title: Resection of the vaginal vault for vaginal recurrence of cervical cancer after hysterectomy and brachytherapy.
abstract: BACKGROUND
  We describe our experiences with vaginal vault resection for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. After operative treatment, the rate of vaginal vault recurrence of uterine cervical cancer is reported to be about 5%. There is no consensus regarding the treatment for these cases.
  
  
  METHODS
  Between 2004 and 2012, eight patients with vaginal vault recurrence underwent removal of the vaginal wall via laparotomy after hysterectomy and radiotherapy.
  
  
  RESULTS
  The median patient age was 45 years (range 35 to 70 years). The median operation time was 244.5 min (range 172 to 590 min), the median estimated blood loss was 362.5 mL (range 49 to 1,890 mL), and the median duration of hospitalization was 24.5 days (range 11 to 50 days). Two patients had intraoperative complications: a grade 1 bowel injury and a grade 1 bladder injury. The following postoperative complications were observed: one patient had vaginal vault bleeding, three patients developed vesicovaginal fistulae, and one patient had repeated ileus. Two patients needed clean intermittent catheterization. Local control was achieved in five of the eight cases.
  
  
  CONCLUSIONS
  Vaginal vault resection is an effective treatment for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. However, complications of this procedure can be expected to reduce quality of life. Therefore, this operation should be selected with great care.
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. akiko06090111@yahoo.co.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Abe
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. maki.matsumura@jfcr.or.jp.
authors.forename: Maki
authors.initials: M
authors.lastname: Matoda
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. sanshiro.okamoto@jfcr.or.jp.
authors.forename: Sanshiro
authors.initials: S
authors.lastname: Okamoto
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. eiji.kondo@jfcr.or.jp.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kondo
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. kazuyoshi.kato@jfcr.or.jp.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kato
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. kohei.omatsu@jfcr.or.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Omatsu
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. kenji.ummyahara@jfcr.or.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Umayahara
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. kuniko.utsugi@jfcr.or.jp.
authors.forename: Kuniko
authors.initials: K
authors.lastname: Utsugi
authors.affiliation: Departments of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. nobuhiro.takeshima@jfcr.or.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007564:Japan / Q000453:epidemiology; D007813:Laparotomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery*; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*