Delayed Presentation of Vaginal Cuff Dehiscence after Robotic Hysterectomy for Gynecologic Cancer: A Case Series and Review of the LiteratureReportar como inadecuado




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Case Reports in Obstetrics and Gynecology - Volume 2016 2016, Article ID 5296536, 5 pages -

Case ReportMontefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics and Gynecology and Women’s Health, 1825 Eastchester Road, Room 722, Bronx, NY 10463, USA

Received 17 December 2015; Accepted 10 March 2016

Academic Editor: Stefan P. Renner

Copyright © 2016 Pamela A. Escobar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Vaginal cuff dehiscence after hysterectomy has varying incidence according to surgical approach, with highest rates associated with laparoscopic surgery. Comparative data on timing of diagnosis describe a wide range of clinical presentation from weeks to years after hysterectomy. Limited reports have focused specifically on delayed presentation of vaginal cuff dehiscence. Cases. All cases of vaginal cuff dehiscence at our institution between 2005 and 2015 were collectively reviewed and three cases were identified of women who presented with cuff dehiscence greater than 180 days from index surgery. Diagnosis occurred at 342 to 461 days after operation. One patient presented with abdominal pain, a second case presented with vaginal discharge, and the third case lacked clinical symptoms altogether. Prior to diagnosis, one case received chemotherapy and external beam radiation for Stage IB1 cervical cancer and another case received external beam radiation alone for Stage II endometrioid adenocarcinoma. All cuffs were repaired vaginally with interrupted, early absorbable suture. Conclusion. Robotic total laparoscopic hysterectomy may be associated with increased risk of vaginal cuff dehiscence. Further studies are needed to determine risk factors and patient characteristics associated with delayed presentation of vaginal cuff dehiscence in robotic total hysterectomy as well as all surgical approaches.





Autor: Pamela A. Escobar, Gregory M. Gressel, Gary L. Goldberg, and Dennis Yi-Shin Kuo

Fuente: https://www.hindawi.com/



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