Dren olmalı mı yoksa olmamalı mı ? Uterin sarkomlu bir hastada dren yeri metastazı için aspirasyon dren kullanımıyla ilgili bir cerrahi ikilem

Abstract

Major cerrahi işlemler sonrasında özellikle yumurtalık kanseri gibi asit fazlalığı olan hastalarda ameliyat alanında sıvı toplanmasını önlemek, kanama veya anastomoz kaçağı riskine karşı takip etmek ve yara iyileşmesini kolaylaştırmak için dren yerleştirilmesi yaygın bir uygulamadır. Laparoskopik cerrahiden sonra giriş yeri nüksleri tanımlanmış olmasına rağmen, jinekolojik kanser hastalarında laparotomiden sonra önceki dren yerine metastaz nadiren görülür. Uterus sarkomundan kaynaklanan cilt tutulumu özellikle sıra dışıdır. Bir dren yerleştirmeye karar verirken, nadir de olsa, yapay bir perkütan yol boyunca tümör ekilebileceği akılda tutulmalıdır. Biz bu olgu sunumda primer tümör rezeksiyonundan bir yıl sonra cerrahi dren bölgesinde uterus andiferansiye sarkom nüksü olan bir olguyu sunuyoruz.

Keywords

• Sarkom
• Endometriyal
• Stromal
• Neoplazm

Drain or not drain? A surgical dilemma using suction drain for drain site metastasis in a patient with uterine sarcoma

Abstract

Drain placement is a common practice after major surgeries to prevent collection accumulation in the operation field, follow up against the risk of bleeding or anastomotic leakage, and facilitate wound healing, especially in patients with large amounts of ascites such as ovarian cancer. Although port site recurrences have been described after laparoscopic surgery, metastasis to the previous drain site rarely occurs after laparotomy in gynecologic cancer patients. Cutaneous involvement originating from uterine sarcoma is particularly unusual. Albeit rare, malignant-cell seeding along an artificial percutaneous tract should be kept in mind when deciding to place a drain. We present a case of uterine undifferentiated sarcoma recurrence at the surgical drain site after one year later of primary tumour resection.

Keywords

• Sarcoma
• Endometrial
• Stromal
• Neoplasm Seeding

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