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Objective:to assess the efficacy of fluorescence sentinel lymph node (SLN) detection with indocyanine green (ICG) in patients with cervical cancer.Materials and methods.We analyzed the results of examination and treatment in 80 patients with morphologically verified stage IA1–IIA1 cervical cancer. All patients underwent laparoscopic surgery with fluorescence SLN detection with ICG using a high-resolution infrared camera.Results.SLNs were detected in 78 out of 80 patients (97.5 %); the rate of bilateral SLN detection was 80.0 % (64 out of 80). SLNs were not identified in 2 patients only (2.5 %). The majority of SLNs (99 out of 176; 56.28 %) were located in the internal group of lymph nodes, near to the common iliac artery bifurcation. Eleven out of 80 patients (13.75 %) were found to have pelvic lymph node metastasis. SLN metastatic lesions were observed in 10 out of 80 patients (12.5 %), whereas only one participant had non-SLN metastasis. Therefore, the sensitivity of the fluorescence method with ICG was 98.75 %.Conclusion.Fluorescence SLN mapping with ICG in patients with stage IA1–IIA1 cervical cancer is an effective diagnostic method allowing SLN topical diagnosis, intraoperative restaging, and correction of the treatment strategy.

Surgery remains the main method of treatment for endometrial cancer (EC). Treatment of elderly and senile patients is particularly difficult due to the high prevalence of comorbidities in this population and large number of intraand postoperative complications that can potentially occur. The article compares laparoscopic and laparotomic approaches in surgical treatment of patients with EC. We analyzed clinical and morphological features of EC, characteristics of intraoperative and postoperative periods, complications and long-term treatment outcomes in patients treated at the N.N. Petrov Research Institute of Oncology.

Introduction . The main method of treatment of endometrial cancer, the most common oncological disease, is surgery. Introduction of high-tech operations into gynecological practice promoted active use of laparoscopy in treatment of malignant tumors of the endometrium. Objective . To evaluate effectiveness of video endoscopic surgery in treatment of endometrial cancer. Materials and methods. In the period from 2010 to 2016, 1127 patients with endometrial cancer underwent surgery using video endoscopic complex with high resolution cameras at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia. Results . Using video endoscopic technology, excision of the uterus with appendages was performed in 588 (52.3 %) patients, excision of the uterus with appendages and pelvic lymph node dissection was performed in 523 (46.4 %) patients including 16 (1.4 %) patients with serous and papillary serous forms of endometrial cancer who also underwent omentectomy. No intraoperative complications were observed. In the majority of patients, postoperative period was characterized by early activization, satisfactory intestinal peristalsis on day 1, minimal complications, absence of contraindications for adjuvant beam therapy. Conclusion . Video endoscopic technology is a modern method of surgical treatment allowing to perform the full scope of planned radical surgical intervention in patients with endometrial cancer irrespectively of age and concomitant disorders with minimal traumatization, risk of intraand postoperative complications as well as favorable and fast rehabilitation period.

During the period of 2010-2015 laparoscopic surgery was performed in 1263 patients: 1113 with endometrial cancer (588 hysterectomies, 509 hysterectomies with pelvic lymphadenectomy, among them 16 with sentinel lymph node (SLN) mapping with Indocyanine green (ICG)); 86 with cervical cancer (80 nerve-sparing radical hysterectomies (NSRH), among them 15 with SLN mapping, 6 radical vaginal trachelectomies with endovideoassisted lymphadenectomy); 64 with ovarian malignancies. The average operating time in the group of hysterectomies was 101 minutes, in the group of hysterectomies with pelvic lymphadenectomy - 184 minutes, in the group of NSRH - 230 minutes. Average blood loss was less than 50 ml. No intraoperative complications were registered. Asymptomatic lymph cysts were observed in 122 cases. Symptomatic lymph cysts requiring surgical treatment were registered in 9 cases. Inconsistencies of vaginal sutures after radical hysterectomy were in two cases, ureterovaginal fistulas - in two cases. During a 3-year follow-up period twelve recurrences were observed in endometrial cancer patients (12/443; 2,7%), four patients (0,9%) died from disease. After NSRH two local recurrences (2,5%) were registered in patients with cervical cancer, after radical trachelectomy -two local recurrences (33%). One patient became pregnant in the group of vaginal trachelectomies. Therefore laparoscopic approach in treatment of female genital malignacies allows performing an adequate volume of surgery with minimal risk of intra- and postoperative complications, favorable course of the rehabilitation period, and oncological safety.

For the period from September 2010 to September 2014 there were operated 513 patients with endometrial cancer using laparoscopic installation the Karl Storz company. 304 patients (59.2%) underwent hysterectomy with appendages, 209 (40.8%)--hysterectomy with appendages and pelvic lymphadenectomy, including 11 patients (2.2%) with the addition of omentectomy in serous and serous-papillary forms of endometrial cancer. The average age of patients was 58.4 years (44-75 years). Body mass index over 25.0 was determined in 456 patients (88.9%), of whom 183 patients (35.6%) had an excess of body weight, in 159 (31.0%)--obesity of I degree, in 79 (15.5%)--obesity of II degree and in 35 patients (6.8%)--obesity of III degree. There were no reported complications during surgery. The postoperative period in the majority of patients was characterized by the minimal complications and absence of contraindications for adjuvant radiotherapy. During follow-up period there were registered 4 relapses: in 1 patient with serous--papillary form of endometrial cancer during the first year after surgery--in the form of dissemination of tumor in the abdomen and pelvis; in 3 patients--in the form of a cytological detection of glandular cancer cells in vaginal stump. As a result, regardless of age and comorbidities, laparoscopy allows performing to endometrial cancer patients the entire volume of planned radical surgery with minimum damage and with minimal risk of intra- and postoperative complications, favorable and accelerated rehabilitation period.

Surgery is the main method in treatment for endometrial cancer. The complexity of treatment of endometrial cancer patients in elderly age is a result of a large number of comorbidities and, as a consequence, the potential possibility of a large number of intra--and postoperative complications. The article presents the international data and the analysis of own results of a use of laparoscopy in surgical treatment of these patients. A comparison with a group of operations performed by laparotomy is carried out as well as it is evaluated the main intra--and perioperative parameters and also complications, and immediate outcomes of patients treated at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology.

We analyzed the international and our own experience of using different dyes in the identification of sentinel lymph nodes in oncogynecological practice. We evaluated the possibility of using indocyanine green (ICG) in the detection of sentinel lymph nodes in patients with endometrial and cervical cancer. The first results of the use of ICG at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology are presented.