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  • 1
    Online Resource
    Online Resource
    Sentinel lymph node biopsy in vulvar cancer: status, level of knowledge, and counseling in outpatient setting
    Springer Science and Business Media LLC ; 2020
    In:  Archives of Gynecology and Obstetrics Vol. 302, No. 4 ( 2020-10), p. 1001-1007
    Details
    In: Archives of Gynecology and Obstetrics, Springer Science and Business Media LLC, Vol. 302, No. 4 ( 2020-10), p. 1001-1007
    Abstract: Evaluating the counseling of patients with vulvar cancer in outpatient setting regarding the application of sentinel lymph node dissection (SLND), the selection of hospitals for further treatment, and level of knowledge. Methods A questionnaire containing 29 questions about SLND in vulvar cancer was sent to gynecologists in Lower Saxony. The questionnaire contained multiple choice questions and open questions. The study was approved by the local ethics committee. Results The median age of the 86 respondents was 54 (26–66) years. Most participants (83.1%) reported to only treat one to five patients with vulvar cancer per year. Interestingly, 70.5% of the gynecologists send their patients to university hospitals and 64.1% to hospitals offering maximum care, respectively. Of all, 32.7% replied that SLND was performed rarely or never in their patients. The gynecologists answered that only 36.7% of the patients are well informed about advantages and possible disadvantages of SLND. Most (84%) felt responsible to counsel patients on treatment decisions independently from or additionally to the hospital. Of all, 72% replied that they are not completely sure about the exact recurrence rates after SLND. Of notice, 66% believe that SLND for vulvar cancer is safe if applied in specialized centers and 92% stated that focusing treatment on specialized centers is required for best results. Conclusion SLND for vulvar cancer is widely accepted and regularly recommended among gynecologists. Outpatient doctors report to send most patients to specialized centers. However, it appears that patients remain uninformed after counseling in the clinics and that there is a lack of detailed knowledge about risks and complication rates of groin treatment in the outpatient setting.
    Type of Medium: Online Resource
    ISSN: 0932-0067 , 1432-0711
    URL: Article
    DOI: 10.1007/s00404-020-05701-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1458450-5
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Peritoneal contamination with ICG ‐stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination: A proof‐of‐principle study for laparoscopic hysterectomy
    Wiley ; 2019
    In:  Acta Obstetricia et Gynecologica Scandinavica Vol. 98, No. 11 ( 2019-11), p. 1398-1403
    Details
    In: Acta Obstetricia et Gynecologica Scandinavica, Wiley, Vol. 98, No. 11 ( 2019-11), p. 1398-1403
    Abstract: Intracorporal colpotomy during radical hysterectomy for cervical cancer is discussed to be a risk factor for peritoneal dissemination of tumor cells. It might lead to increased recurrence rates after laparoscopic radical hysterectomy compared with abdominal hysterectomy, as shown by the recent LACC study. Data on the frequency or mechanisms of peritoneal contamination are missing. We aimed to analyze peritoneal contamination of cervical secretion during intracorporal colpotomy with a novel indocyaningreen ( ICG )‐based technique. Material and methods In this prospective proof‐of‐principle study, patients undergoing routine laparoscopic or robot‐assisted hysterectomy were selected. ICG was specifically applied to the cervical surface and routine surgery was performed. During colpotomy, pictures under white and fluorescence light were taken to evaluate frequency of contamination. Results By using cervically applied ICG we were able to visualize directly peritoneal contamination with cervical secretion during intracorporal colpotomy. We detected peritoneal contamination in 9/12 (75%) patients undergoing routine laparoscopic hysterectomy. Contamination of laparoscopic instruments occurred in 60% of the patients. When contamination occurred, it was routinely detectable during all steps of colpotomy. There were no adverse effects during surgery. Conclusions Peritoneal contamination with cervical secretion frequently occurs during intracorporal colpotomy. This novel technique represents a promising tool for feasible and direct visualization of peritoneal contamination during colpotomy. The technique may be easily implemented in further studies on laparoscopic and abdominal hysterectomy and serve as a quality assessment tool for surgeons and surgical techniques.
    Type of Medium: Online Resource
    ISSN: 0001-6349 , 1600-0412
    URL: Issue
    URL: Article
    DOI: 10.1111/aogs.v98.11
    DOI: 10.1111/aogs.13681
    RVK:
    YM 6500
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2024554-3
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