Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer

Benjamin W. Corn, Barry D. Shaktman, Rachelle M. Lanciano, W. Michael Hogan, Jacqueline R. Cater, Lisa Anderson, Paul Heller, Enrique Hernandez

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose. The purpose of this study was to chronicle the acute morbidity associated with the implantation of tandems and colpostats in women with carcinoma of the cervix; to determine factors that predispose to the development of such complications; and to assess whether the use of ultrasound allowed the apparatus to be safely implanted in women at relatively high risk for perforation of hollow viscous organs. Methods. A database from two Philadelphia institutions was used to assess the aforementioned factors among 143 tandems/colpostats inserted into 100 women with cervix cancer. Twenty patients had insertion under ultrasound guidance because of stenotic cervical os, fibrosis from external-beam irradiation, indeterminate orientation of endometrial cavity axis, or previous perforation. Univariate and multivariate analyses were performed to identify predictors of intra- and perioperative complications. Results. Intraoperative complications occurred in 7 of 143 placements (5%). These included uterine perforations (n = 4), vaginal lacerations (n = 2), and one instance of bladder perforation. Only older age, whether entered as a continuous or a dichotomous variable, was associated statistically with these complications. Perioperative complications (e.g., fever, bowel obstruction, exacerbation of chronic obstructive pulmonary disease, cardiac complication) occurred in 54 of 143 implanted women. In univariate analysis, older age and underlying chronic obstructive pulmonary disease (COPD) appeared to be associated with perioperative complications. A multivariate analysis showed that underlying COPD predisposed to perioperative complications during the first implant and that age over 60 years independently predicted for complications during any implant. Conclusions. Intraoperative complications are relatively rare events. Ultrasonography seems to allow safe intrauterine insertion of the tandem despite the selection of difficult cases for this adjunctive imaging tool. Patient age over 60 years independently predicts for perioperative complications. COPD predicts for perioperative complications during the first but not the second implant, implying that physicians are able to optimize the medical management of pulmonary disease to allow a second implant to be performed more safely.

Original languageEnglish (US)
Pages (from-to)224-229
Number of pages6
JournalGynecologic Oncology
Volume64
Issue number2
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Intraoperative Complications
Uterine Cervical Neoplasms
Chronic Obstructive Pulmonary Disease
Multivariate Analysis
Uterine Perforation
Lacerations
Cervix Uteri
Lung Diseases
Ultrasonography
Urinary Bladder
Fibrosis
Fever
Databases
Morbidity
Carcinoma
Physicians

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Corn, B. W., Shaktman, B. D., Lanciano, R. M., Hogan, W. M., Cater, J. R., Anderson, L., ... Hernandez, E. (1997). Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer. Gynecologic Oncology, 64(2), 224-229. https://doi.org/10.1006/gyno.1996.4564
Corn, Benjamin W. ; Shaktman, Barry D. ; Lanciano, Rachelle M. ; Hogan, W. Michael ; Cater, Jacqueline R. ; Anderson, Lisa ; Heller, Paul ; Hernandez, Enrique. / Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer. In: Gynecologic Oncology. 1997 ; Vol. 64, No. 2. pp. 224-229.
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abstract = "Purpose. The purpose of this study was to chronicle the acute morbidity associated with the implantation of tandems and colpostats in women with carcinoma of the cervix; to determine factors that predispose to the development of such complications; and to assess whether the use of ultrasound allowed the apparatus to be safely implanted in women at relatively high risk for perforation of hollow viscous organs. Methods. A database from two Philadelphia institutions was used to assess the aforementioned factors among 143 tandems/colpostats inserted into 100 women with cervix cancer. Twenty patients had insertion under ultrasound guidance because of stenotic cervical os, fibrosis from external-beam irradiation, indeterminate orientation of endometrial cavity axis, or previous perforation. Univariate and multivariate analyses were performed to identify predictors of intra- and perioperative complications. Results. Intraoperative complications occurred in 7 of 143 placements (5{\%}). These included uterine perforations (n = 4), vaginal lacerations (n = 2), and one instance of bladder perforation. Only older age, whether entered as a continuous or a dichotomous variable, was associated statistically with these complications. Perioperative complications (e.g., fever, bowel obstruction, exacerbation of chronic obstructive pulmonary disease, cardiac complication) occurred in 54 of 143 implanted women. In univariate analysis, older age and underlying chronic obstructive pulmonary disease (COPD) appeared to be associated with perioperative complications. A multivariate analysis showed that underlying COPD predisposed to perioperative complications during the first implant and that age over 60 years independently predicted for complications during any implant. Conclusions. Intraoperative complications are relatively rare events. Ultrasonography seems to allow safe intrauterine insertion of the tandem despite the selection of difficult cases for this adjunctive imaging tool. Patient age over 60 years independently predicts for perioperative complications. COPD predicts for perioperative complications during the first but not the second implant, implying that physicians are able to optimize the medical management of pulmonary disease to allow a second implant to be performed more safely.",
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Corn, BW, Shaktman, BD, Lanciano, RM, Hogan, WM, Cater, JR, Anderson, L, Heller, P & Hernandez, E 1997, 'Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer', Gynecologic Oncology, vol. 64, no. 2, pp. 224-229. https://doi.org/10.1006/gyno.1996.4564

Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer. / Corn, Benjamin W.; Shaktman, Barry D.; Lanciano, Rachelle M.; Hogan, W. Michael; Cater, Jacqueline R.; Anderson, Lisa; Heller, Paul; Hernandez, Enrique.

