Morrow’s Gynecologic Cancer Surgery, 2nd Edition is an invaluable comprehensive surgical text book resource containing step-by-step written and illustrated descriptions of all the important operations in the field of gynecologic oncology.
Benefit from the concise coverage of the relevant anatomy, surgical principles, pre-and postoperative care, and management of surgical complications, written by one of the world’s leading gynecologic oncology surgeon.
Extensively illustrated and well-documented by an abundance of references to the scientific literature, Morrow’s Gynecologic Cancer Surgery, 2nd Edition is a timeless classic which will be consulted endlessly.
The first three Chapters are devoted to issues common to all major surgery, and constitute the framework into which the specific surgical procedures must be integrated to optimize a successful outcome.
Chapter IV is dedicated to surgical anatomy, which is the fundamental basis of all surgical procedures. It is replete with detailed drawings of all regions of the body important to the gynecologic cancer surgeon.
Wound healing is impaired in many patients with gynecologic cancer, especially the malnourished or irradiated patient. Thus, the gynecologic oncologist must be well versed in the identification of and alleviation of malnutrition, the adverse effects of radiation on wound and operative complications, and the selection and performance of the best incision for the anticipated operative procedure.
Chapters 6 and 7
Surgery on the bowel and urinary tract are an important part of some operations for gynecologic cancers. The management of complications related to these organ systems whether a consequence of the tumor itself, or surgery or radiation therapy is of vital relevance to gynecologic oncology. All these issues are discussed in detail in Chapters VI and VII.
One of the most important mangement phases of some gynecologic cancers is the reconstruction of the operative site (perineum, vagina). The indications for, and postoperative care of skin grafts, local flaps, and myocutaneous flaps are presented in addition to the step-by-step description of these procedures.
Chapters 9 -13
The discussion and detailed description of the surgical procedures are integrated into Chapters IX-XIII in an organ-centered arrangement maximizing the association of the treatment with the known behavior, prognosis, and extent of the various neoplasms.
For each operation there is an accompanying discussion of the indications for the procedure, the details of the associated surgical procedures, the potential postoperative complications and their management.
The final Chapter on the trophoblastic tumors of pregnancy, the malignant forms of which are rare, relatively easy to diagnose, and highly curable with chemotherapy. Unfortunately they are also lethal if not diagnosed early and managed correctly.
I Basic Surgical Principles
(vascular access, intra-operative hemorrhage, blood component therapy, instrumentation, sutures, drains)
II Preoperative Assessment: Evaluation and Preparation
(operative consent, blood tests and imaging, evaluation related to specific disease sites, DVT prevention, antibiotics, bowel prep, nutrition)
III Postoperative Care
(orders, diagnostic studies, fluids and electrolytes, nutrition – oral, parenteral, enteral, medications, intensive care, postoperative complications, venous thrombo-embolism, arterial thrombosis, compartment syndrome)
IV Surgical Anatomy
(abdominal wall, the abdomen – small, large intestine; anomalies; omentum; retroperitoneum, pelvis, vulva and perineum; inguinal region)
V Wound Healing and Incisions
(tissue repair, growth factors; abdominal incisions – vertical and transverse; wound closure; morbidly obese; subcostal; retroperitoneal access; Schuchardt; postoperative care; complications; secondary closure)
VI Surgery on the Intestinal Tract
(general principles: hand-sewn anastomoses; staples; procedures on the stomach; small bowel surgery: jejunostomy, resection, by-pass, ileostomy; large bowel surgery: end and loop colostomy; left, right, transverse, rectosigmoid resection; J-pouch; appendectomy; complications of bowel surgery – leak, hemorrhage, blind loop, short bowel, obstruction, fistula; radiation bowel injury)
VII Surgery on the Urinary Tract
(diversion – ileal, jejunal, colonic conduit and stomas; ureterostomy; continent – right colon; ureteroileoneocystostomy; bladder augmentation; ureteral stents; drains; psoas hitch, Boari bladder flap; ureteral anastomosis; suprapubic cystostomy; partial cystectomy.
