Gyn/Onc
How soon should a patient be started on chemotherapy after a hysterectomy?
1 month
This is the only procedure where one could consider prophylactic abx
laparotomy without entry into bowel or bladder
Stage 1a
<50% of the myometrium
most common endometrial cancer
adenocarcinoma
These antibiotics (with dosages) are to be used for patients with immediate hypersensitivity reactions to penicillins
Clinda 900mg or Metro 500mg
Plus
Gent 5mg/kg or aztreonam 2g
Stage IIIA
Invasion of the adnexa and/or uterine serosa
cancer marker used to monitor cancer recurrence
ca 125
Additional antimicrobial prophylaxis dosages or increased doses may be warranted in these three circumstances
Obesity >120kg
>4hr procedure length
Excessive blood loss QBL >1500
Stage II
Invasion into the cervical stroma
Risk factors for endometrial cancer
increased estrogen 2/2 obesity, late menopause, nulliparity, and genetics
These preoperative measures are used to prevent surgical site infections
Treat remote infections
Not shaving incision site (unless immediately prior to operation with electric clippers)
Control of serum BG levels
Advising patients to shower or bathe with soap or antiseptic agent on at least the night before abdominal surgery
Preoperative surgical site skin preparation with an alcohol-based agent
Maintain appropriate aseptic technique
Minimize operating room traffic
Stage IIIC
Invasion of pelvic and/or para-aortic lymph nodes
Most common chemotherapy agents used for treating endometrial cancer
carboplatin and paclitaxol
Give five patient risk factors for surgical site infections
Perioperative hyperglycemia
Smoking
Obesity
Nutritional status
Depth of subq tissue
Coexistent infection
Vaginal colonization
American Society of Anesthesiologists physical status
Immunodeficiency
MRSA status
Stage IVA
Invasion into the bladder or bowel mucosa