Left External Iliac Vein Injury During Laparoscopic Pelvic Lymphadenectomy for Early-Stage Ovarian Cancer: Our Experience and Review of Literature

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Laparoscopic surgical staging is the standard treatment of early-stage ovarian tumors with similar survival outcomes if compared with laparotomic procedures. In this article, we report a case regarding an incidental external iliac vein injury during a pelvic lymphadenectomy for fertility sparing treatment of early-stage ovarian cancer with a video showing the laparoscopic repair without any consequence or side effect. A 36 year-old obese woman with Body Mass Index 30 kg/m ² referred at our hospital with an histological diagnosis of high grade ovarian serous carcinoma after a left laparoscopic salpingo-oophorectomy performed in another hospital. After an hysteroscopy with endometrial biopsy, a laparoscopic surgical staging with a pelvic and aortic lymphadenectomy with lymph-node dissection until the left renal vein, omentectomy, and appendectomy were performed. A thermal injury to the left external iliac vein occurred using the bipolar forceps during lymphadenectomy and was repaired after an immediate clamping of the site using endoclinch and the suction irrigator probe. The laceration on the iliac vein was successfully repaired using 10 mm laparoscopic titanium clips; after a follow-up of 42 months no recurrence was detected. In conclusion, laparoscopy is a safe and effective therapeutic option for fertility sparing treatment patients with early stage ovarian carcinoma with a significantly low morbidity and postoperative hospitalization, but it should be reserved for oncologic surgeons trained in advanced laparoscopic procedures and repair of vascular injuries potentially associated with high mortality rate.

Related collections

Most cited references 21

Record: found
Abstract: found
Article: not found

Total laparoscopic radical hysterectomy versus abdominal radical hysterectomy with lymphadenectomy in patients with early cervical cancer: our experience.

Francesco Cosentino, Raffaele Tinelli, Annarita Fusco … (2009)

The aim of this study was to retrospectively compare, in a series of 127 consecutive women, the safety, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (TLRH) with lymphadenectomy and abdominal radical hysterectomy with lymphadenectomy (ARH) for early cervical carcinoma. A total of 127 consecutive patients with International Federation of Gynecology and Obstetrics stage Ia1 (lymphvascular space involvement), Ia2, and Ib1 early cervical cancer, 65 of whom underwent TLRH and 62 of whom underwent ARH with pelvic lymph node dissection, comprised the study population. The para-aortic lymphadenectomy with the superior border of the dissection being the inferior mesenteric artery was performed in all cases with positive pelvic lymph nodes discovered at frozen section evaluation. The median blood loss in the ARH group (145 ml; range, 60-225 ml) was significantly greater than TLRH group (55 ml; range, 30-80 ml) (P < .01). The median length of hospital stay was significantly greater in the ARH group (7 days; range, 5-9 days) than TLRH group (4 days; range, 3-7 days) (P < .01). The median operating time was 196 min in the TLRH group (range, 182-240 min) compared with 152 min in the ARH group (range, 161-240 min) (P < .01). No statistically significant difference was found between the two groups when the recurrence rate was compared. Total laparoscopic radical hysterectomy is a safe and effective therapeutic procedure for management of early-stage cervical cancer with a far lower morbidity than reported for the open approach and is characterized by far less blood loss and shorter postoperative hospitalization time, although multicenter randomized clinical trials with longer follow-up are necessary to evaluate the overall oncologic outcomes of this procedure.

0 comments Cited 59 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Complications of laparoscopy: a prospective multicentre observational study.

