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https://www.readbyqxmd.com/read/29338993/peritoneal-sarcomatosis-5-years-after-laparoscopic-morcellation-of-uterine-leiomyoma
#1
Marco Petrillo, Margherita Dessole, Vito Chiantera
No abstract text is available yet for this article.
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29251679/morcellation-in-gynecologic-oncology
#2
Eva Chalas
PURPOSE OF REVIEW: Morcellation of uteri with unsuspected malignancies has been the focus of reports for decades. More intensive evaluation of clinical outcomes and evaluation of impact of changes in practice has occurred since the release of FDA statement advising against the use of power morcellators. The review summarizes some of the most relevant publications on this topic. RECENT FINDINGS: The Society of Gynecologic Oncology and the American College of Obstetricians and Gynecologists concur that symptomatic women should undergo appropriate evaluation, morcellation should not be performed whenever malignancy is suspected or diagnosed, and acknowledge the limitations of diagnostic testing currently available to detect leiomyosarcoma...
February 2018: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29251677/indications-for-morcellation-in-gynecologic-surgery
#3
William H Parker
PURPOSE OF REVIEW: Minimally invasive gynecologic procedures, in particular laparoscopic hysterectomy and myomectomy, often require tissue morcellation. RECENT FINDINGS: Whether morcellated or not, myometrial cells can be found in the abdomen and pelvis after either laparoscopic or open myomectomy. Following morcellation, careful inspection for and removal of tissue fragments and copious irrigation and suctioning of fluid can remove residual tissue and cells without the use of containment bags...
February 2018: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29251674/the-prevalence-of-occult-leiomyosarcoma-in-women-undergoing-presumed-fibroid-surgery-and-outcomes-after-morcellation
#4
Elizabeth A Pritts
PURPOSE OF REVIEW: To review the data-derived prevalence rates for occult leiomyosarcoma (LMS), and outcomes for women who have these tumors inadvertently morcellated. RECENT FINDINGS: In 2014, the Food and Drug Administration presented data showing the prevalence rates of occult LMS at 2.02/1000 surgeries for presumed benign fibroids. They also attributed poorer outcomes for women undergoing power morcellation of these tumors. Two more recent meta-analyses have shown much lower rates, as low as one in 8300 surgeries when including only prospective studies, and one in 1428 surgeries when including both prospective and retrospective studies...
February 2018: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29238287/survey-among-esge-members-on-leiomyosarcoma-morcellation-incidence
#5
Vasilios Tanos, Hans Brölmann, Rudi Leon DeWilde, Peter O'Donovan, Elina Symeonidou, Rudi Campo
Background: Increased awareness of leiomyosarcoma (LMS) risk during myomectomy or hysterectomy is essential. Objective and correct reasoning should prevail on any decision regarding the extent and type of surgery to employ. The anticipated risk of a sarcoma after myoma or uterus morcellation is low, and the frequency of leiomyosarcoma especially in women below the age of 40 is very rare. The prevalence data has a wide range and is therefore not reliable. The European Society of Gynaecological Endoscopy (ESGE) initiated a survey among its members looking into the frequency of morcellated leiomyosarcoma after endoscopic surgery...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/29232258/development-and-history-of-morcellators
#6
Ceana Nezhat, Robert K Zurawin
PURPOSE OF REVIEW: Controversy exists surrounding extraction of tissue in gynecologic surgery using morcellators following cases of disseminated uterine cancers discovered after the use of electromechanical morcellators. This chapter traces the history of tissue extraction in gynecology and reviews the evolving scientific data and opinions regarding the future of morcellation. RECENT FINDINGS: Since the initial Food and Drug Administration warning about morcellation in 2014, subsequent studies do not support the Food and Drug Administration's high incidence of occult uterine cancer...
February 2018: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29232257/economics-of-gynecologic-morcellation
#7
Pietro Bortoletto, Jaclyn Friedman, Magdy P Milad
PURPOSE OF REVIEW: As the Food and Drug Administration raised concern over the power morcellator in 2014, the field has seen significant change, with patients and physicians questioning which procedure is safest and most cost-effective. The economic impact of these decisions is poorly understood. RECENT FINDINGS: Multiple new technologies have been developed to allow surgeons to continue to afford patients the many benefits of minimally invasive surgery while minimizing the risks of power morcellation...
