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Best Practice & Research. Clinical Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/28602522/role-of-robotic-surgery-in-ovarian-malignancy
#1
REVIEW
A Lucidi, V Chiantera, V Gallotta, A Ercoli, G Scambia, A Fagotti
As part of minimally invasive surgery, robotic-assisted approach is becoming increasingly popular in gynecologic oncology. It has been shown to be effective and feasible for staging and treating endometrial and cervical cancer, but its role in the context of primary and recurrent ovarian cancers is presently debated. Scanty data are available in the literature, and the level of evidence supporting its use in ovarian cancer is quite low. However, from a retrospective case-control series, robotic surgery seems to be safe and feasible for early-stage ovarian cancer...
May 10, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28601348/genetic-diagnostics-of-male-infertility-in-clinical-practice
#2
REVIEW
Ryan Flannigan, Peter N Schlegel
Approximately 15% of couples are infertile. Male factors contribute to infertility in over 50% of cases. Identifiable genetic abnormalities contribute to 15%-20% of the most severe forms of male infertility, azoospermia. In this chapter, we explore known genetic causes of male infertility such as Klinefelter syndrome, XYY men, Kallmann syndrome, y-microdeletions, Robertsonian translocations, autosomal inversions, mixed gonadal dysgenesis, x-linked and autosomal gene mutations, and cystic fibrosis transmembrane conductance regulator abnormalities...
May 10, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28566135/how-to-set-up-a-robotic-assisted-laparoscopic-surgery-center-and-training-of-staff
#3
REVIEW
John P Lenihan
The use of computers to assist surgeons in the operating room has been an inevitable evolution in the modern practice of surgery. Robotic-assisted surgery has been evolving now for over two decades and has finally matured into a technology that has caused a monumental shift in the way gynecologic surgeries are performed. Prior to robotics, the only minimally invasive options for most Gynecologic (GYN) procedures including hysterectomies were either vaginal or laparoscopic approaches. However, even with over 100 years of vaginal surgery experience and more than 20 years of laparoscopic advancements, most gynecologic surgeries in the United States were still performed through an open incision...
May 10, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28576390/genetic-basis-of-eugonadal-and-hypogonadal-female-reproductive-disorders
#4
REVIEW
Tatiana Trofimova, Daria Lizneva, Larisa Suturina, Walidah Walker, Yen-Hao Chen, Ricardo Azziz, Lawrence C Layman
This review discusses the current state of our understanding regarding the genetic basis of the most important reproductive disorders in women. For clarity, these disorders have been divided into eugonadal and hypogonadal types. Hypogonadal disorders have been further subdivided according to serum gonadotropin levels. Our review focuses on historical and recent data regarding the genetics of the hypothalamic-pituitary-gonadal axis dysfunction, as well as the development and etiology of eugonadal disorders including leiomyomata, endometriosis, spontaneous ovarian hyperstimulation syndrome, polycystic ovarian syndrome, mullerian aplasia, and steroid hormone resistance syndromes...
May 9, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28579145/how-to-prepare-the-patient-for-robotic-surgery-before-and-during-the-operation
#5
REVIEW
Peter C Lim, Elizabeth Kang
Robotic surgery in the treatment of gynecologic diseases continues to evolve and has become accepted over the last decade. The advantages of robotic-assisted laparoscopic surgery over conventional laparoscopy are three-dimensional camera vision, superior precision and dexterity with EndoWristed instruments, elimination of operator tremor, and decreased surgeon fatigue. The drawbacks of the technology are bulkiness and lack of tactile feedback. As with other surgical platforms, the limitations of robotic surgery must be understood...
April 27, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28533152/preface-volume-42-genetics-for-obstetricians-and-gynaecologists
#6
EDITORIAL
Adonis S Ioannides
No abstract text is available yet for this article.
April 27, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28533155/indications-and-techniques-for-robotic-pelvic-and-para-aortic-lymphadenectomy-with-sentinel-lymph-node-mapping-in-gynecologic-oncology
#7
REVIEW
Ketura Preya A Wisner, Sarfraz Ahmad, Robert W Holloway
Robotic-assisted laparoscopic surgery is the most common approach for the treatment of early-stage endometrial and cervical cancers in the US. Surgical staging requires pelvic and often aortic lymphadenectomy, depending on the primary tumor characteristics. Pelvic and aortic lymphadenectomy procedures may also be indicated for debulking of larger metastases to improve disease control. The infra-renal basin is an important anatomic site of metastasis from pelvic tumors, and robotic dissection techniques for this site have been described...
