Gynecologic oncology surgical procedures in the General hospital ”dr. Radivoj Simonovic” in Sombor in the period from 2011-2021

Abstract

Introduction. In the period from 2011 - 2021, 1482 gynecologic surgeries were performed at the Department of Gynecology and Obstetrics of the General Hospital in Sombor, of which 50 (3.4%) were gynecologic oncology surgical procedures. The distribution of the malignant tumor localization was as follows: vulva 4 (8%), cervix 13 (26%), endometrium 24 (48%), and ovary 9 (18%). Material and Methods. The preoperative diagnosis of all patients included standard laboratory tests of blood and urine, chest X-ray, internal medicine specialist examination, electrocardiography, and imaging procedures (magnetic resonance imaging or computed tomography) of the small pelvis and abdomen. In all cases, the diagnosis of vulvar, cervical, and endometrial cancer was made preoperatively, based on pathohistological findings of the biopsy samples of tumor tissue or material obtained using exploratory curettage. In ovarian cancer, the diagnosis was made during surgery based on ex tempore pathohistological analysis. Results. Most of the operated patients were in the International Federation of Gynecology and Obstetrics stage I - 39 (78%) and the most common pathohistological type of tumor was adenocarcinoma of different localizations - 29 (58%). The number of lymph nodes removed per surgery was 16 - 39 (x: 19) and lymphovascular invasion was present in 31 (62%) operated patients. Intraoperative complications (bleeding, ureteral injury, infection, and wound dehiscence) occurred in 8 (16%) patients, recurrence occurred in 3 (6%), and postoperative lethal outcome occurred in 4 (8%) patients. Conclusion. The essential condition for performing gynecologic oncology surgical procedures in a secondary level healthcare facility is a well-trained gynecology surgeon who has received complete training in gynecologic oncology at the tertiary level, as well as the optimal number of gynecologic oncology surgeries in accordance with recommendations of the European Society of Gynecological Oncology.