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1.
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1520016

ABSTRACT

El angiomixoma agresivo pélvico es un tumor de partes blandas extremadamente raro, del cual se han reportado alrededor de 350 casos hasta la fecha. A continuación se reporta el caso clínico de una paciente que presentó dicho tumor y se describe el proceso diagnóstico y su tratamiento quirúrgico. Por otro lado, se realiza una breve revisión de la literatura disponible hasta el momento sobre el tema.


Aggressive pelvic angiomyxoma is an extremely rare soft tissue tumor, of which around 350 cases have been reported to date. This article aims at reporting the case of a patient presenting said tumor, as well as describing its diagnostic approach and its surgical treatment. On the other hand, it aims at briefly reviewing the available literature on the subject.


O angiomixoma pélvico agressivo é um tumor extremamente raro dos tecidos moles, tendo sido descritos até à data cerca de 350 casos. Relatamos o caso de uma doente que apresentava este tumor e descrevemos o processo de diagnóstico e tratamento cirúrgico. É também feita uma breve revisão da literatura disponível até à data sobre o assunto.


Subject(s)
Humans , Female , Middle Aged , Pelvic Neoplasms/surgery , Pelvic Neoplasms/diagnostic imaging , Myxoma/surgery , Myxoma/diagnostic imaging , Biopsy , Magnetic Resonance Imaging
2.
Chinese Journal of Gastrointestinal Surgery ; (12): 260-267, 2023.
Article in Chinese | WPRIM | ID: wpr-971260

ABSTRACT

Objective: To investigate the surgical indications and perioperative clinical outcomes of pelvic exenteration (PE) for locally advanced, recurrent pelvic malignancies and complex pelvic fistulas. Methods: This was a descriptive study.The indications for performing PE were: (1) locally advanced, recurrent pelvic malignancy or complex pelvic fistula diagnosed preoperatively by imaging and pathological examination of a biopsy; (2)preoperative agreement by a multi-disciplinary team that non-surgical and conventional surgical treatment had failed and PE was required; and (3) findings on intraoperative exploration confirming this conclusion.Contraindications to this surgical procedure comprised cardiac and respiratory dysfunction, poor nutritional status,and mental state too poor to tolerate the procedure.Clinical data of 141 patients who met the above criteria, had undergone PE in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to September 2022, had complete perioperative clinical data, and had given written informed consent to the procedure were collected,and the operation,relevant perioperative variables, postoperative pathological findings (curative resection), and early postoperative complications were analyzed. Results: Of the 141 included patients, 43 (30.5%) had primary malignancies, 61 (43.3%) recurrent malignancies, 28 (19.9%) complex fistulas after radical resection of malignancies,and nine (6.4%)complex fistulas caused by benign disease. There were 79 cases (56.0%) of gastrointestinal tumors, 30 cases (21.3%) of reproductive tumors, 16 cases (11.3%) of urinary tumors, and 7 cases (5.0%) of other tumors such mesenchymal tissue tumors. Among the 104 patients with primary and recurrent malignancies, 15 patients with severe complications of pelvic perineum of advanced tumors were planned to undergo palliative PE surgery for symptom relief after preoperative assessment of multidisciplinary team; the other 89 patients were evaluated for radical PE surgery. All surgeries were successfully completed. Total PE was performed on 73 patients (51.8%),anterior PE on 22 (15.6%),and posterior PE in 46 (32.6%). The median operative time was 576 (453,679) minutes, median intraoperative blood loss 500 (200, 1 200) ml, and median hospital stay 17 (13.0,30.5)days.There were no intraoperative deaths. Of the 89 patients evaluated for radical PE surgery, the radical R0 resection was achieved in 64 (71.9%) of them, R1 resection in 23 (25.8%), and R2 resection in two (2.2%). One or more postoperative complications occurred in 85 cases (60.3%), 32 (22.7%)of which were Clavien-Dindo grade III and above.One patient (0.7%)died during the perioperative period. Conclusion: PE is a valid option for treating locally advanced or recurrent pelvic malignancies and complex pelvic fistulas.