December 11, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29227303/alternative-facts-and-morcellation
#8
David L Olive
PURPOSE OF REVIEW: Since the recent black-box warning regarding the use of electromechanical morcellation, there has been a hesitancy to utilize the product and even to perform other types of morcellation by gynecologists. Unfortunately, this Food and Drug Administration action and the continued public criticisms of this procedure are grounded in poor data and faulty reasoning. To truly perform informed consent to patients considering procedures involving morcellation, a thorough review of the facts, not alternative facts, must be communicated...
December 8, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29205507/current-status-of-holmium-laser-enucleation-of-the-prostate
#9
REVIEW
Katsumi Shigemura, Masato Fujisawa
There are several options for the surgical management of benign prostatic hyperplasia representatively from transurethral resection of the prostate. Holmium laser enucleation of the prostate is one of those options, and many institutions and urologists have initiated this technique, and most of them have accomplished better outcomes compared with transurethral resection of the prostate. In contrast to transurethral resection of the prostate, which requires a similar procedure to transurethral resection of bladder tumors, holmium laser enucleation of the prostate requires a special surgical technique: enucleation and morcellation with around 10 years' history of experience, even in Japan...
December 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29203157/-anticoagulation-impact-on-bleeding-risk-during-holep-monocentric-study-of-156-patients
#10
P Neuville, R Codas, E Ravier, D Maucort-Boulch, L Badet, H Fassi-Fehri
OBJECTIVE: Compare the length of hospital stay and the complications after HoLEP between three groups of patients: a control group, a group with antiplatelet therapy, a group with anticoagulation therapy. MATERIALS: Retrospective cohort study that included all consecutive patients who underwent HoLEP for prostatic hyperplasia in our center from may 2013 to may 2016. Anticoagulated patients and patients under clopidogrel had respectively a relay with heparine and aspirine...
December 1, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29200989/pushing-the-boundaries-of-laparoscopic-myomectomy-a-comparative-analysis-of-peri-operative-outcomes-in-323-women-undergoing-laparoscopic-myomectomy-in-a-tertiary-referral-centre
#11
Rebecca Mallick, Funlayo Odejinmi
Background: The aim of this study was to analyse the demographic data and peri-operative outcomes of women undergoing a laparoscopic myomectomy and assess what factors, if any, precluded using the laparoscopic approach. Methods: A single surgeon observational study of 323 patients undergoing a laparoscopic myomectomy was undertaken. Data was collected prospectively over a 12-year period and analysed using SPSS. Surgical outcomes included operating time, estimated blood loss, conversion to laparotomy, intraoperative and postoperative complications and duration of inpatient stay...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/29194076/morcellation-equipment-past-present-and-future
#12
Charles E Miller
PURPOSE OF REVIEW: This review was written in an effort to describe the evolution of power morcellation equipment from their creation to their current state. In addition, this review addresses the continuously evolving equipment involved with power morcellation and looks to describe where the field is headed in the future. In addition, recent professional and federal recommendations have changed the way power morcellation is being approached and has led to the development of contained morcellation systems, which, although in their infancy, are also being proven to be well tolerated options...
November 30, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29181031/laparoscopic-supracervical-hysterectomy-with-in-bag-morcellation-in-very-large-uterus
#13
Harald Krentel, Rudy Leon De Wilde
Laparoscopic supracervical hysterectomy (LASH) is a safe and fast minimally invasive approach in hysterectomy. In order to extract the uterine body from the abdominal cavity, one condition for LASH is the morcellation of the tissue. The intra-abdominal dissemination of benign and occult malignant uterine cells is a possible risk of this method, which can be avoided by the use of special bags for laparoscopic in-bag morcellation. We present a case of laparoscopic supracervical hysterectomy with in-bag morcellation in a uterus of more than 1400 g...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29161905/a-focused-review-on-the-effects-of-preoperative-5%C3%AE-reductase-inhibitors-treatment-in-patients-undergoing-holmium-laser-enucleation-of-the-prostate-what-do-we-know-so-far
#14
Panagiotis Dimopoulos, Panagiotis Christopoulos, Spyridon Kampantais
INTRODUCTION: The effects of medical therapy with finasteride or dutasteride during transurethral enucleation of prostate and tissue morcellation are not well defined. In theory, the risk of prostatic fibrosis versus the potential benefit of reduced intraoperative bleeding have been addressed as potential competing factors. The aim of this review was to provide evidence if 5a-reductase inhibitors put the surgeon at a disadvantage or impacts on patient outcomes. MATERIAL AND METHODS: We performed a literature search of PubMed, Scopus and Web of science databases...
