11/13. Chyloperitoneum following treatment for advanced gynecologic malignancies.BACKGROUND: Chyloperitoneum is an uncommon complication following retroperitoneal surgery. Blunt abdominal trauma, abdominal surgery, abdominal or pelvic radiation, cirrhosis, lymphoma, tuberculosis, and congenital defects of lacteal formation may also lead to chylous ascites. CASES: Two patients developed chylous ascites after treatment for gynecologic malignancies. One, who also received pelvic and abdominal radiation, developed chylous ascites 11 months after retroperitoneal lymph node dissection for advanced endometrial cancer. She was treated with a diet low in fat and high in medium-chain triglycerides, as well as with intravenous hyperalimentation. She had recurrences of chylous ascites, which responded to paracentesis and intravenous hyperalimentation. The second patient developed chylous ascites 2 months after retroperitoneal lymph node dissection for advanced fallopian tube cancer. She was treated with a medium-chain triglyceride diet, which resulted in resolution of her symptoms. CONCLUSION: Chyloperitoneum is an uncommon complication following treatment for gynecologic malignancies. Our second case is the first reported in which retroperitoneal lymph node dissection for gynecologic malignancy resulted in chyloperitoneum. However, because gynecologic malignancies frequently metastasize to the periaortic lymph nodes, chylous ascites may be an important cause of morbidity following treatment.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
12/13. Laparoscopic paraaortic node sampling in gynecologic oncology: a preliminary experience.Because of the poor accuracy of nonsurgical methods in the detection of occult paraaortic lymph node metastasis, and because of the cost and discomfort of surgical staging, the feasibility of selective or elective paraaortic lymphadenectomy has been investigated in a preliminary series of four cases. Selective sampling of the lower paraaortic nodes in two cases of cervical carcinoma and of the infrarenal paraaortic nodes in two cases of early ovarian carcinomas were successfully completed by laparoscopy. The potential application of this new technique are discussed.- - - - - - - - - - ranking = 0.5keywords = gynecologic (Clic here for more details about this article) |
13/13. A case of concurrent uterine cervical adenocarcinoma and renal-cell carcinoma, and subsequent vaginal metastasis from the renal-cell carcinoma.We report a case of concurrent uterine cervical adenocarcinoma and renal-cell carcinoma and a subsequent vaginal metastasis from the renal-cell carcinoma. The renal-cell carcinoma, which was located in the upper pole of the right kidney, was detected incidentally by preoperative CT scanning. We simultaneously performed in a timely manner radical hysterectomy, pelvic and paraaortic lymphadenectomies, and a right nephrectomy. Subsequently, however, the patient suffered from vaginal metastasis arising from the renal-cell carcinoma. As a result of this case, we emphasize the importance of making a thorough preoperative assessment prior to performance any definitive surgery for a gynecologic malignancy.- - - - - - - - - - ranking = 0.125keywords = gynecologic (Clic here for more details about this article) |
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