Subject(s)
Humans , Pelvic Exenteration/methods , Pelvic Neoplasms/surgery , Retrospective Studies , Neoplasm Recurrence, Local/surgery , Postoperative Complications
3.
Int. j. morphol ; 37(2): 677-681, June 2019. graf
Article in Spanish | LILACS | ID: biblio-1002275

ABSTRACT

El angiomixoma de la pelvis es un tumor mesenquimal inusual; que dado su alto potencial de recidiva es relevante que la exéresis quirúrgica sea lo más radical posible. Por su parte, la endometriosis infiltrativa profunda, es otra entidad poco frecuente que requiere de tratamientos complejos. La co-existencia de ambas patologías representa una situación absolutamente infrecuente; de los que hay muy pocos casos reportado en la literatura occidental. Se presenta el caso de una mujer de 41 años de edad que desarrolló ambas entidades nosológicas de forma concomitante y que fue tratada quirúrgicamente con buenos resultados.


Angiomyxoma of the pelvis is an unusual mesenchymal tumor; that given its high potential for recurrence, it is relevant that the surgical resection be as radical as possible. For its part, to deep infiltrative endometriosis is another rare entity that requires complex treatments. The co-existence of both pathologies represents an absolutely infrequent situation; of which there are very few cases reported in western literature. We present the case of a 41-year-old woman who developed both clinical entities concomitantly and who was treated surgically with good results.


Subject(s)
Humans , Female , Adult , Pelvic Neoplasms/pathology , Endometriosis/pathology , Myxoma/pathology , Pelvic Neoplasms/surgery , Pelvic Neoplasms/complications , Colectomy , Endometriosis/surgery , Endometriosis/complications , Myxoma/surgery , Myxoma/complications
6.
Acta ortop. bras ; 21(3): 150-154, maio-jun. 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-681802

ABSTRACT

Objetivos: A reconstrução pélvica após excisão de tumor é um desafio. Métodos: realizou-se um estudo retrospectivo para comparar os desfechos entre pacientes submetidos a cirurgia de reconstrução da pelve com aloenxerto ósseo após excisão em bloco de tumores pélvicos e pacientes submetidos apenas à excisão. Resultados: os pacientes sem reconstrução tiveram escores funcionais significantemente menores 3 meses (10 vs. 15, P = 0,001) e 6 meses após a cirurgia (18,5 vs. 22, P = 0,0024), menor tempo de hospitalização (16 dias vs. 40 dias, P < 0,001) e menor custo hospitalar (97.500 vs.193.000 yuans, P < 0,001) do que os que foram submetidos a reconstrução pélvica. Os escores funcionais foram similares 12 meses depois da cirurgia (21,5 vs. 23, P = 0,365) sem diferença na taxa de complicações entre os dois grupos (P > 0,05). Conclusões: A reconstrução pélvica com aloenxerto ósseo depois de cirurgia de tumores pélvicos é associada a desfechos cirúrgicos e funcionais satisfatórios. Outros estudos clínicos são necessários para explorar como selecionar o melhor método de reconstrução. Nível de Evidência IV, Séries de Casos.


Objectives: Pelvic reconstruction after tumor resection is challenging. Methods: a retrospective study had been performed to compare the outcomes between patients undergoing reconstructive surgery of the pelvis with allogeneic bone graft after en bloc resection of pelvic tumors and patients undergoing en bloc resection only. Results: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 days vs. 40 days, P < 0.001), and lower hospital costs (97,500 vs. 193,000 RMB, P < 0.001) than those undergoing pelvic reconstruction. Functional scores were similar after 12 months of surgery (21.5 vs. 23, P = 0.365) with no difference in the rate of complications between the two groups (P > 0.05). Conclusions: pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pelvic Neoplasms/surgery , Pelvis/surgery , Transplantation, Homologous/adverse effects , Transplantation, Homologous/rehabilitation , Biopsy, Needle , Magnetic Resonance Spectroscopy , Radiography , Retrospective Studies , Data Interpretation, Statistical
7.
Rev. bras. ortop ; 47(6): 776-779, 2012. ilus, tab
Article in Portuguese | LILACS | ID: lil-666226