April 24, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28533153/role-of-robotic-surgery-in-cervical-malignancy
#8
REVIEW
Jeong-Yeol Park, Joo-Hyun Nam
Surgical treatment is the mainstay of the management of early-stage cervical cancer. Abdominal radical hysterectomy and trachelectomy have long been the standard surgical approach to early-stage cervical cancer, achieving excellent survival outcomes. Recently, laparoscopic radical hysterectomy and trachelectomy have become the preferred alternative to abdominal surgery because laparoscopic approaches lead to better surgical outcomes without compromising survival outcomes. Since the robotic surgery platform was approved for the use of gynaecologic surgery in 2005, robotic radical hysterectomy and trachelectomy have been increasingly used in the surgical management of early-stage cervical cancer...
April 24, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28551090/role-of-robotic-surgery-in-treating-fibroids-and-benign-uterine-mass
#9
REVIEW
Suejin Kim, Thanh Ha Luu, Natalia Llarena, Tommaso Falcone
Fibroid uterus can be managed medically, surgically, or through non-extirpative procedures, depending on the clinical situation. Myomectomy may be beneficial, especially to those desiring to preserve the uterus and/or fertility, with outcomes comparable to those of hysterectomy, with a laparoscopic approach being favored when feasible. For definitive therapy, hysterectomy can be pursued where the surgical approach should be individualized. Comparison of robotic-assisted laparoscopic approach shows that the robotic approach may be favored for cases with higher complexity and multiple fibroids in myomectomy; however, no clear advantage is seen with hysterectomy at this time, necessitating further research in the area of robotics for hysterectomy in benign uterine mass treatment to justify the cost...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28528932/robot-assisted-gynaecological-cancer-surgery-complications-and-prevention
#10
REVIEW
Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28526229/cost-benefit-analysis-of-robotic-surgery-in-gynaecological-oncology
#11
REVIEW
Christos Iavazzo, Ioannis D Gkegkes
Robotic approach is a rather new technique that can be used to optimise the management of patients with gynaecological cancer. However, concerns have been raised regarding the cost of such an approach compared to laparoscopic or open techniques. The aim of our chapter is to review the data of papers published so far that analyse the cost of robotic gynaecological oncology. A systematic review of the current literature was performed trying to assess the cost of the robotic technique including parameters that affect it and ways to minimise it in favour of the patients and health care systems...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28533154/preconception-and-prenatal-genetic-counselling
#12
REVIEW
Adonis S Ioannides
Identifying individuals at risk of having children affected by genetic conditions or congenital anomalies allows counselling that aims to inform reproductive decisions. This process takes place either at the preconception or early prenatal stage, although more options are available if risks are identified before the pregnancy. Preconception counselling covers issues that can affect the health of the mother and baby including folic acid supplementation. Carrier screening for autosomal recessive diseases, such as beta thalassaemia, has resulted in a significantly reduced incidence in many countries...
April 21, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28506471/genetics-of-gonadotropins-and-their-receptors-as-markers-of-ovarian-reserve-and-response-in-controlled-ovarian-stimulation
#13
REVIEW
Laura Riccetti, Francesco De Pascali, Lisa Gilioli, Daniele Santi, Giulia Brigante, Manuela Simoni, Livio Casarini
Several controlled ovarian stimulation (COS) protocols have been developed to increase the yield of mature oocytes retrieved in assisted reproductive techniques (ARTs). The ovarian reserve (OR) influences the COS response, and it represents the main parameter that helps clinicians in refining clinical treatments in the perspective of a "personalized" ART. This approach is even more needed in particular conditions such as poor OR or polycystic ovary syndrome. Follicle-stimulating hormone, luteinizing hormone, and human chorionic gonadotropin are currently used in COS at different combinations and with different efficacies, even if the best approach definition is controversial...
