title: Laparoscopic Management of a Small Bowel Recurrence of Endometrial Cancer.
abstract: OBJECTIVE
  We present a very rare case of focal metastasis of endometrial cancer to the small bowel entirely managed laparoscopically.
  
  
  METHODS
  Case report (Canadian Task Force Classification Study design III).
  
  
  METHODS
  Tertiary referral centre in Rome, Italy.
  
  
  METHODS
  A 58 year-old patient with a FIGO Stage IB G2 N0 endometrial cancer was found to have a vaginal cuff recurrence and an isolated distant metastasis to the small bowel 13 months after primary treatment.
  
  
  METHODS
  In this video we show a fully laparoscopic management mainly focusing on small bowel resection with intracorporeal anastomosis. A laparoscopic partial colpectomy was also performed. Our institutional review board approved this study.
  
  
  RESULTS
  Operative time was 180 minutes. Intraoperative blood loss was less than 100 mL. The operation was performed successfully with no intraoperative complications. Pathologic findings showed recurrent disease in the vaginal cuff and in the resected small bowel segment with free resection margins in both specimens and 3 mesenteric local nodes negative for metastasis. The patient was discharged on day 3 and 26 days later started adjuvant chemotherapy. After a 16-month follow-up period, the patient is still disease free and in good general conditions.
  
  
  CONCLUSIONS
  This case shows a successful laparoscopic management of recurrent endometrial cancer equiring complex surgical procedures.
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gallottav@gmail.com.
authors.forename: Valerio
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Nero
authors.affiliation: General Surgery Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Callari
authors.affiliation: General Surgery Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Lodoli
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000556:secondary / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology*; D007558:Italy; D010535:Laparoscopy / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D016896:Treatment Outcome
keywords: Bowel resection; Laparoscopy; Recurrent endometrial cancer