ABSTRACT

A hemipelvectomia interna é um procedimento cirúrgico adequado no tratamento de certos tumores de cintura pélvica. É uma alternativa terapêutica capaz de preservar o membro inferior do paciente, ao contrário das amputações clássicas como a amputação interilioabdominal (AIIA) e desarticulação coxofemoral. De acordo com a classificação de Enneking, existem quatro tipos de hemipelvectomia interna, mas, se for necessário, é possível a associação de diferentes tipos de ressecção em um único procedimento. É fundamental que esta cirurgia seja indicada de forma correta para que interfira positivamente na morbimortalidade e qualidade de vida do paciente. Relatamos oito casos de hemipelvectomia interna em pacientes diagnosticados com tumores de cintura pélvica, bem como os tipos de tratamento neoadjuvantes e adjuvantes a que eles foram submetidos e o follow-up dos mesmos.


Internal hemipelvectomy is a surgical procedure adequate for treatment of certain tumors of the pelvic girdle. Being a lower limb-preserving approach, it is a therapeutic alternative to the classical interilioabdominal amputation and hip joint disarticulation. According to Enneking`s classification, there are four types of internal hemipelvectomies, although the association of different types of resection in the same procedure is feasible if necesary. This surgical approach should be correctly indicated to positively affect the patient`s morbidity, mortality and quality of life. We report eight cases of internal hemipelvectomy in patients diagnosed with tumors of the pelvic girdle. We also discuss the neoadjuvant and adjuvant treatments used, along with their follow-up.


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Middle Aged , Drug Therapy , Pelvic Neoplasms/surgery , Radiotherapy
8.
Rev. chil. obstet. ginecol ; 75(1): 42-46, 2010. ilus
Article in Spanish | LILACS | ID: lil-561831

ABSTRACT

Se presentan los casos de tres pacientes en su quinta década de vida que fueron sometidas a histerectomia por miomas uterinos sintomáticos. Caso 1: Paciente sometida a histerectomia supracervical laparoscópica. El cuerpo uterino fue extraído del abdomen mediante morcelación eléctrica. Cuatro años después presenta intenso dolor pélvico cíclico que requiere hospitalizaciones. La resonancia magnética sugiere nodulos vascularizados en pelvis. Se efectúa laparotomía diagnóstica resecándose implantes de tejido miometrial y endometrio en pelvis. Caso 2: Paciente sometida a histerectomia subtotal laparoscopica hace 12 años por miomatosis uterina. Consulta por dolor en fosa iliaca izquierda con exacerbación cólica de larga evolución. La tomografia helicoidal sin contraste (pielo TAC) muestro imagen hipodensa en fosa iliaca izquierda. Se realiza laparoscopia quirúrgica resecándose el tumor. La biopsia fue informada como muestra constituida por pared tipo corporal uterino. Caso 3: Paciente sometida a histerectomia total abdominal. Dos años después en ecotomografía vaginal de rutina se pesquisa tumor pelviano sólido de probable origen anexial izquierdo. La resonancia magnética sugiere leiomioma. La laparoscopia diagnóstica objetiva tumor sólido en relación a la cúpula vaginal compatible con mioma. Se reseca el tumor y el estudio anátomo patológico confirma el diagnóstico. Conclusión: La retención de fragmentos uterinos es una complicación infrecuente de la histerectomia supracervical laparoscópica que sería posible prevenir. La laparoscopia tiene un rol en la resolución de retención de fragmentos uterinos post histerectomia. La resonancia magnética aportó información relevante en estos casos.


