Perpustakaan Fakultas Kedokteran dan Ilmu Kesehatan

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Is pre-operative risk-assessment in laparoscopic treatment of presumed low-risk endometrial cancer effective?

Heijden, P. A. H. H. van der - Nama Orang; Y. P. Geels - Nama Orang; S. H. M. van den Berg-van Erp - Nama Orang; L. F. A. G. Massuger - Nama Orang; M. P. M. L. Snijders - Nama Orang;

Abstract In endometrial (pre)malignancy the pre-operative work-up is primarily based on the histopathological specimen obtained. Total laparoscopic hysterectomy with bilateral
salpingo-oophorectomy (TLH + BSO) in presumed low-risk clinical stage I endometrioid endometrial carcinoma (EEC) or atypical hyperplasia (AH), is nowadays considered preferred
and sufficient treatment in the Netherlands. To test the effec-tiveness of this pre operative work-up, a retrospective cohort analysis was performed. Revised pre- and post-operative his-topathologywas compared and intra- and post-operative com-plications registered. In 116 consecutive patients with a pre-operative diagnosis of AH or presumed stage I, grade I or II EEC planned for TLH + BSO. In 24.1 % (28/116) revised endometrial histopathology was upgraded on the definitive hysterectomy specimen. In 3.5 % (4/116) pgrading to high-risk grade III endometrial cancer (EC) was observed. In 9.9% (8/81) of EC cases a post-operative FIGO stage IG3, II, or III was diagnosed. The major and minor short-term complication rates of TLH + BSO were 12.1 and 7.8 %. In 13.8% (16/116) of cases conversion to laparotomy was necessary, with a significant higher percentage of obese (68.8 %) patients in the conversion versus the successful TLH + BSO group (42 %). Clinical relevant inconsistency between pre- and post-operative histopathology or FIGO stage was observed in 9.9 % of EC cases. More extensive pre-operative risk analysis of presumed low-risk EEC may be indicated, espe-cially for the morbid obese, harboring a substantial risk for conversion to laparotomy and complications.


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Informasi Detail
Judul Seri
-
No. Panggil
Artikel
Penerbit
USA : Springer., 2013
Deskripsi Fisik
-
Bahasa
English
ISBN/ISSN
DOI 10.1007/s10397-0
Klasifikasi
NONE
Tipe Isi
-
Tipe Media
-
Tipe Pembawa
-
Edisi
Gynecol Surg (2014) 11:97–103
Subjek
Medicine
endometrial cancer
pre-operative
Info Detail Spesifik
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Pernyataan Tanggungjawab
-
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  • Is pre-operative risk-assessment in laparoscopic treatment of presumed low-risk endometrial cancer effective?
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