April 17, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28502422/preimplantation-genetic-diagnosis-for-monogenic-diseases
#14
REVIEW
Vivian Chi Yan Lee, Judy F C Chow, William Shu Biu Yeung, Pak Chung Ho
Preimplantation genetic diagnosis (PGD) was first reported in 1990. Thereafter, more and more indications for PGD, including monogenic diseases (MGD) and translocations, are presently available, and the list of indications of PGD is expanding from early-onset and serious conditions to late-onset diseases. Polymerase chain reaction has been used for PGD of MGD, while newer techniques, including karyomapping and next-generation sequencing, emerge in recent decade. The limitations of various methods for PGD are discussed in this review...
April 15, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28277307/pathology-of-borderline-and-invasive-cancers
#15
REVIEW
Jaime Prat
Epithelial ovarian tumors are heterogeneous neoplasms primarily classified according to cell type. They are further subdivided into benign, borderline, and malignant (carcinomas), and this subdivision is very important as it correlates with behavior. Borderline ovarian tumors show epithelial proliferation higher than that seen in their benign counterparts and variable nuclear atypia; however, in contrast to carcinomas, there is no destructive stromal invasion, and their prognosis is much better. Ovarian carcinomas are the most common ovarian cancers and the most lethal gynecological malignancies...
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28262552/preface-volume-41
#16
EDITORIAL
Neville F Hacker
No abstract text is available yet for this article.
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28254144/hereditary-ovarian-cancer-and-risk-reduction
#17
REVIEW
Lesley Andrews, David G Mutch
Mutations in BRCA1 and BRCA2 account for hereditary breast and ovarian cancer syndrome in a majority of families and 14% of epithelial ovarian cancer cases. Despite next-generation sequencing, other identified genes (Lynch Syndrome, RAD51C, RAD51D, and BRIP1) account for only a small proportion of cases. The risk of ovarian cancer by age 70 is approximately 40% for BRCA1 and 18% for BRCA2. Most of these cancers are high-grade serous cancers that predominantly arise in the fimbriae of the fallopian tube. Ovarian screening does not improve outcomes, so women at high risk are recommended to undergo risk-reducing salpingo-oophorectomy around the age of 40, followed by hormone replacement therapy (HRT)...
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28111228/targeted-therapies-for-ovarian-cancer
#18
REVIEW
Tami Grunewald, Jonathan A Ledermann
Epithelial ovarian cancer has the highest mortality rate of all gynaecological malignancies. Most women present with advanced disease and develop a recurrence after radical surgery and chemotherapy. Improving the results of first- or subsequent-line chemotherapy has been slow, and novel approaches to systemic treatment are needed. Ovarian cancer is a heterogeneous disease with complex molecular and genetic changes. Understanding these better will provide information on the mechanisms of resistance and opportunities to target therapy more rationally, exploiting specific changes in the tumour...
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28029502/ovarian-cancer-in-pregnancy
#19
REVIEW
Robert Fruscio, Jorine de Haan, Kristel Van Calsteren, Magali Verheecke, Mina Mhallem, Frederic Amant
Although the occurrence of ovarian masses in pregnancy is relatively common, the majority of them is functional and resolve spontaneously; nevertheless, ovarian cancer is the fifth most common malignancy diagnosed in pregnancy. If malignancy is suspected, treatment should be decided on the basis of gestational age, stage of the disease and patient preferences. In early stage, ovarian cancer surgery may be planned preferably after 16 weeks of pregnancy, and chemotherapy can be administered from the second trimester if indicated as in non-pregnant patients...
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28027849/chemotherapy-for-epithelial-ovarian-fallopian-tube-and-primary-peritoneal-cancer
#20
REVIEW
Kate Webber, Michael Friedlander
Chemotherapy plays a key role in the management of women with epithelial ovarian, fallopian tube and primary peritoneal cancer (EOC). Platinum- and taxane-based regimens are the standard of care for adjuvant treatment in early-stage EOC and first-line therapy for advanced stage disease. Efforts to define the optimal scheduling, timing and route of administration are ongoing. The majority of women with EOC will develop recurrent disease, and treatment options for these women are depend on the time that has elapsed from first-line therapy...
May 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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