Elaboração de um protocolo de exenteração pélvica em hospital de referência oncológica em Manaus – Amazonas - Brasil

Abstract

BACKGROUND: Amazonas is the state with the highest incidence of cervical cancer in the country. As in other states, more than 60% of patients reach health services in the advanced, no longer respond to initial treatment, radio chemotherapy. Aspects of rescue treatment, pelvic exenteration. The purchase consists of a complex and mutilated and needs a protocol for its indication, in order to have a positive result in a patient, that does not exist in the Foundation Center of Control of Oncology of the Amazon - FCECON. The literature consulted is scarce in one type of editing tool for pelvic exenteration OBJECTIVES: To establish a pelvic exenteration protocol for use in FCECON. Identify and analyze as indications, contraindications and procedures adopted by oncological surgeons who practice the pelvic exenteration procedure usually. The literature is pertinent and is a protocol proposal for performing the surgery. METHOD: A qualitative study using a survey constructed to be applied by the DELPHI method, carried out by the electronic medium to take advantage of its universal use. Oncological surgeons, pelvic exenteration specialists, were selected from FCECON and Members of the Brazilian Society of Oncologic Surgery - SBCO. A questionnaire with 42 questions divided into two stages was applied. In a descriptive statistical analysis, the protocol considered consensual as responses that obtained agreement equal or superior to 65% between the participants. RESULTS: Fourteen specialists from 45 invited to the questionnaire. After a first step of 42 structured questions, a second round of tags was followed, obtaining 65% in 64% of responses and 100% of responses together. Pelvic Exenteration Protocol for patients with advanced cervical treatment functions to be used in the FCECON, with the possibility of transferring other services of the same nature, which categorized as conduct the consensus and relativized responses as a consensus. The protocol translates the practice of oncological surgeons consulted with the procedure. CONCLUSION: In a consensual way, the indications, contraindications, and procedures adopted by oncological surgeons who routinely practice the pelvic exenteration procedure for the treatment of advanced uterine cervix cancer have been identified and analyzed. The data obtained were compared with the relevant literature, a protocol proposal was drawn for the execution of the surgery, and the Protocol was created to be employed in FCECON.