We will present the cases of three patients in the fifth decade of their life, that had undergone an histerec-tomy with the diagnosis of uterine leiomyoma. Case 1: Pacient had undergone a supracevical laparocopic hysterectomy. The uterus had been extracted from the abdominal cavity by electrical morcellation. Four years after the procedure, she presents ciclic pelvic pain which requires hospitalization. The magnetic resonante suggests vascularized tumors in the pelvis. A diagnostic laparoscopy was done, removing miometrial and endometrial tissue. Case 2: Pacient had undergone a supracevical laparocopic hysterectomy twelve years ago with the diagnosis of leiomyoma. She requires medical attention because of a colic pain in the left ilac fossa. The unhenhanced helicoidal CT- Scan shows an hipodense image in the left iliac fossa. A diagnostic laparoscopy was done, removing the tumor. The biopsy showed a sample constituded of uterine corpus. Case 3: Pacient had undergone an abdominal histerectomy. Two years after the procedure, a vaginal ecotomography showed a solid pelvian tumor that was propably located in the left adnexa. The magnetic resonante suggests a leyomioma. The diagnostic laparoscopy shows a solid tumor in touch with the cúpula vaginalis, the tumor was removed. The biopsy confirms the diagnosis. Conclusion: The uterine fragments retention is an infrecuent complication of the supracervical laparoscopic hysterectomy that can be prevenible. The laparoscopy has a role in the resolution of the uterine fragments post histerectomy. The magnetic resonance contributed with relevant information in this cases.


Subject(s)
Humans , Female , Middle Aged , Hysterectomy/adverse effects , Laparoscopy/adverse effects , Abdominal Neoplasms/surgery , Abdominal Neoplasms/etiology , Hysterectomy/methods , Pelvic Neoplasms/surgery , Pelvic Neoplasms/etiology
9.
Rev. argent. coloproctología ; 20(2): 72-90, jun. 2009. ilus, tab
Article in Spanish | LILACS | ID: lil-596762

ABSTRACT

Antecedentes: Los tumores que asientan en el espacio virtual entre el mesorrecto y el sacrocoxis comprenden un grupo heterogéneo y poco frecuente cuya incidencia se estima en 1/40.000 ingresos. Se clasifican en congénitos, neurogénicos, óseos y misceláneas. Por ser asintomáticos u ocasionar síntomas inespecíficos su diagnóstico suele ser tardío y muchas veces cuando han alcanzado un gran tamaño o comprometido las estructuras vecinas. El diagnóstico y tratamiento, que requiere un equipo multidisciplinario, han evolucionado en los últimos años por el aporte de la resonancia magnética nuclear (RMN), las nuevas terapias quimiorradiantes y un abordaje quirúrgico más agresivo. Objetivo: Comunicar nuestra experiencia y sugerir la estrategia de manejo de estos tumores basada en esta serie y la de los centros internacionales de referencia. Pacientes y Métodos: Se revisaron retrospectivamente las historias clínicas de los pacientes con tumores retrorrectales operados entre 1991 y 2006 en la División Cirugía del Hospital Juan A. Fernández. Se excluyeron procesos inflamatorios, tumores rectales localmente avanzados y metastásicos. Se registraron sexo, edad, síntomas/signos, tiempo de evolución, estudios preoperatorios, tamaño tumoral, compromiso sacro y/o de órganos vecinos, tratamiento quirúrgico, morbimortalidad inmediata, estadía postoperatoria, secuelas, histopatología, recurrencia y supervivencia. Además se evaluó la utilidad de la tomografía axial computada (Te) y la RMN para establecer la estirpe tumoral, la posible malignidad, la invasión de estructuras vecinas y la vía de abordaje. Resultados: Hubo 7 pacientes (5 mujeres), edad promedio 37,5 (23-54) años. Congénitos: 2 (cordoma 1, hamartoma quístico 1), neurogénicos: 2 (neurofibroma plexiforme 1, schwanoma maligno 1), óseos: 1 (tumor de células gigantes del sacro) y misceláneas: 2 (liposarcoma 1, fibroma extrapleural maligno 1)...


