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Pelvic infection after hysterectomy

Ido Feferkorn, Meirav Schmidt, Yakir Segev, Ariel Zilberlicht, Ron Auslender, Yoram Abramov
OBJECTIVES: Infected pelvic hematoma is a relatively common complication of vaginal hysterectomy, manifesting with postoperative pain and fever which often necessitate surgical drainage. We aimed to assess the effect of the surgical technique for vaginal cuff closure on the incidence of this complication. STUDY DESIGN: Until March 31, 2010, our surgical protocol for vaginal hysterectomy included complete vaginal cuff closure. After this date, all surgeries were performed using another technique, by which a patent tract was left at the vaginal cuff for drainage of blood, secretions and debris...
September 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jeong-Yeol Park, Daeyeon Kim, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
OBJECTIVE: To compare long-term survival outcomes and patterns of recurrence of laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in early-stage cervical adenocarcinoma. METHODS: The medical records of 293 patients with stage IA2-IIA cervical adenocarcinomas who underwent radical hysterectomy were retrospectively reviewed. RESULTS: In total, 186 patients underwent LRH and 107 underwent ORH. There was no difference between the two surgery groups in clinicopathologic characteristics...
August 8, 2016: Annals of Surgical Oncology
Cæcilie Krogsgaard Tolstrup, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes...
August 2, 2016: International Urogynecology Journal
Salma Rahimi, Peter C Jeppson, Leda Gattoc, Lauren Westermann, Sara Cichowski, Chris Raker, Emily Weber LeBrun, Vivian Sung
OBJECTIVE: The aim of this study was to compare perioperative complications by route of hysterectomy before and after the introduction of robotic surgery. METHODS: This is an ancillary analysis of a multicenter, retrospective cohort study with historical controls through the Fellows' Pelvic Research Network. Hysterectomies performed for benign conditions were collected prior to introduction of the robot (prerobot) and the year after introduction of the robot (postrobot) at each institution...
September 2016: Female Pelvic Medicine & Reconstructive Surgery
L B Xiang, Y X Tu, T C He, X Pei, X X Shen, W T Yang, X H Wu, H J Yang
OBJECTIVE: The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). METHODS: A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed...
May 25, 2016: Zhonghua Fu Chan Ke za Zhi
Nathan A Keller, Xin Guan, Alicia Wiczulis, Paul Burcher
BACKGROUND: Group A Streptococcus is one of the most morbid infections in modern obstetric practice. Pregnant women are known to have a 20-fold increased risk of invasive Group A Streptococcus with greatest risk in the first 4 days postpartum. The overwhelming majority of these infections will present with fever, uterine tenderness, or vaginal discharge. A much smaller subset may present to the Emergency Room after initial hospital discharge with much less obvious symptoms. In our case, persistent palpitations with unexplained tachycardia led to improper diagnosis in multiple Emergency Rooms...
2015: BMC Research Notes
Audra Jolyn Hill, Mark D Walters, Cecile A Unger
BACKGROUND: Colpocleisis, a vaginal obliterative procedure, offers women with symptomatic pelvic organ prolapse an effective, durable anatomic repair and is associated with high patient satisfaction rates. Historically, colpocleisis was reserved for the medically frail or elderly with the goal of limiting anesthetic exposure, decreasing operative time, and minimizing adverse events. Several colpocleisis and colpectomy procedures exist and limited evaluation has been performed comparing these differences in regards to perioperative adverse events...
April 2016: American Journal of Obstetrics and Gynecology
Masato Tamate, Motoki Matsuura, Shutaro Habata, Yushi Akashi, Ryoichi Tanaka, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Saito
INTRODUCTION: Placenta percreta is associated with maternal morbidity and mortality. A hysterectomy is often needed to control the bleeding in such cases. However, it has been advocated that placenta percreta be managed conservatively to avoid massive pelvic bleeding and to preserve the patient's fertility. Here, we present a case of placenta percreta diagnosed by magnetic resonance imaging, and treated with systemic administration of methotrexate. CASE PRESENTATION: A 27-year-old nulliparous Japanese woman at 39 gestational weeks had an uncomplicated vaginal delivery of a 3244-g infant...
2015: Journal of Medical Case Reports
Paula Norinho de Oliveira, Nicolas Bourdel, Benoit Rabischong, Michel Canis, Revaz Botchorishvili
STUDY OBJECTIVE: To show that in selected cases laparoscopic sacrocolpopexy can be used for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. METHODS: Step-by-step examination of the technique using an educative video. Institutional review board approval was obtained. SETTING: The authors describe two clinical cases of treatment of recurrent pelvic organ prolapse, after a vaginal mesh surgery, using laparoscopic sacrocolpopexy...
February 1, 2016: Journal of Minimally Invasive Gynecology
Suzanne Forsyth Herling, Maria Cecilie Havemann, Connie Palle, Ann Merete Møller, Thordis Thomsen
INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications...
August 2015: Danish Medical Journal
Mary R Kwaan, Genevieve B Melton, Robert D Madoff, Jeffrey G Chipman
BACKGROUND: Determining predictors of surgical site infection (SSI) in a large cohort is important for the design of accurate SSI surveillance programs. We hypothesized that additional organ resection and pelvic exenterative procedures are associated independently with a higher risk of SSI. METHODS: Patients in the American College of Surgeons National Surgical Quality Improvement Program® (ACS NSQIP®; American College of Surgeons, Chicago, IL) database (2005-2012) were identified (n=112,282)...
