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Gynecological Surgery

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https://www.readbyqxmd.com/read/28327917/fifth-ovarian-cancer-consensus-conference-of-the-gynecologic-cancer-intergroup-first-line-interventions
#1
A Karam, J A Ledermann, J-W Kim, J Sehouli, K Lu, C Gourley, N Katsumata, R A Burger, B-H Nam, M Bacon, C Ng, J Pfisterer, R L M Bekkers, A Casado Herráez, A Redondo, H Fujiwara, N Gleeson, O Rosengarten, G Scambia, J Zhu, A Okamoto, G Stuart, K Ochiai
The consensus statements regarding first-line therapies in women with ovarian cancer, reached at the Fifth Ovarian Cancer Consensus Conference held in Tokyo, Japan, in November 2015 are reported. Three topics were reviewed and the following statements are recommended: (i) Surgery: the subgroups that should be considered in first-line ovarian cancer clinical trials should be (a) patients undergoing primary debulking surgery and (b) patients receiving neo-adjuvant chemotherapy. The amount of residual disease following surgery should further stratify patients into those with absent gross residual disease and others...
February 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28326210/cesarean-scar-endometriosis-an-uncommon-surgical-complication-on-the-rise-case-report-and-literature-review
#2
Imane Khachani, Abdelhai Filali Adib, Rachid Bezad
Endometriosis is defined by the presence and growth of ectopic functional endometrial tissue outside the uterus. Scar endometriosis has been described following obstetrical and gynecological surgery. It is a rare condition, though probably on the rise, due to the considerable increase of cesarean sections performed worldwide. Its physiopathology is complex; its symptomatology is rich and diverse but thorough clinical examination along with ultrasound imaging and potentially pretherapeutic cytologic evaluation are usually efficient in diagnosing the condition...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28319576/microscopic-heterotopic-extraovarian-sex-cord-stromal-proliferations-expanding-the-histologic-spectrum
#3
Aisling Longworth, Raji Ganesan, Adrian K H Yoong, Lynn Hirschowitz
Microscopic, heterotopic extraovarian sex cord-stromal proliferations have only recently been reported in the literature. We describe the largest series to date, of 30 cases of microscopic, incidentally detected, heterotopic extraovarian sex cord-stromal proliferation, in women aged 25-79 yr who had undergone surgery for a range of benign and malignant gynecologic conditions. In 14 patients the foci of proliferation comprised ovarian cortical stroma, in some cases with an ovarian fibroma-like appearance. Ten cases of adenofibroma and cystadenofibroma were also identified, including 1 Brenner adenofibroma; 2 cases comprised both ovarian cortical stroma and serous cystadenofibroma; 4 cases showed sex cord proliferation resembling microscopic adult granulosa cell tumors...
March 17, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28315665/physician-scientists-in-obstetrics-and-gynecology-predictors-of-success-in-obtaining-independent-research-funding
#4
Ijeoma Okeigwe, Cynthia Wang, Joseph A Politch, Linda J Heffner, Wendy Kuohung
BACKGROUND: Obstetrics and gynecology departments receive the smallest amount of National Institutes of Health (NIH) research funding and have significantly lower application success rates compared to pediatric, internal medicine, and surgery departments. The development of mentored early career development training grants (K awards) has been one strategy implemented by the NIH to help aspiring physician-scientists establish independent research careers. OBJECTIVE: The purpose of this study is to describe the cohort of ob/gyn physician-scientists who were K08, K12, and K23 recipients from 1988-2015 and to identify predictors of success in obtaining independent federal funding, as defined by acquisition of an R01, R21, R34, U01, U54, P01, or P50...
