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https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#1
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28260596/robotic-assisted-laparoscopic-hysterectomy-for-women-with-endometrial-cancer
#2
Suzanne Forsyth Herling, Ann M Møller, Connie Palle, Anja Grynnerup, Thordis Thomsen
INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes. METHODS: A non-randomised, controlled before and after study of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls)...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28246921/magnetic-resonance-imaging-features-of-uterine-sarcoma-and-mimickers
#3
REVIEW
Matthias Barral, Vinciane Placé, Raphaël Dautry, Sandra Bendavid, Françoise Cornelis, Romain Foucher, Youcef Guerrache, Philippe Soyer
Uterine myometrial tumors are predominantly benign conditions that affect one-third of women and represent the main indication for hysterectomy. Preoperative imaging is of utmost importance for characterization and for precise mapping of myometrial tumors to best guide therapeutic strategy. New minimally invasive therapeutic strategies including morcellation, myolysis, uterine artery embolization and image-guided radiofrequency or focused ultrasound ablation have been developed for the treatment of uterine leiomyoma...
February 28, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28242556/intracavitary-ethanol-ablation-for-the-management-of-uterine-hemorrhage-refractory-to-uterine-artery-embolization
#4
Taylor M Morris, David H Ballard, Horacio B D'Agostino
A 57-year-old postmenopausal woman with end-stage liver disease secondary to alcoholic cirrhosis, esophageal varices, severe alcoholic cardiomyopathy, and metrorrhagia causing persistent anemia despite multiple transfusions presented with heavy vaginal bleeding. The patient underwent two uterine artery embolizations with proximal coils instead of directed particles due to difficult anatomy but the bleeding continued despite these interventions. Since she was a poor surgical candidate for hysterectomy, the decision was made to attempt achievement of hemostasis via ethanol injection into the uterine cavity...
January 30, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28223670/-clinical-management-of-hboc-in-our-hospital
#5
Hidetaka Nomura, Nobuhiro Takeshima
The cumulative risks of developing epithelial ovarian cancer in women aged 70-75years with BRCA1 and BRCA2 germline mutations are approximately 39-40% and 11-18%, respectively. Here, we present the management of hereditary breast and ovarian cancer(HBOC)in our hospital. HBOC management commences with the selection of appropriate candidates for genetic testing, based on personal and familial characteristics that determine the individual's probability of being a mutation carrier. Pre-test counseling, which is an essential element of genetic counseling, should include discussion of why the test is being offered, how the test results may affect medical management, and the cancer risks associated with the gene mutation...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28209495/maternal-obesity-and-major-intraoperative-complications-during-cesarean-delivery
#6
Marcela C Smid, Catherine J Vladutiu, Sarah K Dotters-Katz, Kim A Boggess, Tracy A Manuck, David M Stamilio
BACKGROUND: Multiple studies have demonstrated an association between maternal obesity and postoperative complications, but there is a dearth of information about the impact of obesity on intraoperative complications. OBJECTIVE: To estimate the association between maternal obesity at delivery and major intraoperative complications during cesarean delivery (CD). METHODS: This is a secondary analysis of the deidentified Maternal-Fetal Medicine Unit Cesarean Registry of women with singleton pregnancies...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28208947/delayed-uterine-necrosis-rare-cause-of-nonhealing-wound
#7
Aruna Nigam, Neha Gupta, Arifa A Elahi, Zeeba S Jairajpuri, Swaraj Batra
Uterine necrosis is a very rare condition and most of the reported cases occurred after pelvic arterial embolization for post-partum haemorrhage, embolization of fibroid uterus or application of B-Lynch sutures. A case of delayed myometrial necrosis is reported in post-cesarean patient where no embolization or uterine compression sutures have been applied. Patient presented with foul smelling discharge from the gaped abdominal wound following caesarean section. Abdomen was closed after exploration and lavage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203626/diffuse-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-power-morcellation-a-case-report-with-review-of-literature
#8
Don Nguyen, Rishi Maheshwary, Cassie Tran, Scott Rudkin, Luke Treaster
•Leiomyomatosis following laparoscopic hysterectomy with morcellation is reported.•Parasitic myomas grow in a benign fashion but may be fatal depending on location.•Fibroids are a contraindication for laparoscopic hysterectomy with morcellation.•Containment bags may address intraperitoneal spillage of malignant tissue.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28191790/safety-and-short-term-outcomes-of-a-new-truly-minimallyinvasive-mesh-less-and-dissection-less-anchoring-system-for-pelvic-organ-prolapse-apical-repair
#9
Adi Y Weintraub, Masha Ben Zvi, David Yohay, Joerg Neymeyer, Yonatan Reuven, Menahem Neuman, Alex Tsivian