Background: Tumors occupying the virtual space between the mesorectum and sacro-coccyx are heterogeneous and infrequent, with an estimated incidence of 1/40.000 hospitalizations. They are classified as congenital, neurogenic, osseous, and miscellaneous. Because they are asymptomatic or cause non-specific symptoms diagnosis is usually delayed, and very often done when have reached a great dimension or involved adjacent structures. Diagnosis and treatment, that required a multidisciplinary team, has evolved in recent years due to the role of magnetic resonance imaging (MRI), new chemo-radiation therapies and a more aggressive surgical approach. Objective: Report on our experience, and suggest the management strategy for these tumors based on this series and that of international referral centers. Patients and Methods: Clinical records of patients with retrorectal tumors operated on, between 1991 and 2006 in the Division of Surgery of the Hospital Juan A. Fernández were retrospectively reviewed. Inflammatory processes, locally advanced rectal tumors and metastatic lesions were excluded. Registe red data included gender, age, symptom/signs, time of evolution, preoperative studies, size of tumors, involvement of sacrum and/or adjacent viscera, surgical treatment, 30-day morbidity and mortality, postoperative hospital stay, secuela, histopathology, recurrence and survival. Besides, the usefulness of computed tomography (CT) and MRI to establish the histologic tumor type, possible malignancy, invasion of adjacent structures, and operative approach was assessed. Results: Seven patients (5 women), mean age 37.5 (23-54) years, were treated. Congenital: 2 (chordoma 1, tailgut cyst 1), neurogenic: 2 (plexiform neurotibroma 1, malignant schwannoma 1), osseous: 1 (gigant cell tumor of the sacrum) and miscellaneous: 2 (liposarcoma 1, extrapleural malignant fibroma 1)...


Subject(s)
Humans , Male , Adult , Female , Young Adult , Middle Aged , Pelvic Neoplasms/surgery , Pelvic Neoplasms/classification , Pelvic Neoplasms/complications , Pelvic Neoplasms/diagnosis , Sacrococcygeal Region/surgery , Biopsy/methods , Clinical Evolution , Delayed Diagnosis , Diagnostic Imaging , Follow-Up Studies , Prognosis , Surgical Procedures, Operative/methods , Rectum/anatomy & histology
10.
Article in English | IMSEAR | ID: sea-37905

ABSTRACT

BACKGROUND: Primary non-gestational uterine cervical choriocarcinoma is very unusual and although it has been hypothesized that it can arise by metaplastic transformation of cervical epithelium, solid evidence has been lacking. CASE: Primary non-gestational uterine cervical choriocarcinoma was diagnosed in a 47-year-old, woman undergoing tubal resection 17 years previously. A histologically- and immunohistochemically-confirmed, non-gestational cervical choriocarcinoma could be diagnosed in which there was metaplastic transformation from squamous cells . The patient underwent 5 courses of an actinomycin-D chemotherapeutic regimen and radical hysterectomy with bilateral pelvic lymphadenectomy. CONCLUSION: Primary non-gestational uterine cervical choriocarcinoma may indeed arise from metaplastic transformation of epithelial tissue.


Subject(s)
Antibiotics, Antineoplastic/therapeutic use , Carcinoma, Squamous Cell/pathology , Cell Transformation, Neoplastic , Choriocarcinoma, Non-gestational/drug therapy , Dactinomycin/therapeutic use , Female , Humans , Hysterectomy , Lymph Node Excision , Metaplasia/drug therapy , Middle Aged , Pelvic Neoplasms/surgery , Uterine Cervical Neoplasms/drug therapy
11.
Rev. argent. cir ; 92(3/4): 161-166, mar.-abr. 2007. tab
Article in Spanish | LILACS | ID: lil-508366