March 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28304416/gynecologic-malignancies-in-pregnancy-balancing-fetal-risks-with-oncologic-safety
#5
Christina N Cordeiro, Mary L Gemignani
Importance: Cancer occurs in 0.05% to 0.1% of all pregnancies. Despite literature reporting good oncologic and fetal outcomes in women treated for cancer during pregnancy, as many as 44% of gynecologists would offer termination, and 37% would not administer chemotherapy or radiotherapy in pregnancy. Objectives: The aims of this study were to summarize current recommendations for the treatment of cervical and ovarian cancers in pregnancy and to review updates on existing knowledge regarding the safety of surgical and chemotherapeutic treatments in pregnancy, including both oncologic and fetal outcomes...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28303850/incidence-and-risk-factors-of-de-novo-stress-urinary-incontinence-after-pelvic-floor-reconstruction-a-nested-case-control-study
#6
Shi-Yan Wang, Ting-Ting Cao, Run-Zhi Wang, Xin Yang, Xiu-Li Sun, Jian-Liu Wang
BACKGROUND: Some patients with pelvic organ prolapse may suffer from lower urinary tract symptoms (LUTS), especially stress urinary incontinence (SUI) named de novo SUI after pelvic floor reconstruction. This study aimed to investigate the incidence and risk factors of de novo SUI. METHODS: This is a nested case-control study of 533 patients who underwent pelvic floor reconstruction due to pelvic organ prolapse (POP) at the Department of Gynecology in Peking University People's Hospital from January 2011 to March 2013...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28299405/validation-of-the-international-consultation-on-incontinence-questionnaire-vaginal-symptoms-iciq-vs-in-two-south-asian-languages
#7
Chanil D Ekanayake, Arunasalam Pathmeswaran, Rasika P Herath, H Suharshi S Perera, Malitha Patabendige, Prasantha S Wijesinghe
INTRODUCTION: The multifaceted nature of pelvic floor disorders means that a systematic evaluation is required for optimal treatment outcome. It is also generally acknowledged that a valid tool is necessary to objectively assess symptoms reported by affected women. METHODS: The International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) questionnaire was translated to Sinhala and Tamil and a validation study carried out among women attending gynecology clinics at North Colombo Teaching Hospital, Ragama, and the district general hospitals Mannar and Vavuniya...
March 16, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28298761/a-comparative-evaluation-of-ramosetron-with-ondansetron-for-the-prevention-of-postoperative-nausea-and-vomiting-in-patients-undergoing-urological-procedures
#8
Samiullah Mujoo, Zulfiqar Ali, Majid Jehangir, Asif Iqbal, Nargis Qayoom, Abdul Qayoom Lone
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common problem causing distress to patients in the postoperative period. Younger age, gynecological surgeries, laparoscopic surgeries, female gender, volatile anesthetics, increased duration of anesthesia, and postoperative opioid use are associated with increased incidence of PONV. AIM: The present study was conducted to study the efficacy of ramosetron and its comparison with ondansetron in the prevention of PONV in patients undergoing pyelolithotomy, pyeloplasty, and upper ureterolithotomy...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28293723/continuous-wound-infiltration-system-for-postoperative-pain-management-in-gynecologic-oncology-patients
#9
Banghyun Lee, Kidong Kim, Soyeon Ahn, Hyun-Jung Shin, Dong Hoon Suh, Jae Hong No, Yong Beom Kim
PURPOSE: Major open surgery for gynecologic cancer usually involves a long midline skin incision and induces severe postoperative surgical site pain (POSP) that may not be effectively controlled with the conventional management. We investigated whether combining a continuous wound infiltration system (CWIS, ON-Q PainBuster(®)) and intravenous patient-controlled analgesia (IV PCA) effectively decreases POSP, compared with IV PCA alone, in gynecologic oncology patients. METHODS: This retrospective study included 62 Korean patients who received a long midline skin incision during gynecologic cancer surgery...
