Optimal surgical planning for gynaecological patients

Surgery for myometrial lesions and for deep endometriosis are amongst the most common gynaecological procedures. A reliable preoperative evaluation is pivotal to tailor the most appropriate procedure, estimate the surgical complexity, select the most appropriate surgical team, and provide correct patient counselling. This will optimize patients’ outcome, avoiding unnecessary or inappropriate procedures and minimize operation time and costs for both patients and health service. In myometrial lesions, the preoperative differentiation between benign (myoma) and malignant (sarcoma) lesions is of utmost importance: the former is often managed conservatively or treated by laparoscopic resection and morcellation, while the latter requires radical surgery by an oncological surgeon, morcellation being absolutely contraindicated. In endometriosis the preoperative evaluation is crucial to estimate operative complexity, selecting the appropriate surgical team.The aim of our project is to improve management for both myometrial lesions and deep endometriosis. As first line evaluation, alongside the patient’s history and clinical examination, we will define relevant sonographic features, based on our recent consensus papers on the systematic ultrasonographic evaluation of the myometrium and of endometriosis. As second line evaluation, alongside MRI, we will assess the added value of novel liquid biopsy biomarkers.

Keywords:Leiomyoma, Uterine sarcoma, Ultrasonography, Adenomyosis, Endometriosis, Liquid Biopsy

Disciplines:General diagnostics, Gynaecology, Cancer diagnosis