ABSTRACT

Antecedentes: La invasión ósea del sacro fue tradicionalemente considerada como criterio de irresecabilidad (pelvis congelada). Objetivo: Analizar la técnica y los resultados a mediano plazo de la Resecciones Sacras (RS) en Tumores Pelvianos Avanzados (TPA) realizadas en el Instituto Alexander Fleming. Diseño: Estudio retrospectivo. Población: 21 pacientes portadores de TPA que requirieron RS a diversos niveles. Método: Se analizaron retrospectivamente las Historias Clínicas de los 21 pacientes. El seguimiento se realizó mediante visitas periódicas en consultorio externo, o telefónicamente en los perdidos. La supervivencia se analizó con el método actuarial de Kaplan Meier. Resultados: La altura de RS fue: S1 9,5%, S2 38%, S3 28,6%, S4 14,4% y S5 9,5%. La mortalidad de la serie fue del 81%. Transtornos esfinterianos 24%; infección y dehiscencia de herida posterior 57%; infección de la herida anterior 9,5% y fístula posoperatoria 9,5%. El seguimiento promedio fue de 21 meses, la supervivencia libre de enfermedad fue de 17 meses, la supervivencia global acutuarial a 5 años fue de 37,6 y excluyendo los 2 cordomas operados del 20,2%. Conclusiones: Técnica factible realizada por grupos entrenados. Procedimiento e internación prolongados. Es necesario estricta selección de los pacientes para evitar morbimortalidad innecesaria. La invasión sacra No debe ser considerada una contraindicación para el intento de resección.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Pelvic Neoplasms/surgery , Sacrum/surgery , Chordoma/surgery , Rectal Neoplasms/surgery , Retrospective Studies , Survival Rate
12.
Int. braz. j. urol ; 32(4): 445-447, July-Aug. 2006. ilus
Article in English | LILACS | ID: lil-436889

ABSTRACT

We report a pelvic liposarcoma originating from the left spermatic cord that recurred following inadequate excision. In our case, the tumor was resected without performing orchiectomy previously. The patient was managed by laparoscopic resection, before undergoing radical orchiectomy in the left inguinal region. To our knowledge, no case of laparoscopic resection for the recurrent liposarcoma has been described. In addition, the present case serves to demonstrate that radical orchiectomy with wide excision is needed for paratesticular tumor.


Subject(s)
Aged , Humans , Male , Genital Neoplasms, Male , Laparoscopy , Liposarcoma/surgery , Pelvic Neoplasms/surgery , Spermatic Cord , Genital Neoplasms, Male/pathology , Genital Neoplasms, Male/surgery , Liposarcoma/secondary , Orchiectomy , Pelvic Neoplasms/diagnosis , Pelvic Neoplasms/secondary , Tomography, X-Ray Computed
13.
Rev. chil. urol ; 71(2): 110-117, 2006. ilus, tab
Article in Spanish | LILACS | ID: lil-460599

ABSTRACT

Se revisan los datos de 18 pacientes portadores de carcinoma de células transicionales del tracto urinario superior (TCT), 13 hombres y 5 mujeres, tratados entre junio de 1998 y julio de 2004. Con una edad promedio de 62 años (34-84), diez y seis pacientes presentaban un tumor de pelvis renal y dos un tumor de uréter. En 13 pacientes se utilizó la vía transperitoneal y en 5 la vía retroperitoneal. El tiempo promedio de cirugía fue de 150 minutos (80-240) y el sangrado estimado promedio fue de 209 cc (50-400). El tiempo promedio de estadía hospitalaria fue de 72 horas. Dos pacientes presentaron complicaciones. Uno de ellos en el intraoperatorio presentó una lesión aórtica, reparada en forma laparoscópica. Otro paciente evolucionó con una obstrucción intestinal, requiriendo una exploración abierta al décimo día de la cirugía. No hubo conversión a cirugía abierta. El seguimiento promedio fue de 40 meses, no se han presentado recidivas en los pacientes con enfermedad localizada. La factibilidad de realizar esta cirugía, con un adecuado control oncológico, con un bajo nivel de complicaciones y todas las ventajas de la cirugía laparoscópica, nos llevan a considerar esta técnica como una alternativa a la cirugía convencional, en pacientes portadores de TCT de la vía urinaria superior en una etapa localizada


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carcinoma, Transitional Cell , Video-Assisted Surgery/methods , Laparoscopy/methods , Nephrectomy/methods , Pelvic Neoplasms/surgery , Kidney Neoplasms/surgery , Urethral Neoplasms/surgery , Intraoperative Complications , Postoperative Complications , Follow-Up Studies , Urologic Surgical Procedures , Length of Stay
14.
Rev. chil. obstet. ginecol ; 70(1): 41-48, 2005. tab
Article in Spanish | LILACS | ID: lil-417775

