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Overview of Traditional Methods of Diagnosis and Treatment for Women-Associated Cancers
Published in Shazia Rashid, Ankur Saxena, Sabia Rashid, Latest Advances in Diagnosis and Treatment of Women-Associated Cancers, 2022
Malika Ranjan, Namyaa Kumar, Safiya Arfi, Shazia Rashid
The surgical procedures used for ovarian cancer include unilateral and bilateral salpingo-oophorectomy and debulking or cytoreduction [19]. The most common surgery used for endometrial cancer is a total hysterectomy. Vulvectomy and vaginectomy are the surgical procedure used for treating vulvar and vaginal cancer, respectively.
Gynaecological cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Radiotherapy is indicated for stage 2 and stage 3 diseases. It should also be considered for those with early tumours who are unwilling to accept vaginectomy, reserving surgery for salvage patients whose disease recurs and for those unfit for surgery. External beam irradiation to the pelvis including the inguinal nodes for lower third tumours should be followed by intracavitary or interstitial treatment to give a high dose of radiation directly to the vaginal mucosa and surrounding local tumour extension. Chemoradiation using weekly cisplatin with radiotherapy is considered for younger patients.
Phalloplasty
Published in James Barrett, Transsexual and Other Disorders of Gender Identity, 2017
Total vaginectomy (where the muscle and mucosa and serosa of the vagina are completely removed) is a major operation with a high risk of blood loss, bladder dysfunction and bladder and bowel perforation. This kind of surgery was originally designed to remove malignancy, and the the risks were thus felt acceptable.
Robotic Hysterectomy as a Step of Gender Affirmative Surgery in Female-to-Male Patients
Published in Journal of Investigative Surgery, 2021
Pierluigi Giampaolino, Luigi Della Corte, Francesco Paolo Improda, Luca Perna, Marcello Granata, Attilio Di Spiezio Sardo, Giuseppe Bifulco
A collaboration between several disciplinary sectors can become fundamental in the work with TGNC people [7, 8]. Affirmative Gender Surgery (GAS) is usually the final and irreversible step of the therapeutic algorithm. Interventions such as psychotherapy, the alteration of one’s gender expression and hormone therapy, must take place before the surgical consideration. Surgeries that confirm the gender can be any surgical procedure aimed at producing a greater alignment between one’s own body and one’s gender identity; as such, GAS can include a wide spectrum of demolition and reconstruction procedures. It is important to note that not all transgender patients undergo surgery [9, 10]. Surgery―especially the genital one―is often the last and most considered step in the process of treating gender dysphoria. For the Female-to-Male (FtM) patient, surgical interventions may include subcutaneous mastectomy, creation of a male-type chest; hysterectomy/ovariectomy, reconstruction of the fixed part of the urethra, which can be done in conjunction with metoidioplasty or phalloplasty (using a pedunculated or free vascularized flap), and vaginectomy, in the context of genital surgery; vocal surgery (rare), liposuction, lipofilling, pectoral implants, and other esthetic procedures, included in many of surgical operation outside genitalia/breast [10, 11].
Total Colpectomy Increases the Risk of Postoperative Hydronephrosis in Vaginal Cancer Patients
Published in Journal of Investigative Surgery, 2019
Octavian Constantin Neagoe, Mihaela Ionica, Dorin Nicolae Agapie
Surgical treatment is recommended especially for early stages I and II, as defined by the International Federation of Gynecology and Obstetrics (FIGO),6 preceded or not by radiotherapy. Depending on tumor location, surgical options range from local excision, to vulvo-vaginectomy for tumors of the lower third, colpohysterectomy for tumors of the middle and upper third and even pelvic exenteration in selected cases. Loco-regional disease progression for vaginal tumors of the middle and upper thirds follows a similar pattern to that of cervical cancers making radical or modified radical hysterectomy with pelvic lymphadenectomy and colpectomy a surgical option for both cervical and vaginal cancer of the upper two-thirds.7,8 Several studies have shown, in the case of patients undergoing modified radical hysterectomy with pelvic lymphadenectomy, especially for cervical cancer, that hydronephrosis is not an uncommon late complication, with significant impact not only on quality of life, but also on survival.9,10 Scarce data are available in the literature regarding the incidence and impact on survival of postoperative hydronephrosis in vaginal cancer patients.
Management Strategies for Recurrent Endometrial Cancer
Published in Expert Review of Anticancer Therapy, 2018
Elizabeth V. Connor, Peter G. Rose
Surgical excision with vaginectomy may be acceptable for focal recurrences where an appropriate margin may be achieved. More extensive surgery such as pelvic exenteration is usually reserved for patients with localized recurrence who fail to be cured following radiation. The two largest case series included a total of 65 patients with exenteration for recurrent endometrial cancer and reported 5-year overall survival rates of 20–45%, and postoperative complication rates of 60–80% [20,21]. More contemporary case series have reported 5-year overall survival rates of 40–73% and complication rates of 30–48% [22,23]. Utilizing the National Cancer Database, Seagle et al reported on 652 women who underwent pelvic exenteration for endometrial carcinoma. By multivariate regression, increased age, positive surgical margins, nodal metastasis or unknown nodal status, higher histologic grade, and black race were associated with increased hazards for death [24]. Clearly, exenteration is not without serious morbidity and should only be selected for patients with greatest potential for long-term survival.