Gynecologic Oncology

• New edition fully includes Grades and Levels of evidence, providing a better idea of what the sum total of existing evidence suggests regarding key topics
• Grades and levels of evidence consistently highlighted throughout
• Greater number of tables and algorithms ("decision trees") for key decision-making areas
• "Scope of concept" introduction to chapters are significantly enhanced, allowing the reader to reference the concepts while reviewing the specific details in the clinically oriented chapters
• The only available book with an evidence-based approach covering this specific subject matter in one compendium

Das Handbuch stellt gewöhnliche ebenso wie spezielle Probleme in der gynäkologischen Klinik in Form evidenzbasierter Behandlungsformen dar und benennt die diagnostischen und therapeutischen Möglichkeiten, die heute zur Verfügung stehen. Datenerhebung, Entscheidungsanalyse, Kosten und Ergebnisse sind die Prozessstufen, die detailliert dargestellt werden. Jedes Kapitel beginnt mit einem klinischen Profil der Krankheit bzw. Beschwerde und stellt eine Methodologie vor, die auf Daten datenbasierende Entscheidungsanalysen verwendet, um schließlich zu einer Behandlungsempfehlung zu gelangen. Ein "Entscheidungs-Baum" führt Faktoren wie Behandlungsoptionen, erwartete Ergebnisse und Kosten zusammen. Evidenzgrade und Levels werden im Layout unterschiedlich dargestellt und helfen bei der Orientierung. Mit diesem Band liegt das erste konsequent evidenzbasierte Werk zur perioperativen und unterstützenden Versorgung in der gynäkologischen Onkologie vor. Foreword to the Second Edition ix

Contributors xi

Part One General Principles

1. Introduction 1
Steven A. Vasilev and Scott E. Lentz

2. Evidence-Based Medicine and Decision Support 11
Steven A. Vasilev

3. Vascular Access and Other Invasive Procedures 43
Paul Koonings and Scott E. Lentz

4. Fluids, Electrolytes, and Nutrition 69
Howard Silberman and Matthew Powers

Part Two Perioperative Management of Gynecologic Surgery

5. Preoperative Evaluation 145
Devansu Tewari

6. Postoperative Surveillance and Perioperative Prophylaxis 161
Harriet O. Smith and Lejla Delic

7. Perioperative Infections: Prevention and Therapeutic Options 235
Amy Stenson

8. Intraoperative and Perioperative Considerations in Laparoscopy 261
Steven A. Vasilev and Scott E. Lentz

Part Three Oncologic Perioperative Decision Making

9. Cervical Carcinoma 299
Fidel A. Valea

10. Endometrial Cancer 329
R. Wendel Naumann

11. Pelvic Masses and Ovarian Carcinoma 361
Margarett C. Ellison

12. Molar Gestation 377
Allison E. Axtell and Steven A. Vasilev

13. Perioperative Issues in the Management of Vulvar Cancer 389
Kathryn F. McGonigle and Maliaka W. Amneus

Part Four Complimentary Medicine/Supportive Care

14. Perioperative Psychosocial Considerations 419
Judith McKay and Steven A. Vasilev

15. Pain Management in Gynecologic Oncology 443
Laszlo Z. Galffy and Clayton A. Varga

16. Fertility Preservation in the Gynecologic Cancer Patient 469
Nicole Fleming

17. Perioperative Herbal and Supplement Use 487
Alexander Vasilev and Steven Vasilev

18. End-of-Life Decision Making 509
Scott E. Lentz

Index 539

Steven Anatol Vasilev, MD, MBA, is Clinical Professor in the Division of Gynecologic Oncology at the University of Southern California's Keck School of Medicine.

Scott E. Lentz, MD, is Clinical Assistant Professor in the Division of Gynecologic Oncology at the University of Southern California's Keck School of Medicine.

Allison E. Axtell, MD, is Assistant Professor of Obstetrics and Gynecology and is based at the?UCLA-Olive View Medical Center in Sylmar, California. Now updated—the only reference to cover perioperative and supportive care in gynecologic oncology within the framework of evidence-based medicine

This clinically practical work details the available diagnostic and therapeutic options for a range of common to very difficult problems specific to perioperative care of gynecologic oncology patients. It is the only book to analyze these issues by employing the principles of evidence-based medicine, featuring an emphasis on data gathering, decision-analysis, costs, and outcomes in order to provide guidelines for superior perioperative and supportive care.

Chapters provide a clinical profile of the disease or problem and exploit data-driven decision analysis methodology to provide recommendations, including cost-effective clinical guidelines, decision "trees" summarizing treatment options, expected outcomes, and relative costs in key areas. The book also includes an informed discussion on the importance of evidence-based medical treatment.

This Second Edition has been fully revised and updated, featuring:

• A focus on evidence-based review regarding perioperative issues related to each of the major disease sites in gynecologic oncology

• Enhanced "scope of concept" introductions, allowing the reader to reference the concepts while reviewing specific details in the clinically oriented chapters

• Grades and levels of evidence highlighted throughout, indicating what the sum of existing evidence suggests regarding key topics

• A practical chapter on the prevention and treatment of laparoscopic complications

• The role of perioperative herbal supplements, along with necessary precautions

• An increased number of tables and algorithms for vital decision-making areas

• A section on the management of end-of-life complications such as tumor-related bowel obstruction, persistent ascites, and pleural effusion—common afflictions in patients with advanced gynecologic cancer

• Discussions on the challenge of pain management at end of life

Included and expanded from the first edition are the basics and physiologic principles of perioperative and critical care, as well as essential procedures and clinical tools.

The information provided in this important work is much needed in the everyday management of patients with gynecologic cancer. It is an indispensable resource for gynecologists, gynecologic oncologists, gynecologic surgeons, and fellows and residents in these disciplines; general surgeons; medical students; nurses; and nurse practitioners.