March 14, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28290769/sequencing-brain-metastases-and-opportunities-for-targeted-therapies
#10
Ugonma N Chukwueke, Priscilla K Brastianos
CNS metastases have long been recognized as a common and late complication of systemic malignancies. They represent the most common tumor of the brain. As outcomes and overall survival improve with better tolerated and more durable responses from therapies for systemic cancers, the incidence and prevalence of brain metastases is likely to increase. Among the most common systemic cancers leading to brain metastases include lung, melanoma, breast (triple-negative histology) and renal cell cancers. To date, there has been infrequent involvement of gastrointestinal and gynecologic malignancies; however, this may also change, reflecting improvement in overall survival and therapeutic regimens...
March 14, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28285537/milestone-clinical-trials-of-the-national-surgical-adjuvant-breast-and-bowel-project-nsabp
#11
REVIEW
Priya Rastogi, D Lawrence Wickerham, Charles E Geyer, Eleftherios P Mamounas, Thomas B Julian, Norman Wolmark
The National Surgical Adjuvant Breast and Bowel Project (NSABP) has made significant contributions in reducing the extent of breast surgery and in improving outcomes of patients with early-stage breast cancer through the conduct of large randomized clinical trials evaluating local and systemic therapy. In 2014, the NSABP merged with two other US National Cancer Institute-funded cooperative groups, the Radiation Therapy Oncology Group (RTOG) and the Gynecologic Oncology Group (GOG), to form NRG Oncology. The combined organization has 218 member institutions with more than 600 affiliate centers located throughout the United States, Canada, Puerto Rico, and other international sites...
February 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28277596/the-mccarus-volker-fornisee%C3%A2-a-novel-trans-illuminating-colpotomy-device-and-uterine-manipulator-for-use-in-conventional-and-robotic-assisted-laparoscopic-hysterectomy
#12
Melissa M Gutierrez, Jasmine D Pedroso, K Warren Volker, David L Howard, Steven D McCarus
PURPOSE: The purpose of this paper is to introduce a novel trans-illuminating culdotomy and uterine manipulator device. MATERIALS AND METHODS: The study was a prospective, non-randomized, non-blinded observational clinical study involving 50 female patients undergoing total laparoscopic hysterectomy (TLH) or laparoscopic supracervical hysterectomy (LSH) for benign indications. The surgeries were performed from March through May 2012 at two institutions. The primary study objectives were to demonstrate the safety and adequate clinical performance of the uterine manipulator device and to illustrate its potential widespread future use in minimally invasive gynecologic procedures...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277591/the-role-of-fluorescent-angiography-in-anastomotic-leaks
#13
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, Michael J Stamos
Anastomotic leaks following colorectal anastomosis has substantial implications including increased morbidity, longer hospitalization, and reduced overall survival. The etiology of leaks includes patient factors, technical factors, and anastomotic perfusion. An intact anastomotic blood supply is especially crucial in the physiology of anastomotic healing. To date, no established intraoperative methods have been developed that reliably and reproducibly identify and prevent leak occurrence. Recently, fluorescent angiography (FA) with indocyanine green (ICG) has emerged as an innovative modality for intraoperative perfusion assessment...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277315/clear-cell-carcinoma-of-the-uterine-cervix-presented-as-submucosal-tumor-arising-from-a-background-of-cervical-endometriosis
#14
Mariko Hashiguchi, Keita Kai, Satoshi Nishiyama, Yoshifumi Nakao, Masatoshi Yokoyama, Shinichi Aishima
Clear cell carcinoma (CCC) of the uterine cervix without prenatal diethylstilbestrol exposure is rare, and its etiology is unclear. We present a case of cervical CCC presenting as a submucosal tumor, which strongly suggests an association between cervical endometriosis and cervical CCC. A 56-year-old postmenopausal Japanese woman visited a gynecologic clinic with a complaint of watery vaginal discharge. A few atypical cells suggesting adenocarcinoma were detected in a cervical cytologic specimen. Magnetic resonance imaging revealed a cystic lesion with a solid component at the uterine cervix...
