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abstract
Introduction
Port-site
metastases are a recognised complication of laparoscopy in the presence
of malignancy. With the increased use of minimally invasive technology
to surgically manage gynaecological malignancy, their incidence is
likely to increase. We describe three cases where patients underwent
laparoscopy prior to referral for definitive surgery.
Materials and methods
Patient
one attended a secondary centre complaining of urinary incontinence and
abdominal pain. Pre-operative imaging identified omental thickening and
ascites. Laparoscopy was performed and malignancy of the omentum and
peritoneum was identified in addition to a suspicious appearing ovary.
The second case concerned a 65 year-old patient presented with abdominal
pain and underwent emergent laparoscopy in which adenocarcinoma of the
ovary was diagnosed. After biopsies were obtained, the patient was
referred for definitive surgical management. Patient three underwent
laparoscopy due to abdominal pain. Pre-operative imaging identified
ascites and a pelvic mass. Biopsies were taken at laparoscopy which
confirmed ovarian malignancy.
Results
All
three patients developed histologically proven port-site metastatic
disease prior to undergoing definitive surgical management.
Conclusion
In
all cases, port-site metastatic disease developed rapidly and was
clinically suspected at the time of definitive surgery. We recommend
that consideration be given towards removing port sites when performing
cytoreductive surgery for gynaecological malignancy.
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