Vaginal vault metastasis – The new enigma in port site recurrences in gynecological laparoscopic surgeries

Abstract

Objective: To determine the frequency of vaginal vault recurrences in comparison with other port site recurrences following unplanned laparoscopic surgical treatment for gynecological malignancies. Design: Retrospective analysis of a prospectively maintained database of eight patients who underwent laparoscopic procedures for different gynecological malignancies. Results: Eight patients were identified to have port site recurrences. Out of these, seven had undergone laparoscopic surgery for ovarian tumor and were reported to be malignant with the exception of one which was a borderline ovarian tumor. One case had a fibroid uterus, which later turned out to be a leiomyosarcoma. Vaginal vault recurrence was seen in four out of the eight cases, and only one patient could be saved. Whereas out of the four cases with other port recurrences, three patients are in complete remission. Conclusion: Apart from other port recurrences, vaginal vault is a potential site of recurrence. But it is more significant as it results in greater morbidity and carries a worse prognosis than other port recurrences.

Keywords

• gynecological laparoscopic surgeries
• port recurrence
• vaginal vault recurrence