ABSTRACT

La identificación de varios factores de riesgo patológico y una mejor definición de grupos de riesgo, luego de manejo quirúrgico primario de cáncer cérvico uterino en etapa temprana, ayuda a definir el mejor tratamiento adyuvante. Dos estudios clínicos randomizados han hecho avanzar nuestro entendimiento del rol del tratamiento adyuvante en cáncer cérvico uterino. En pacientes con etapa clínica IA2, IB y IIA inicialmente tratados con histerectomía y linfadenectomía pelviana y que tienen linfonodos pelvianos positivos, y/o márgenes quirúrgicos comprometidos, y/o invasión parametrial microscópica, el uso de radioterapia y quimioterapia adyuvante combinada mejora significativamente la sobrevida global y la sobrevida libre de progresión comparado con radioterapia pelviana exclusiva. Para mujeres con etapa IB tratadas con histerectomía radical y linfadenectomía pelviana con ganglios negativos y al menos 2 de los siguientes factores de riesgo: >1/3 invasión estromal, invasión vascular-linfática, y gran diámetro tumoral clínico el tratamiento con radioterapia pelviana adyuvante mejora significativamente sobrevida libre de enfermedad comparado con observación. Mejores resultados de tratamiento adyuvante, para pacientes con cáncer cérvico uterino etapa temprana de riesgo intermedio o alto se producirán con una mejor definición de factores de riesgo, mejor selección de pacientes y mejores tratamientos locales y sistémicos.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/surgery , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/therapy , Risk Factors , Ganglia/surgery , Pelvic Neoplasms/surgery
15.
Rev. bras. cancerol ; 50(4): 301-305, out.-dez. 2004. ilus
Article in Portuguese | LILACS | ID: lil-421330

ABSTRACT

A hemipelvectomia com reconstrução usando-se retalho miocutâneo ântero-medial da coxa, é indicada para o tratamento dos sarcomas da região glútea e da porção proximal posterior da coxa. O grande defeito cirúrgico é coberto pelo retalho miocutâneo do músculo quadríceps femoral. O resultado da hemipelvectomia com reconstruçãopor retalho miocutâneo anterior de coxa é excelente, exceto pela dor fantasma e sensação do membro persistenteem alguns pacientes. As considerações quanto à reabilitação e ao risco de dor e membro fantasma são similares aos associados aos outros tipos de hemipelvectomias. Em virtude da rápida cicatrização vista neste tipo de retalho, a adaptação de uma prótese, quando requerida, pode ser mais precoce. No presente trabalho apresentamos um caso em que foi realizado este tipo de cirurgia, procedendo-se à descrição da técnica cirúrgica utilizada.


Subject(s)
Adult , Female , Humans , Hemipelvectomy , Pelvic Neoplasms/surgery , Sarcoma, Synovial , Surgical Flaps , Buttocks/pathology , Thigh
16.
Acta oncol. bras ; 24(1): 581-585, jan.-mar. 2004. ilus
Article in English | LILACS | ID: lil-428573
17.
Femina ; 32(2): 131-136, mar. 2004. tab
Article in Portuguese | LILACS | ID: lil-395911

ABSTRACT

Os Autores apresentam revisão da literatura e concluem que a transposição ovariana laparoscópica é procedimento efetivo de preservação ovariana e que deve ser oferecido a pacientes jovens submetidas à radioterapia pélvica. É frequente a utilização de irradiação pélvica no tratamento de neoplasias em mulheres jovens, incluindo neoplasias ginecológicas, neoplasias de reto e ânus, doença de Hodgkin e outras de apresentação mais rara. Dependendo da extensão e sítio da doença esta terapêutica pode ser bastante deletéria, causando infertilidade e falência ovariana. A transposição de ovários previamente à irradiação pélvica tem sido realizada para minimizar estes efeitos no aparelho reprodutor feminino e até possibilitar gestação futura


Subject(s)
Humans , Female , Infertility , Laparoscopy , Pelvic Neoplasms/surgery , Pelvic Neoplasms/radiotherapy , Ovary , Review , Transposition of Great Vessels/surgery
18.
São Paulo; s.n; 2004. [113] p. graf.
Thesis in Portuguese | LILACS | ID: lil-403693

