ASST Monza, Ospedale San Gerardo, University of Milano-Bicocca, Monza, Italy.
ASST Monza, Ospedale San Gerardo, Monza, Italy.
Int Urogynecol J. 2020 Aug;31(8):1703-1705. doi: 10.1007/s00192-020-04263-y. Epub 2020 Mar 3.
The concurrence of vaginal cancer with irreducible uterine prolapse is rare. Reports about the management of vaginal cancer and concomitant irreducible prolapse are scanty in the literature, and there is no consensus on optimal treatment. In this video case report, we show surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse.
The featured video shows surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse through anterior colpectomy and retrograde hysterectomy en bloc plus transvaginal levator ani plication as a non-obliterative native-tissue technique for apical support.
Final examination revealed good apical support and vaginal "habitability" preservation. The patient underwent five sessions of intracavity brachytherapy for a total of 20 Gy as adjuvant therapy.
Surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse was successfully achieved without complications. Transvaginal levator ani plication can provide a versatile non-obliterative native-tissue technique for apical support, allowing subsequent adjuvant brachytherapy.
阴道癌伴不可还原的子宫脱垂同时发生的情况较为罕见。关于阴道癌和同时发生的不可还原脱垂的处理，文献中的报道很少，对于最佳治疗方法也没有共识。在本视频病例报告中，我们展示了阴道癌和 IV 期阴道子宫脱垂同时发生的手术治疗方法。
特色视频展示了通过前阴道切除术和逆行子宫切除术整块切除联合经阴道肛提肌折叠术，作为一种非闭塞性的固有组织技术，用于 apical 支撑，治疗阴道癌和 IV 期阴道子宫脱垂。
最终检查显示 apical 支撑和阴道“可居住性”保持良好。患者接受了五次腔内近距离放射治疗，总剂量为 20 Gy，作为辅助治疗。
阴道癌和 IV 期阴道子宫脱垂的手术治疗成功完成，无并发症。经阴道肛提肌折叠术可为 apical 支撑提供一种通用的非闭塞性固有组织技术，允许随后进行辅助性近距离放射治疗。
