Abstract
The aim of this report is to describe the surgical procedure done in a 24-year-old woman who presents a locally advanced squamous cervix carcinoma and is proposed to laterally extended endopelvic resection (LEER), intraoperative radiation therapy with electrons (IORT) and urinary and colon diversion with vaginal reconstruction. A year after surgery the patient is alive, without disease and with and acceptable quality of life.
Highlights
Cancer of the uterine cervix is the third most common gynaecologic cancer diagnosis and cause of death among gynaecologic cancers in the United States [1]
The rate of relapse is at least 30 percent, and five-year survival rates range from 80 percent for stage IB disease to 30 percent for stage III disease [3, 4]
New ablative techniques based on developmentally derived surgical anatomy termed laterally extended endopelvic resection (LEER) aim to increase the curative resection rate, even of tumours extending to and fixed to the pelvic side wall5
Summary
Cancer of the uterine cervix is the third most common gynaecologic cancer diagnosis and cause of death among gynaecologic cancers in the United States [1]. As well as 3 left iliac nodes and other bilateral inguinal ones After studies she is staged as locally advanced cervix and paraaortic lymphadenectomy retroperitoneal staging is done to determine the level of radiation, being negative the nodes studied. Extended endopelvic resection (LEER) is aimed to resect en bloc multiple visceral compartments in the female pelvis within intact borders for local control of advanced and recurrent malignancies of the lower female genital tract [7,8 ]. The continent reservoir (Indiana Pouch) was created in a classic manner, in literature is described that appendix can provide a convenient continence mechanism, in our patient is not applicable as she had pelvic radiation because of the associated atrophy and fibrosis of the appendix. In our patient we prefered a vertical myocutaneous flap to create the neovagina and one year after the intervention, the patient has none of these complications and it has achieved an increase in its quality of life, a long-term monitoring is necessary to assess late complications
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