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.
Anastomotic Leak ; Humans ; Ovarian Neoplasms ; Pelvic Exenteration ; Pelvis ; Peritonitis ; Vacuum

OBJECTIVE: The objective of this study is to examine the course of fatigue in female cancer patients during the first months after treatment. METHODS: We examined a sample of 110 patients suffering from gynecological or breast cancer. Fatigue was assessed with two questionnaires, the Multidimensional Fatigue Inventory (MFI) and the fatigue scale of the quality of life questionnaire European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30). Participants were tested during their stay in the hospital (t1), two weeks after discharge (t2), and three months after discharge (t3). RESULTS: Fatigue in the patients' sample was markedly higher than the general population reference values. At t1, the effect sizes are d=0.81 (MFI) and d=1.21 (EORTC QLQ-C30 fatigue scale). Age and tumor stage had no significant influence on fatigue, but patients with a long time since diagnosis had higher fatigue levels than patients with a shorter time since diagnosis. From t1 to t3, fatigue mean scores decreased. The correlations between the t1 and the t3 fatigue scores were weak, with correlation coefficients of only about 0.30. CONCLUSION: Though the mean scores of fatigue, averaged across all patients, decreased over the first three months, the individual courses could not be predicted from the t1 score.
Breast ; Breast Neoplasms ; Fatigue ; Female ; Humans ; Quality of Life ; Reference Values ; Stress, Psychological ; Surveys and Questionnaires