OBJECTIVE: To evaluate the safety and short term outcomes of a new, truly minimallyinvasive, mesh-less and dissection-less anchoring system for pelvic floor apical repair. METHODS: A prospective study was conducted using the NeuGuide™ device system for pelvic floor apical repair. The primary effectiveness outcome was centro-apical pelvic floor prolapse by POP-Q after six months. The primary safety outcome was intra-operative, immediate (first 48 h) post-operative complications and adverse effects after six months...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28182668/cross-sectional-study-of-mode-of-delivery-and-maternal-and-perinatal-outcomes-in-mainland-china
#10
Lei Hou, Susan Hellerstein, Allison Vitonis, Liying Zou, Yan Ruan, Xin Wang, Weiyuan Zhang
BACKGROUND: Cesarean delivery (CD) rates have risen globally with nearly 50% of the non-indicated CDs worldwide in China and Brazil. In China's One Child Policy era (1979-2015) most deliveries were women having their only child. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. The goal of this study is to document CD rates, indications, and analyze the relative safety of non-indicated CD compared to SVD and intrapartum CD. METHODS: Univariate and multivariate logistic regression analyses of the association between mode of delivery and short-term maternal and perinatal outcomes were performed on a cross-section of all deliveries at 39 hospitals in 14 provinces of China in 2011, presented as adjusted odds ratio (aOR), 99% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28167486/removal-of-all-ovarian-tissue-versus-conserving-ovarian-tissue-at-time-of-hysterectomy-in-premenopausal-patients-with-benign-disease-study-using-routine-data-and-data-linkage
#11
Jemma Mytton, Felicity Evison, Peter J Chilton, Richard J Lilford
OBJECTIVE:  To conduct a nationwide study of associations between removal of all ovarian tissue versus conservation of at least one ovary at the time of hysterectomy and important health outcomes (ischaemic heart disease, cancer, and all cause mortality). STUDY DESIGN AND SETTING:  Retrospective analysis of the English Hospital Episode Statistics database linked to national registers of deprivation indices and of deaths. PARTICIPANTS:  113 679 patients aged 35-45 who had had a hysterectomy for benign conditions between April 2004 and March 2014...
February 6, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28162785/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-in-laparoscopic-hysterectomy-clinical-trial
#12
D S Guardabassi, S Lupi, R Agejas, J M Allub, G García-Fornari
OBJECTIVES: Transversus abdominis plane block is a regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. This study evaluated its efficacy on post laparoscopic hysterectomy pain intensity and analgesic consumption. MATERIALS AND METHODS: Randomized controlled trial which included 40 patients scheduled for laparoscopic hysterectomy, enrolled in 2 groups: transversus abdominis plane block+systemic analgesia (Group 1; n=20), versus systemic analgesia (Group 2; n=20)...
February 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28152776/utilization-and-effectiveness-of-extended-duration-thromboprophylaxis-after-high-risk-abdominopelvic-cancer-surgery
#13
Ling Chen, Soledad Jorge, William M Burke, Ana Tergas, June Hou, Jim Hu, Alfred I Neugut, Cande Ananth, Dawn L Hershman
62 Background: Extended-duration thromboprophylaxis for 4 weeks after discharge has been demonstrated to reduce venous thromboembolic events (VTE) in cancer patients undergoing abdominopelvic surgery and is recommended in national guidelines. We examined the utilization and effectiveness of extended-duration low molecular weight heparin prophylaxis in high-risk cancer patients after surgery. METHODS: We analyzed patients with colon, ovarian, and uterine cancer who underwent surgery from 2009-2013 and who were recorded in the MarketScan database...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28123726/post-hysterectomy-intravenous-leiomyomatosis-a-case-of-successful-multidisciplinary-surgery-under-non-extracorporeal-circulation
#14
Yucui Zeng, Huiru Tang, Liping Zeng, Lihui Wei, Xiaoming Zhang, Ruifang Wu
Intravenous leiomyomatosis is a rare benign disease. We here in present the case of a 39-year-old woman with a history of hysterectomy who presented with intermittent abdominal pain, palpitations and tightness of the chest. Physical examination revealed the presence of a pelvic mass of regular shape. Gynecological ultrasonography, computed tomography scans and three-dimensional (3D) cardiac ultrasonography were used to evaluate the imaging characteristics of the mass and reach a final diagnosis. The mass appeared to extend to the iliac veins, renal veins and inferior vena cava on imaging examination...
January 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28116884/robotic-sacrocolpopexy-for-posthysterectomy-vaginal-vault-prolapse-a-case-series-of-31-patients-by-a-single-surgeon-with-a-long-term-follow-up
#15
Antonio Pellegrino, Gianluca R Damiani, Mario Villa, Ciro Sportelli, Maria G Pezzotta
BACKGROUND: The aim of this paper was to evaluate the feasibility, short-term complications of robotic surgery and clinical outcomes in terms of long-term complications, pain relief and recurrence rate, for the treatment of vaginal vault prolapse (VVP). METHODS: Prospective analysis of robotic-assisted laparoscopic sacrocolpopexy (RALS) performed between October 2011 and February 2015, in patients with advanced post-hysterectomy VVP and significant apical defects as defined by Baden- Walker Score ≥3...
