Surgical Principles and Practices in Gynaecological Oncology: Achieving the Best Outcome

Abstract

Despite the recent advances in non-surgical anticancer treatment, surgical resection has remained the most important treatment modality in the management of majority of solid cancers. Whilst chemo- and radiotherapy have both been greatly standardised and protocol driven, surgery has remained highly dependent on human factors. It is imperative to prepare both the patient and the surgical team, and optimise the institutional circumstances well before the operation. Before surgery it is very important to make the correct decision, choose the correct patient, ensure the patient is properly counselled, consent is taken and the whole team including the lead surgeon, anaesthetist, assistants, srub nurses are well informed about the patient and the procedure. Intraoperative factors that affect surgical outcome range from theatre environment, noise levels, adequate infrastructure, surgeon skills, ensuring safe surgery with good clearance of margins. When surgery is to go ahead as planned then the key elements for most cancer operations are exploration, decision-making, resection and reconstruction. Post operative care is very important and includes the principles of enhanced recovery and holistic care to facilitate the patient’s recovery for timely adjuvant treatment.