VIII Reconstructive Surgery
(split thickness skin graft; Z-plasty, rhomboid flaps; perineal-thigh flap; V-Y flap; Martius flap; pudendal thigh flap; myocutaneous flaps – rectus abdominis, gracilis, and tensor fasciae latae flap; vaginal reconstruction: skin graft, myocutaneous flap, axial and fasciocutaneous flaps, intestine; perineal and inguinal reconstruction)
IX Surgery for Vulvar Neoplasia
(vulvar intraepithelial neoplasia: laser ablation; surgical resection – local, skinning vulvectomy and skin graft; Pagets disease; melanotic lesions; invasive carcinoma: radical local excision, radical vulvectomy +/- partial vaginectomy, distal urethrectomy, anoproctectomy, partial pubectomy, pelvic exenteration; superficial or complete inguinal lymphadenectomy, pelvic lymphadenectomy; outcome and complications including lymphedema, sexual dysfunction; radiation therapy; uncommon cancers)
X Surgery for Cervical Neoplasia
(intraepithelial neoplasia: malignant potential, detection, diagnosis, management – LEEP, laser, cryosurgery, scalpel; invasive carcinoma: diagnosis, work-up, staging, ovarian preservation, microinvasion, bulky Ib, neoadjuvant chemotherapy, chemoradiation therapy, pregnancy; surgery: simple hysterectomy, variations of radical abdominal hysterectomy; radical trachelectomy; postop complications; radical vaginal hysterectomy; pelvic lymphadenectomy; exenterative procedures; resecting the hypogastric system; urethral preservation; intraoperative radiation)
XI Management of Uterine Neoplasia
(endometrial hyperplasia – classification, malignant potential, surgery, hormonal therapy; polyps; carcinoma: epidemiology, clinical features Type I and II, diagnosis, ECC, intra-operative assessment or risk factors, surgical-pathological staging, pelvic and aortic node staging, sentinel node, value of node dissection, scoring system to predict node metastases, complications, postoperative therapy; treatment recommendations by surgical stage; cytoreduction; hormone replacement therapy; the inoperable patient; postoperative diagnosis; the young woman – hormone therapy, ovarian preservation; treatment of recurrence; histologic subtypes – clear cell, PSC; uterine sarcomas: low grade and high grade stromal sarcoma, rare uterine smooth muscle tumors such as intravenous leiomyomatosis, myxoid leiomyosarcoma, etc; leiomyosarcoma, carcinosarcoma, rhabdomyosarcoma, osteosarcoma, etc.
XII Surgery for Ovarian Neoplasia
(general features, tumors of low malignant potential, management of LMP tumors; ovarian carcinoma: screening, diagnosis, evaluation; surgico-pathological staging; management of early stage – surgical staging, aortic node staging, adjuvant therapy; tumor reductive surgery: radical oophorectomy, abdominal tumor removal – diaphragm, spleen, omentum, bowel resection, peritoneal stripping, nodal masses; results; postoperative therapy – IV and IP chemotherapy; second-look; secondary cytoreduction; prophylactic ovariectomy; ovarian cancer in pregnancy; pseudomyxoma; bowel obstruction; serous effusions; germ cell and stromal ovarian tumors)
XIII Tumors of the Vagina, Broad Ligament, and Fallopian Tube
(vaginal intraepithelial neoplasia: laser, 5-FU, radiation; carcinoma: surgery, radiation, outcome; non-squamous cancers; vaginal adenosis and clear cell cancer; tumors of the broad ligament; tumors of the fallopian tube.
XIV Tumors of the Placental Trophoblast
(hydatidiform mole: epidemiology, diagnosis, complete and partial mole, invasive mole, management – suction curettage, hysterectomy, theca-lutein cysts, complications, fetus and mole, malignant potential, follow-up, post-molar hCG regression curve, repeat curettage; choriocarcinoma; management of non-metastatic and metastatic trophoblastic disease; single agent and multiagent chemotherapy; complications; hCG testing; indications for hysterectomy; trophoblastic pseudotumor)