ABSTRACT

A exenteração pélvica é método efetivo no tratamento de tumores pélvicos localmente avançados. As cirurgias mais conservadoras, com preservação funcional dos esfíncteres e reconstrução continente dos tratos intestinal e urinário podem melhorar a qualidade de vida e estimular os pacientes a aceitar a cirurgia. O objetivo deste estudo foi avaliar os resultados da exenteração pélvica no tratamento dos tumores pélvicos localmente avançados em relação à preservação dos esfícteres e fatores associados ao prognóstico. Com os resultados deste estudo podemos concluir que houve aumento da frequência de margens cirúrgicas comprometidas nem prejuízo na sobrevida dos pacientes submetidos à exenteração pélvica com preservação dos esfíncteres / Pelvic exenteration (PE) is an effective method for treating locally advanced pelvic tumors. More conservative surgeries, preserving sphincteres and continent reconstruction of the intestinal and urinary tarct, which could contribute to a better quality of life and encourage patients to accept this procedure. The objective of this study was to evaluate the results of PE in the treatment of locally advanced pelvic tumors, mainly considering sphincter preservation and factors associated to rhe prognosis. Between 1980 and 2000, 96 PE were performed. Factors related tosphincter preservation as well as factors associated to prognosis were respectively analyzed. Of the 96 patients treated with pelvic exenteration, at least one sphincter in 36 patients was preserved (37.5per cent) in the 1990's, the sphincter preservation rate was significantly higher than in the 1980's and coloproctogical tumors...


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Pelvic Exenteration/methods , Pelvic Neoplasms/surgery , Anal Canal , Prognosis , Retrospective Studies
19.
Rev. bras. cancerol ; 48(2): 253-256, abr.-jun. 2002. ilus
Article in Portuguese | LILACS | ID: lil-429435

ABSTRACT

Hemipelvectomia utilizando retalho miocutâneo anterior é indicada para tumores extensos da região glútea e parte posterior proximal da coxa. Um paciente do sexo masculino com 49 anos apresentou-se para tratamento de tumor ulcerado e infectado com crescimento progressivo há 3 anos em região glútea esquerda, originado de uma área de ulceração e cicatrização crônicas provocadas pela aplicação de múltiplas injeções de drogas ilícitas no local. O tumor infiltrava a pele, tecido celular subcutâneo e musculatura glútea, estando fixo ao osso ilíaco, articulação coxo-femural e trocanter maior. A tomografia computadorizada da pelve confirmou os achados do exame físico. A biópsia aberta foi realizada e revelou um carcinoma de células escamosas. Hemipelvectomia externa foi a opção escolhida para o tratamento. Um grande defeito foi criado após ressecção da extremidade inferior, hemipélvis e glúteo. Um retalho miocutâneo anterior do músculo quadríceps femural, adutores, sartório, pectíneo e grácil com pele e tecido celular subcutâneo sobrejacentes foi realizado. Os vasos femurais foram utilizados para manter o retalho viável. A recuperação pós-operatória aconteceu sem intercorrências e o retalho permaneceu totalmente viável. Alguns aspectos da técnica são apresentados.


Subject(s)
Male , Middle Aged , Humans , Carcinoma, Squamous Cell/surgery , Hemipelvectomy , Pelvic Neoplasms/surgery , Surgical Flaps , Thigh
20.
Bol. Asoc. Méd. P. R ; 93(1/12): 23-25, Jan.-Dec. 2001.
Article in English | LILACS | ID: lil-411252

ABSTRACT

Presacral location of neuroblastoma is rare. Resection entails an abdomino-sacral approach. This case report discusses clinical, imaging and successful surgical management of a presacral neuroblastoma in a one-year-old male child


Subject(s)
Male , Infant , Humans , Neuroblastoma , Pelvic Neoplasms , Age Factors , Magnetic Resonance Imaging , Pelvic Neoplasms/diagnosis , Pelvic Neoplasms/surgery , Pelvic Neoplasms , Neuroblastoma/diagnosis , Neuroblastoma/surgery , Neuroblastoma , Prognosis , Sacrococcygeal Region
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