In: Gynecologic Oncology, Vol. 64, No. 2, 01.01.1997, p. 224-229.

Research output: Contribution to journalArticle

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T1 - Intra- and perioperative complications associated with tandem and colpostat application for cervix cancer

AU - Corn, Benjamin W.

AU - Shaktman, Barry D.

AU - Lanciano, Rachelle M.

AU - Hogan, W. Michael

AU - Cater, Jacqueline R.

AU - Anderson, Lisa

AU - Heller, Paul

AU - Hernandez, Enrique

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Purpose. The purpose of this study was to chronicle the acute morbidity associated with the implantation of tandems and colpostats in women with carcinoma of the cervix; to determine factors that predispose to the development of such complications; and to assess whether the use of ultrasound allowed the apparatus to be safely implanted in women at relatively high risk for perforation of hollow viscous organs. Methods. A database from two Philadelphia institutions was used to assess the aforementioned factors among 143 tandems/colpostats inserted into 100 women with cervix cancer. Twenty patients had insertion under ultrasound guidance because of stenotic cervical os, fibrosis from external-beam irradiation, indeterminate orientation of endometrial cavity axis, or previous perforation. Univariate and multivariate analyses were performed to identify predictors of intra- and perioperative complications. Results. Intraoperative complications occurred in 7 of 143 placements (5%). These included uterine perforations (n = 4), vaginal lacerations (n = 2), and one instance of bladder perforation. Only older age, whether entered as a continuous or a dichotomous variable, was associated statistically with these complications. Perioperative complications (e.g., fever, bowel obstruction, exacerbation of chronic obstructive pulmonary disease, cardiac complication) occurred in 54 of 143 implanted women. In univariate analysis, older age and underlying chronic obstructive pulmonary disease (COPD) appeared to be associated with perioperative complications. A multivariate analysis showed that underlying COPD predisposed to perioperative complications during the first implant and that age over 60 years independently predicted for complications during any implant. Conclusions. Intraoperative complications are relatively rare events. Ultrasonography seems to allow safe intrauterine insertion of the tandem despite the selection of difficult cases for this adjunctive imaging tool. Patient age over 60 years independently predicts for perioperative complications. COPD predicts for perioperative complications during the first but not the second implant, implying that physicians are able to optimize the medical management of pulmonary disease to allow a second implant to be performed more safely.

AB - Purpose. The purpose of this study was to chronicle the acute morbidity associated with the implantation of tandems and colpostats in women with carcinoma of the cervix; to determine factors that predispose to the development of such complications; and to assess whether the use of ultrasound allowed the apparatus to be safely implanted in women at relatively high risk for perforation of hollow viscous organs. Methods. A database from two Philadelphia institutions was used to assess the aforementioned factors among 143 tandems/colpostats inserted into 100 women with cervix cancer. Twenty patients had insertion under ultrasound guidance because of stenotic cervical os, fibrosis from external-beam irradiation, indeterminate orientation of endometrial cavity axis, or previous perforation. Univariate and multivariate analyses were performed to identify predictors of intra- and perioperative complications. Results. Intraoperative complications occurred in 7 of 143 placements (5%). These included uterine perforations (n = 4), vaginal lacerations (n = 2), and one instance of bladder perforation. Only older age, whether entered as a continuous or a dichotomous variable, was associated statistically with these complications. Perioperative complications (e.g., fever, bowel obstruction, exacerbation of chronic obstructive pulmonary disease, cardiac complication) occurred in 54 of 143 implanted women. In univariate analysis, older age and underlying chronic obstructive pulmonary disease (COPD) appeared to be associated with perioperative complications. A multivariate analysis showed that underlying COPD predisposed to perioperative complications during the first implant and that age over 60 years independently predicted for complications during any implant. Conclusions. Intraoperative complications are relatively rare events. Ultrasonography seems to allow safe intrauterine insertion of the tandem despite the selection of difficult cases for this adjunctive imaging tool. Patient age over 60 years independently predicts for perioperative complications. COPD predicts for perioperative complications during the first but not the second implant, implying that physicians are able to optimize the medical management of pulmonary disease to allow a second implant to be performed more safely.

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