Laparoscopic Management of a Small Bowel Recurrence of Endometrial Cancer

Study Objective: We present a very rare case of focal metastasis of endometrial cancer to the small bowel entirely managed laparoscopically. Design: Case report (Canadian Task Force Classification Study design III). Setting: Tertiary referral centre in Rome, Italy. Patients: A 58 year-old patient with a FIGO Stage IB G2 N0 endometrial cancer was found to have a vaginal cuff recurrence and an isolated distant metastasis to the small bowel 13 months after primary treatment. Intervention: In this video we show a fully laparoscopic management mainly focusing on small bowel resection with intracorporeal anastomosis. A laparoscopic partial colpectomy was also performed. Our institutional review board approved this study. Measurements and main results: Operative time was 180 minutes. Intraoperative blood loss was less than 100 mL. The operation was performed successfully with no intraoperative complications. Pathologic findings showed recurrent disease in the vaginal cuff and in the resected small bowel segment with free resection margins in both specimens and 3 mesenteric local nodes negative for metastasis. The patient was discharged on day 3 and 26 days later started adjuvant chemotherapy. After a 16-month follow-up period, the patient is still disease free and in good general conditions. Conclusions: This case shows a successful laparoscopic management of recurrent endometrial cancer equiring complex surgical procedures.