March 8, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28271700/the-actual-role-of-robotics-in-the-management-of-endometriosis
#15
Vito Cela, Maria E Obino, Claudia Sergiampietri, Giovanna Simi, Francesca Papini, Sara Pinelli, Letizia Freschi, Paolo G Artini
The advent of robot-assisted laparoscopy (RAL) represents an important innovation and has opened new perspectives for treatment of endometriosis, in particular in deep infiltrating endometriosis (DIE). RAL could offer several technical advantages in treating this complex disease, such as 3D vision, tremor filtration and better surgical ergonomy, would be able to improve surgical performances without increasing in surgical time, blood loss, intra- and postoperative complications and it reduces the rates of conversion to laparotomy...
March 7, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28270880/colonic-endometriosis-dig-deeper-for-diagnosis
#16
Kanthi Rekha Badipatla, Anisha Vupputuri, Masooma Niazi, Marie-Nirva Blaise, Suresh Kumar Nayudu
Endometriosis is a common gynecological condition wherein there is an ectopic implantation of the uterine endometrial tissue. While several diagnostic modalities are described for the condition, laparoscopy remains the gold standard. There is still an undiscovered area to diagnose colonic endometriosis at an earlier stage. We present a case report of a reproductive age woman with cyclical rectal bleeding diagnosed with colonic endometriosis with colonoscopy and biopsy using saline injection lift and sampling technique...
February 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28267861/periodic-screening-pelvic-examination-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#17
Janelle M Guirguis-Blake, Jillian T Henderson, Leslie A Perdue
Importance: Recent changes in the periodicity of cervical cancer screening have led to questions about the role of screening pelvic examinations among asymptomatic women. Objective: To systematically review literature on health benefits, accuracy, and harms of the screening pelvic examination for gynecologic conditions for the US Preventive Services Task Force (USPSTF). Data Sources: MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials for relevant English-language studies published through January 13, 2016, with surveillance through August 3, 2016...
March 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28266033/first-international-consensus-report-on-adnexal-masses-management-recommendations
#18
Phyllis Glanc, Beryl Benacerraf, Tom Bourne, Douglas Brown, Beverly G Coleman, Christopher Crum, Jason Dodge, Deborah Levine, Edward Pavlik, Dirk Timmerman, Frederick R Ueland, Wendy Wolfman, Steven R Goldstein
The First International Consensus Conference on Adnexal Masses was convened to thoroughly examine the state of the science and to formulate recommendations for clinical assessment and management. The panel included representatives of societies in the fields of gynecology, gynecologic oncology, radiology, and pathology and clinicians from Europe, Canada, and the United States. In the United States, there are approximately 9.1 surgeries per malignancy compared to the European International Ovarian Tumor Analysis center trials, with only 2...
March 7, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28265843/validity-of-self-reported-fertility-threatening-cancer-treatments-in-female-young-adult-cancer-survivors
#19
Samantha C Roberts, Amber Knight, Brian W Whitcomb, Jessica R Gorman, Andrew C Dietz, H Irene Su
PURPOSE: Detailed cancer treatment information is important to fertility and pregnancy care of female young adult cancer survivors. Accuracy of self-report of treatments that impact fertility and pregnancy is unknown. This study assessed agreement between self-report and medical records on receipt of fertility-threatening treatments. METHODS: A national cohort study of female young adult cancer survivors reported cancer treatments via Web-based questionnaires. Primary cancer treatment records were abstracted...
March 6, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28263200/increasing-utilization-of-minimally-invasive-hysterectomy
#20
Mark D Walters, Beri M Ridgeway
Once the decision to perform a hysterectomy has been made, the type and route of hysterectomy must be chosen, and efforts made to accomplish the surgery as safely as possible. Hysterectomy can be performed vaginally, abdominally with laparoscopic or robotic assistance, or open. The main goal of gynecologic surgeons should be to lower the rate of open abdominal hysterectomy and increase use of both vaginal and laparoscopic hysterectomy in their patients. We discuss efforts to accomplish a greater use of minimally invasive hysterectomy...
March 3, 2017: Clinical Obstetrics and Gynecology
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