0000000000292107
AUTHOR
Luciano Monfardini
EP1201 Laparoscopy versus laparotomy for surgical treatment of obese women with endometrial cancer: a cost-benefit comparative analysis
Introduction/Background Obesity represents a major health problem. Several studies reported that morbid obesity is associated with an 81% greater health care expenditure per capita compared with normal weight adults in the US. Although many articles have investigated costs of laparoscopic versus open approach for endometrial cancer, very few data are available in selected population of patients, such as obese women. The aim of this study has been to evaluate pre-, intra- and post-operative costs in obese women affected by endometrial cancer comparing laparoscopic versus open abdominal surgery. Methodology Economic expenditure in pre-operative, intra-operative and post-operative phases of th…
Obesity, an independent predictor of pre and postoperative tumor grading disagreement in endometrial cancer
Abstract Introduction Obesity is a known independent risk factor for endometrial cancer (EC), and obese patients have a 4.7-fold increased risk compared to the general population to develop the neoplasm. To date, a general pre and postoperative tumor grading agreement from 53 % to 82 % is reported for endometrial analysis, and a consensus on which factors might influence the tumor grading discordance is still absent. Furthermore, although obesity alters the endometrial microenvironment, no studies investigated the role of obesity in the grading agreement of EC patients. This study aims to analyze the role of obesity in the pre and postoperative tumor grading agreement. Materials and methods…
Obstetrics outcomes after complete and partial molar pregnancy: Review of the literature and meta-analysis.
The hydatidiform mole is a rare gynecological disease rising from the trophoblastic. Post-molar pregnancies have an extremely variable course, varying from repeated abortions, stillbirths, preterm births, live births, or recurring in further molar pregnancies. Literature on obstetric outcomes following molar pregnancy is poor, often including monocentric studies, and with data collected from national databases. This review and meta-analysis aim to analyze the obstetric outcomes after conservative management of complete (CHM) and partial (PHM) molar pregnancies. The meta-analysis was performed following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and the preferred repo…
Transperitoneal versus extraperitoneal laparoscopic aortic lymph nodal staging for locally advanced cervical cancer: A systematic review and meta-analysis
Abstract Cervical cancer is the fourth most common neoplasm in women. In locally advanced cervical cancers, the international guidelines recommend nodal aortic assessment. Two techniques have been described to perform laparoscopic aortic lymphadenectomy: transperitoneal laparoscopic lymphadenectomy (TLL) and extraperitoneal laparoscopic lymphadenectomy (ELL). This meta-analysis aims to compare the surgical outcomes of TLL and ELL for staging purposes. The systematic review was carried out in agreement with the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA). Two hundred and twenty studies were analyzed, and 19 studies were included in the review (7 for …
EP1155 Endoscopic near infrared and indocyanine green to verify the viability of the subcutaneous flap for vulvar cancer
Introduction/Background Vulvar cancer often requires radical vulvectomy with subsequent vulvar flap due to tumor aggressiveness and a high percentage of relapses. Approximately in 20–60% of cases, there are post-operative complications ranging from infection to wound dehiscence, lymphocele and flap necrosis that often require reoperation. Several methods have been described to verify the vitality of the flap, especially in plastic surgery, but these are often expensive and require specific machinery that is not generally present in a gynecological clinic. We present a viability verification of V-Y fasciocutaneous advancement flap for vulvar reconstruction by Endoscopic Near-Infrared and Ind…
Laparoscopy versus laparotomy for surgical treatment of obese women with endometrial cancer: A cost-benefit comparative analysis
The aim of the present study was to demonstrate the cost of obese patients affected by endometrial cancer undergoing open surgery compared with minimally invasive surgery. In the retrospective cohort study (Canadian Task Force classification II-2), the economic expenditure in pre-operative, intra-operative and post-operative phases of the selected patients was evaluated. Costs were analyzed for all blood tests, instrumental examinations, consultations, operating materials, drugs, gynecological examinations, hospital stay, intensive care hospitalization and management of operative complications. The average length of stay was longer for patients who underwent laparotomy, with an almost doubl…
EP485 Confounding factors of trans-vaginal ultrasonography accuracy in endometrial cancer
Introduction/Background Endometrial cancer is the most frequently diagnosed gynecological tumor with more than 60.000 new cases each year. Following the ESMO-ESGO-ESTRO consensus conference, patients are classified in different classes of risk for lymph node metastases based on the instrumental suspected stage of the disease. In this scenario, a correct pre-operative workup is essential for a proper planning treatment offered to the patient. Although most of the oncological centers have replaced the MRI with trans-vaginal ultrasound, this, in the international guidelines, is considered only in the fertility sparing and in cases of contraindicated MRI. The Aim of our study is to evaluate the…
Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique
Introduction: Vulvar cancer is a rare condition affecting older women and accounts for 3–5% of all gynecological cancers. Primary surgical treatment involves the removal of a large amount of tissue for which reconstructive surgery is often necessary with a high rate of postoperative complications. Despite several techniques for the evaluation of vulvar flap viability have been proposed, many methods cannot be performed during surgery and require expensive devices often missing in a gynecological clinic. This study aims to verify the feasibility and the safety of the vulvar flap viability evaluation through a near-infrared endoscopic probe and Indocyanine green (ICG) tracer in a small group …