IMR Press / EJGO / Volume 31 / Issue 2 / pii/1630984575735-450965756

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report
External iliac artery ligation due to late postoperative rupture after radical lymphadenectomy for advanced ovarian cancer - two case reports
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1 Department of Gynecology, Charité, Campus Virchow Clinic, University Hospital, Berlin
2 Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow Clinic, University Hospital, Berlin (Germany)
Eur. J. Gynaecol. Oncol. 2010, 31(2), 198–200;
Published: 10 April 2010
Abstract

According to the present guidelines for advanced epithelial ovarian cancer (EOC), bulky lymph nodes should be removed as part of the routine surgical staging and the primary goal being removal of all macroscopic tumor residuals. Furthermore, EOC-patients with bulky lymph node relapse seem to benefit from lymphadenectomy in terms of recurrence and overall survival.We present two cases of severe postoperative hemorrhage due to external iliac artery rupture ten and 12 days after radical bulky lymph node removal in primary and recurrent EOC-patients. Both cases were successfully managed by ligation of the two arms of the external iliac artery achieving immediate hemostasis. No crossover bypass was required to maintain lower extremity perfusion. Late rupture of the iliac vessels is a rare complication of systematic lymphadenectomy in EOC. This complication can be managed by unilateral external iliac artery ligation without mandatory subsequent graft interposition or crossover bypass.
Keywords
Hemorrhage
Ovarian cancer
Bulky lymph nodes
External iliacal artery
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