December 2015: Surgical Infections
Z Qi, Y Zhang
BACKGROUND: Cervical cancer case supervened with chylous ascites after extensive hysterectomy is rarely reported, and is very difficult to deal with. CASE: A 40-year-old female patient complained of a small amount of vaginal bleeding after intercourse over the past seven years, and then was diagnosed as cervical squamous cell carcinoma IIa, with moderate anemia and leucopenia. The patient underwent radiotherapy and was given leucogen and iron dextran to elevate blood leukocyte at the same time...
2015: European Journal of Gynaecological Oncology
Kristian Jäckel, Thomas Braschler, Wolfram Jochum, Tanja Hülder, Beat Knechtle
We report on a typical clinical course of pelvic actinomycosis: initial uncharacteristic discomfort develops into a systemic illness associated with a pelvic mass, which progresses so fast that along with the systemic infection further symptoms can be reduced to its growth rate--tiredness, abdominal pain, micturition deficiency, and leg pain. Distinction between malignancy and pelvic actinomycosis could be made only intraoperative. After hysterectomy and with antibiotics the patient recovered quickly.
May 6, 2015: Praxis
H Krissi, A Aviram, R Eitan, A From, A Wiznitzer, Y Peled
INTRODUCTION: We investigated parameters associated with recurrence after partial (Le Fort) colpocleisis surgery for severe pelvic organ prolapse (POP) in elderly women. METHODS: A retrospective cohort study included all women who underwent partial colpocleisis in a single tertiary center from February 2007 through July 2013 for stage 3 or 4 triple compartment prolapse. Inclusion criteria were age over 60, sexually inactive, medical comorbidities, increased risk for comprehensive reconstructive pelvic surgery, and refusal or failure to use a pessary as a conservative non-surgical treatment...
August 2015: International Journal of Surgery
Alexander Melamed, Jennifer L Katz Eriksen, Emily M Hinchcliff, Michael J Worley, Ross S Berkowitz, Neil S Horowitz, Michael G Muto, Richard D Urman, Colleen M Feltmate
PURPOSE: The aim of this study was to investigate the relationship between same-day discharge (SDD) and postoperative complications within 30 days of laparoscopic hysterectomy for endometrial cancer and endometrial intraepithelial neoplasia (EIN). METHODS: This single-institution retrospective cohort included all patients who underwent conventional and robotic-assisted laparoscopic hysterectomy for endometrial cancer or EIN in a large teaching hospital between 2011 and 2013...
January 2016: Annals of Surgical Oncology
Lindsay E Clark, Gulden Menderes, Amanda M Tower, Dan-Arin Silasi, Masoud Azodi
INTRODUCTION: Posterior colpotomy incision for specimen retrieval is infrequently used in gynecologic laparoscopic surgery unless a concomitant hysterectomy is performed. We aim to describe a simple and unique technique for creating the colpotomy incision and to describe intraoperative and postoperative outcomes. METHODS: Fifty patients underwent adnexal specimen retrieval through a posterior colpotomy incision. After devascularization and detachment of the adnexal specimen, the posterior cul-de-sac was visualized...
April 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Pratiksha Gupta
The result of transvaginal sacrospinous ligament fixation technique, as part of the vaginal repair procedure for massive uterovaginal (Pelvic Organ Prolapse stage III and stage IV and vault prolapse) is evaluated. A total of 32 women were included in the present case series. Marked uterovaginal prolapse was present in 28 women and four had vault prolapse following hysterectomy. Patients with vault prolapse and marked uterovaginal prolapse underwent sacrospinous colpopexy. The mean follow-up period was 2.5 years...
January 2015: Iranian Journal of Medical Sciences
Cecile A Unger, Mark D Walters, Beri Ridgeway, J Eric Jelovsek, Matthew D Barber, Marie Fidela R Paraiso
OBJECTIVE: We sought to describe perioperative and postoperative adverse events associated with uterosacral colpopexy, to describe the rate of recurrent pelvic organ prolapse (POP) associated with uterosacral colpopexy, and to determine whether surgeon technique and suture choice are associated with these rates. STUDY DESIGN: This was a retrospective chart review of women who underwent uterosacral colpopexy for POP from January 2006 through December 2011 at a single tertiary care center...
May 2015: American Journal of Obstetrics and Gynecology
Peng Zhang, Wan-Li Hu, Bei Cheng, Long Cheng, Xiao-Kan Xiong, Yang-Jun Zeng
BACKGROUND: The use of an indwelling catheter after uncomplicated hysterectomy is common, but remains controversial because of the occurrence of catheter-associated urinary tract infections (UTIs) and discomfort. OBJECTIVE: To examine the evidence on the benefits and harm from the use of an indwelling catheter after uncomplicated hysterectomy. DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: Electronic databases including PubMed, Embase, the Cochrane Library, and Science Citation Index up to July 2014 were searched for relevant RCTs and the reference lists of the included studies were also searched manually...
May 2015: International Urogynecology Journal
Masaki Fujioka, Kenji Hayashida, Sin Morooka, Hiroto Saijo, Takashi Nonaka
BACKGROUND: Usually, several surgical methods are used, with re-suturing, free skin grafting and local flaps, for the reconstruction of wall defects after abdominoperineal resection. However, or larger defects, free flaps have been preferred because they can provide a large area of well-vascularized soft tissue, which is suitable for defect repair. We present the case of a large abdominal wall defect, which was treated with a free combined serratus anterior and latissimus dorsi myocutaneous flap, resulting in a successful outcome...
2014: World Journal of Surgical Oncology
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