Sonographic diagnosis and Endo-SPONGE assisted vacuum therapy of anastomotic leakage following posterior pelvic exenteration for ovarian cancer without using a protective stoma.
10.3802/jgo.2011.22.2.131
- Author:
Jens EINENKEL
1
;
Babett HOLLER
;
Albrecht HOFFMEISTER
Author Information
1. Department of Obstetrics and Gynecology, Center for Women's & Children's Health, University of Leipzig, Leipzig, Germany. jens@einenkel.eu
- Publication Type:Case Report
- Keywords:
Posterior pelvic exenteration;
Anastomotic leakage;
Ovarian cancer;
Transvaginal ultrasound
- MeSH:
Anastomotic Leak;
Humans;
Ovarian Neoplasms;
Pelvic Exenteration;
Pelvis;
Peritonitis;
Vacuum
- From:Journal of Gynecologic Oncology
2011;22(2):131-134
- CountryRepublic of Korea
- Language:English
-
Abstract:
Anastomotic leakage is a very significant complication after posterior pelvic exenteration and a major cause of postoperative morbidity and mortality. We present a patient who underwent an optimal debulking surgery for an advanced stage ovarian cancer (FIGO IIIC). On postoperative day 12, transvaginal ultrasound revealed an anastomotic dehiscence following an unsuspicious computer tomography scan the day before. The patient was successfully managed by transanal vacuum therapy without re-laparotomy within a period of 4 weeks after diagnosis. We conclude that high-resolution transvaginal ultrasound is a crucial method in the management of complications after surgery and even allow diagnosing leakages of colorectal anastomosis. In selected cases characterized by a small leak size and a local peritonitis confined to the pelvis a transanal vacuum therapy may avoid both surgical re-intervention and creating a secondary diverting stoma.