F W Jansen, K Kapiteyn, T Trimbos-Kemper … (1997)

To determine the incidence and describe the complications of laparoscopic procedures in The Netherlands. A nationwide prospective multicentre observational study. Data on complications were registered from 1 January to 31 December 1994 by 72 hospitals. Any unexpected or unplanned event requiring intra-operative or post-operative intervention was defined as a complication. Complications were classified in two groups: approach and technique related complications. Complication rates were compared with these already published. Of 25,764 laparoscopic procedures, 145 complications occurred (rate 5.7 per 1000 [/1000]); two deaths occurred. In 84 women laparotomy was necessary (rate 3.3/1000). In 83 cases (57%; 95% CI for approach = 49-65%) the complication was caused by the surgical approach; in 62 cases (43%) the technique was at fault. Haemorrhage of the epigastric vein and intestinal injury, often requiring laparotomy (90% of cases) were the most frequently observed complications. The complication rate was 2.7/1000 for diagnostic laparoscopic procedures, 4.5/1000 for sterilisation and 17.9/1000 (chi 2 = 127; dF = 2; P < 0.001) for operative laparoscopy. The highest incidence was registered for complications occurring during laparoscopic (assisted) hysterectomy. Stepwise logistic regression analysis showed that previous laparotomy and surgical experience were associated with complications requiring laparotomy. Most complications occurred during operative laparoscopic procedures (rate 17.9/1000). Residents in training are required to learn diagnostic laparoscopy and sterilisation and this training programme results in a fall in the risk of the complications. However, operative laparoscopic procedures are still hazardous, especially laparoscopic hysterectomy. Women with a previous laparotomy are particularly at risk.

0 comments Cited 46 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Sentinel-Node Biopsy in Early Stage Ovarian Cancer: Preliminary Results of a Prospective Multicentre Study (SELLY)

S Uccella, C Nero, E Vizza … (2019)

0 comments Cited 27 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Raffaele Tinelli: URI : http://loop.frontiersin.org/people/1591163/overview

Miriam Dellino: URI : http://loop.frontiersin.org/people/1009173/overview

Luigi Nappi: URI : http://loop.frontiersin.org/people/1568129/overview

Maurizio Nicola D'Alterio: URI : http://loop.frontiersin.org/people/1150720/overview

Stefano Angioni: URI : http://loop.frontiersin.org/people/70635/overview

Giorgio Bogani: URI : http://loop.frontiersin.org/people/1587564/overview

Erica Silvestris: URI : http://loop.frontiersin.org/people/955184/overview

Journal

Journal ID (nlm-ta): Front Surg

Journal ID (iso-abbrev): Front Surg

Journal ID (publisher-id): Front. Surg.

Title: Frontiers in Surgery

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2296-875X

Publication date (Electronic): 09 March 2022

Publication date Collection: 2022

Volume: 9

Electronic Location Identifier: 843641

Affiliations

[1] ¹Department of Obstetrics and Gynecology, “Valle d'Itria” Hospital , Martina Franca, Taranto, Italy

[2] ²Department of Gynecology Oncology, “Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giovanni Paolo II” , Bari, Italy

[3] ³Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia , Foggia, Italy

[4] ⁴Department of Surgical Science, Cittadella Universitaria Blocco I, Asse Didattico Medicina P2, University of Cagliari , Cagliari, Italy

[5] ⁵Department of Obstetrics and Gynecology, University Medical School “La Sapienza” , Rome, Italy

[6] ⁶Department of Medical Oncology, National Oncology Institute “Moscati” , Taranto, Italy

[7] ⁷Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata Verona , Verona, Italy

Author notes

Edited by: Rafał Watrowski, University of Freiburg, Germany

Reviewed by: Luigi Turco, Mater Olbia Hospital, Italy; Francesco Cosentino, University of Molise, Italy; Antonino Ditto, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy

*Correspondence: Raffaele Tinelli raffaeletinelli@ 123456gmail.com

This article was submitted to Obstetrics and Gynecology, a section of the journal Frontiers in Surgery

Article

DOI: 10.3389/fsurg.2022.843641

PMC ID: 8959709

SO-VID: 85b3e122-3bdc-485e-aeb6-fde46eb6239e

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 26 December 2021

Date accepted : 31 January 2022

Page count

Figures: 1, Tables: 0, Equations: 0, References: 21, Pages: 5, Words: 3567

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.