Yong-Soon Kwon1, Jae-Young Gwack1, Kyong S Im2, Dong-Il Choi2. 1. Department of Obstetrics and Gynecology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea. 2. Department of Anesthesiology and Pain Medicine, Uijeongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Abstract
BACKGROUND: Gynaecological surgery techniques and instruments have advanced and there is increasing effort to reduce operative complications by preventing adhesion complications after surgery. AIMS: The purpose of this study was to evaluate a possible limitation of the Surgi-Wrap(®) anti-adhesion material during clinical follow-up of surgically managed gynaecological malignancies. METHODS: We retrospectively analysed the medical records and imaging findings of 92 patients who received the Surgi-Wrap(®) anti-adhesion material. RESULTS: Nine of the 92 patients had local recurrence based on the imaging findings. The positive imaging findings showed focal, isolated and small pelvic lesions without other distant metastasis or recurrence and normal tumour marker levels. Laparoscopic exploration and biopsy were performed in six patients and close clinical follow-up was performed for the other three patients, who had a strong diagnostic impression of a foreign body reaction mimicking a focal recurrence of the tumour. The histological findings of the six laparoscopically-explored patients revealed a foreign body reaction without malignancy in five and recurrence in one case. The rate of foreign body reaction, mimicking a local recurrence, was 5/92 (5.4% of histologically confirmed cases) and 8/92 cases had ambiguous findings between a foreign reaction and local recurrence (8.7% of clinically suspected cases). CONCLUSIONS: It is important to avoid confusion between benign and recurrent conditions during follow-up for gynaecological malignancies. We suggest avoiding use of Surgi-wrap(®) during cancer surgeries and a need for further studies on the safety of Surgi-wrap(®) in patients with cancer.
BACKGROUND: Gynaecological surgery techniques and instruments have advanced and there is increasing effort to reduce operative complications by preventing adhesion complications after surgery. AIMS: The purpose of this study was to evaluate a possible limitation of the Surgi-Wrap(®) anti-adhesion material during clinical follow-up of surgically managed gynaecological malignancies. METHODS: We retrospectively analysed the medical records and imaging findings of 92 patients who received the Surgi-Wrap(®) anti-adhesion material. RESULTS: Nine of the 92 patients had local recurrence based on the imaging findings. The positive imaging findings showed focal, isolated and small pelvic lesions without other distant metastasis or recurrence and normal tumour marker levels. Laparoscopic exploration and biopsy were performed in six patients and close clinical follow-up was performed for the other three patients, who had a strong diagnostic impression of a foreign body reaction mimicking a focal recurrence of the tumour. The histological findings of the six laparoscopically-explored patients revealed a foreign body reaction without malignancy in five and recurrence in one case. The rate of foreign body reaction, mimicking a local recurrence, was 5/92 (5.4% of histologically confirmed cases) and 8/92 cases had ambiguous findings between a foreign reaction and local recurrence (8.7% of clinically suspected cases). CONCLUSIONS: It is important to avoid confusion between benign and recurrent conditions during follow-up for gynaecological malignancies. We suggest avoiding use of Surgi-wrap(®) during cancer surgeries and a need for further studies on the safety of Surgi-wrap(®) in patients with cancer.