November 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29161797/electromechanical-morcellators-black-box-warning-tribulations-expectations-and-solutions
#15
Papri Sarkar, Emad Mikhail, Lenox Hoyte, Shayne Plosker, Anthony Imudia
Laparoscopic minimally invasive gynecologic surgery (MIGS) for benign conditions results in decreased morbidity, and faster recovery, compared with laparotomy. Tissue fragmentation by electromechanical morcellation permits the removal of large specimens through small laparoscopic incisions. Since the US Food and Drug Administration (FDA) published its safety warning about the risk of power morcellators spreading cancer during fibroid surgery in 2014, power morcellation has become rare. MIGS for fibroids and other large tissue specimens has declined...
November 21, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/29149644/assessing-the-risk-of-laparoscopic-morcellation-of-occult-uterine-sarcomas-during-hysterectomy-and-myomectomy-literature-review-and-the-isge-recommendations
#16
REVIEW
Ornella Sizzi, Lucia Manganaro, Alfonso Rossetti, Matteo Saldari, Giuseppe Florio, Alessandro Loddo, Robert Zurawin, Bruno van Herendael, Dusan Djokovic
OBJECTIVE: This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. STUDY DESIGN: The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment...
January 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29138602/improved-adequacy-of-endometrial-tissue-sampled-from-postmenopausal-women-using-the-myosure-lite-hysteroscopic-tissue-removal-system-versus-conventional-curettage
#17
Peter Rosenblatt, Sara Barcia, Anthony DiSciullo, Hussein Warda
Objective: To compare the diagnostic suitability of endometrial tissues obtained from postmenopausal women using the MyoSure Lite tissue removal system versus conventional curettage. Materials and methods: Endometrial tissue was sampled in hysteroscopically normal extirpated uteri from seven postmenopausal women (65.9±6.6 years old) using both hysteroscopicguided morcellation and curettage (two quadrants/uterus with each method). Endometrial sampling was performed immediately after hysterectomy for benign reasons unrelated to uterine pathology...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29135414/retroperitoneoscopic-nephrectomy-for-huge-autosomal-dominant-polycystic-kidney-disease-using-morcellator
#18
Dong Sup Lee, Hee Youn Kim, Seung-Ju Lee
No abstract text is available yet for this article.
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29133752/proportion-of-uterine-malignant-tumors-in-patients-with-laparoscopic-myomectomy-a-national-multicenter-study-in-china
#19
Hua Yang, Xiao-Chuan Li, Chen Yao, Jing-He Lang, Hang-Mei Jin, Ming-Rong Xi, Gang Wang, Lu-Wen Wang, Min Hao, Yan Ding, Jie Chen, Jian-Qing Zhang, Lu Han, Cheng-Xiu Guo, Xiang Xue, Yan Li, Jian-Hua Zheng, Man-Hua Cui, Huai-Fang Li, Guang-Shi Tao, Long Chen, Su-Min Wang, An-Wei Lu, Ze-Hua Huang, Qing Liu, Ya-Li Zhuang, Xiang-Hua Huang, Gen-Hai Zhu, Ou-Ping Huang, Li-Na Hu, Mu-Jun Li, Hong-Lin Zhou, Jing-Hui Song, Lan Zhu
BACKGROUND: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. METHODS: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29128980/reducing-the-spread-of-occult-uterine-sarcoma-at-the-time-of-minimally-invasive-gynecologic-surgery
#20
Marron Wong, Rudy Leon De Wilde, Keith Isaacson
PURPOSE: This review covers the most recent evidence to discuss the incidence of occult uterine sarcoma, whether morcellation increases tumor dissemination or mortality, and whether there is a difference between different types of morcellation. We will also discuss techniques to reduce the spread of an undiagnosed uterine sarcoma. METHOD: A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, and Google Scholar for articles related to the incidence of occult uterine sarcoma after morcellation...
November 11, 2017: Archives of Gynecology and Obstetrics
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