Geburtshilfe Frauenheilkd 2022; 82(10): e59-e60
DOI: 10.1055/s-0042-1756784
Abstracts | DGGG

The treatment of vaginal carcinoma recurrence in a neovagina with laser skinning colpectomy

Authors

  • A Denecke

    1   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland

  • M Jentschke

    1   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland

  • E Kuehnle

    1   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland

  • P Hillemanns

    1   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland
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The 59-year-old patient was admitted to a dysplasia consultation for the first time following repeated unsucccesfull antimycotic treatment.

During colposcopy we confirmed a squamous cell cervical cancer and carcinoma in situ with focal microinvasion in the left vaginal wall.

The patient then underwent radical hysterectomy and adenectomy, pelvic and para-aortic lymphonodectomy, radical colpectomy in the upper vaginal area, laser skinning colpectomy with adhesiolysis in the lower vagina area. We decided to create a neovagina by way of an omentum graft . We decided not to use skin grafts and reconstructed the posterior wall with transposition flaps. Reepitheliarisation proceeded correct. The final tumour stage was T2b, N0 (0/59), L0, V0, R0.

During a routine check-up 1 year after the primary therapy, we saw invasion in the posterior vaginal wall. In the biopsy we again secured a microinvasive squamous cell carcinoma. We decided not to make an excision in the area of the neovagina, instead we used the CoLaSCo technique.

Histologically, we confirmed a microinvasive vaginal carcinoma (rpT1, rpTis, R0). The further course was regular.

The Colasco technique is based on superficial laser excision under colposcopic control along the lamina vasorum with about 2-3 mm penetration depth. In patients with post-vaginal hysterectomy, excision was performed after considering and taking into account the corners of the vaginal stump. The effectiveness of this procedure is very high.

Our case shows recurrence of a vaginal carcinioma in the omentum only a short time after reconstruction of the vagina.

The recurrence could be treated very effectively with CoLasco.


Interessenkonflikt

Ich erkläre als korrespondierender Autor, dass meine Koautoren mir mitgeteilt haben, dass sie während der letzten 3 Jahre keine wirtschaftlichen oder persönlichen Verbindungen im oben genannten Sinne hatten. Auch ich selbst hatte keine derartigen Verbindungen in den letzten 3 Jahren.

Publication History

Article published online:
11 October 2022

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