “Robotic Radical Parametrectomy, Pelvic Lymphadenectomy, Resection of the Upper 1/3 Vagina” operation. Case: A 61 year old patient was admitted to our clinic because of the diagnosis of invasive cervical cancer after simple hysterectomy. “Robotic Radical Parametrectomy, Pelvic Lymphadenectomy, Resection of the Upper 1/3 Vagina” operation was offered to patient due to incomplete surgery. Surgery was completed succesfully and no intra-operative or post-operative complications were observed. Results: 35 pelvic lymph nodes were obtained during the operation and the console time was 277 minutes. All lymph nodes, parametria and vaginal cuff were negative for metastatic disease. Blood transfusion was not necessary for the patient, neither per-operatively nor post-operatively. Bladder catheter was removed on the 14th postoperative day, after a residual urine volume of 90 cc. Robotic radical parametrectomy represents an effective alternative to other methods in terms of feasibility and safety. Radical parametrectomy avoids the use of radiotherapy in approximately 78-80 % of the patients with occult cervical cancer. To our best knowledge “Robotic Radical Parametrectomy, PND, Resection of the Upper 1/3 Vagina” operation has not been published from our country and articles about this subject were limited and low in number in English literature

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  • 1. Zapardiel I, Zanagnolo V, Magrina JF, Magtibay PM. Robotic radical parametrectomy in cervical cancer. Gynecol Obstet Invest 2011;72:179-182.
  • 2. Ramirez PT, Schmeler KM, Wolf JK, Brown J, Soliman PT. Robotic radical parametrectomy and pelvic lymphadenectomy in patients with invasive cervical cancer. Gynecol Oncol 2008;111:18-21.
  • 3. Leath CA 3rd, Straughn JM, Bhoola SM, Partridge EE, Kilgore LC, Alvarez RD. The role of radical parametrectomy in the treatment of occult cervical carcinoma after extrafascial hysterectomy. Gynecol Oncol 2004;92:215-219.
  • 4. Magrina JF, Zanagnolo VL. Robotic surgery for cervical cancer. Yonsei Med J 2008;49:879-885.
  • 5. Suh DH, Chung HH, Kim JW, Park NH, Song YS, Kang SB. An occult invasive cervical cancer found after a simple hysterectomy: a 10-year experience in a single institution. Int J Gynecol Cancer 2011;21:1646-1653.
  • 6. Vitobello D, Siesto G, Bulletti C, Accardi A, Iedà N. Robotic radical parametrectomy with pelvic lymphadenectomy: our experience and review of the literature. Eur J Surg Oncol 2012;38:548-554.
  • 7. Wright JD, Grigsby PW, Brooks R et al. Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy. Cancer 2007;110:1281-1286.
  • 8. Yim GW, Kim SW, Nam EJ, Kim YT. Role of robot-assisted surgery in cervical cancer. Int J Gynecol Cancer 2011;21:173-181.
  • 9. Gori JR, Fritsches HG, Castanño R, Toziano M, Habich D. Radical parametrectomy for occult cervical carcinoma detected posthysterectomy. J Low Genit Tract Dis 2004;8:102-105.
  • 10. Chi DS, Abu-rustum NR, Hoskins WJ. Cancer of the Cervix. In:Rock JA, Jones HW (eds). Te Linde’s Operative Gynecology. Lippincott Williams & Wilkins. Philadelphia, USA, 2003; 1373-1444.
  • 11. Gadducci A, Tana R, Cosio S, Cionini L. Treatment options in recurrent cervical cancer (Review). Oncol Lett 2010;1:3-11.
  • 12. Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Management of occult invasive cervical cancer found after simple hysterectomy. Ann Oncol 2010;21:994- 1000.
  • 13. Yim GW, Kim YT. Robotic surgery in gynecologic cancer. Curr Opin Obstet Gynecol 2012;24:14-23.