Enrico Vizza's Articles: (4)
AbstractObjectives: The main purpose of our study was to identify the patient characteristics of women undergoing hysterectomy and to estimate the proportion of hysterectomies that could be done vaginally by recognized surgical techniques. Study Design: The records of 500 women who underwent hysterectomy were reviewed. The characteristics of patients without an absolute contraindication to vaginal hysterectomy were analyzed. Results: Overall, 96 (19.2%) of our study group underwent vaginal hysterectomy. A total of 382 (76.4%) women were judged not to have an absolute contraindication to this route. The most frequent characteristics of this group were lack of uterine prolapse (76.4%), a myomatous uterus (44.5%), and a need for oophorectomy (43.2%). We did not exclude women who did not have significant uterine prolapse or a history of pelvic surgery or pelvic tenderness and we included those requiring oophorectomy or with a uterine size up to that of 14 weeks’ gestation; with these criteria more than two thirds of the entire study population could undergo vaginal surgery. Conclusions: To maximize the proportion of hysterectomies performed vaginally, gynecologists need to be familiar with surgical techniques for dealing with nonprolapsed uteri, uterine leiomyomas, and vaginal oophorectomy. (Am J Obstet Gynecol 1998;179:1008-12.)
Highlights•In elderly EC patients, laparoscopy has less complications than open surgery.•The advantages of laparoscopy are maintained even among elderly/very elderly subjects.•Elderly subjects with EC are more delicate and have a higher risk of complications.
Highlights•Peritoneal positive cytology could be an independent risk factor for endometrial cancer prognosis.•L1CAM are related to tumor progression.•Peritoneal positive cytology and L1CAM could be a potential additional tool for endometrial cancer stratification.
AbstractStudy ObjectiveTo investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement.DesignRetrospective cohort study (Canadian Task Force classification II-2).SettingMulti-institutional study performed in 6 referral gynecologic oncology units.PatientsBetween June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach.InterventionsAll patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction.Measurements and resultsSixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6 -55 months); 15 (21.7%) patients developed recurrence.ConclusionThe present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.