February 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28109895/pilot-study-of-the-mirabilis-system-prototype-for-rapid-noninvasive-uterine-fibroid-treatment-using-an-ultrasound-guided-volumetric-shell-ablation-technique
#16
Jessica E Parsons, Michael P H Lau, Patrick J Martin, Joel J Islas Lagos, Juan M Aguilar Aguirre, José G Garza Leal
STUDY OBJECTIVE: The primary objective of this pilot study was to evaluate the safety and acute tissue ablation efficacy of a transabdominal high-intensity focused ultrasound (HIFU) prototype device that uses ultrasound imaging guidance for rapid noninvasive ablation of uterine fibroids. The secondary objective was to assess preliminary fibroid-related symptom improvement and fibroid volume reduction at 3 - 6 months post-treatment in subsets of patients. DESIGN: Multi-center prospective single-arm pilot study (Canadian Task Force Classification II-2) SETTING: University-affiliated teaching hospital and private community hospital PATIENTS: Women with a diagnosis of symptomatic uterine fibroids planning to undergo hysterectomy INTERVENTIONS: Seventy-three (73) women underwent transabdominal ultrasound-guided HIFU treatment using a volumetric ablation technique referred to as 'shell ablation,' in which the HIFU energy is deposited in patterns that partially encapsulate the peripheral region of the targeted fibroid(s)...
January 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28099763/the-effectiveness-of-a-multidisciplinary-team-based-approach-to-cesarean-hysterectomy-in-modern-obstetric-practice
#17
Caitlin Gillespie, Haleh Sangi-Haghpeykar, Uma Munnur, Maya S Suresh, Harold Miller, Shannon M Hawkins
OBJECTIVE: To examine the effectiveness of a multidisciplinary, team-based approach to management of cesarean hysterectomy. METHODS: In a retrospective chart review, data were analyzed from a quality assurance database of hysterectomies performed after cesarean delivery at one institution in the USA. Patients were identified through billing codes for cesarean delivery, cross-referenced to codes for hysterectomy. Demographic, reproductive, and outcome data were compared before (2000-2005) and after (2011-2013) implementation of a multidisciplinary team-based protocol...
January 5, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099744/a-retrospective-cohort-study-of-hemostatic-agent-use-during-hysterectomy-and-risk-of-post-operative-complications
#18
John A Harris, Shitanshu Uppal, Neil Kamdar, Carolyn W Swenson, Darrell Campbell, Daniel M Morgan
OBJECTIVE: To determine if the use of intraoperative hemostatic agents was a risk factor for post-operative adverse events within 30 days of patients undergoing hysterectomy. METHOD: A population-based retrospective cohort study included data from patients undergoing hysterectomy for any indication between January 1, 2013, and December 31, 2014, at 52 hospitals in Michigan, USA. Any individuals with missing covariate data were excluded, and multivariable logistic regression and propensity score-matching were used to estimate the rate of post-operative adverse events associated with intra-operative hemostatic agents independent of demographic and surgical factors...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28065954/postpartum-depression-and-associated-factors-after-emergency-peripartum-hysterectomy
#19
Mehmet Baki Senturk, Yusuf Cakmak, Ahmet Ozalp
OBJECTIVE: To investigate post-partum depression after emergency peripartum hysterectomy and associated factors. METHODS: This cross-sectional controlled study was conducted at Batman Gynaecology and Paediatric Diseases Hospital, Batman, Turkey, between June 15 and July 23, 2015, and comprised cases of patients with peripartum hysterectomy and of those who had experienced surgical procedures other than hysterectomy (hypogastric artery ligation and/or B-Lynch suture)...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28063908/laser-angiography-with-indocyanine-green-icg-to-assess-vaginal-cuff-perfusion-during-total-laparoscopic-hysterectomy-tlh-a-pilot-study
#20
Benjamin D Beran, Marie Shockley, Katrin Arnolds, Pedro Escobar, Stephen Zimberg, Michael L Sprague
STUDY OBJECTIVE: To determine feasibility of using laser angiography with ICG to assess vaginal cuff vascular perfusion during TLH. DESIGN: Pilot feasibility trial DESIGN CLASSIFICATION: Canadian Task Force Class II-2 SETTING: Academic-affiliated hospital PATIENTS: Twenty women undergoing TLH for benign disease. INTERVENTIONS: Participants underwent 1:1 randomization of energy method used for colpotomy (ultrasonic versus monopolar) and vaginal cuff closure suture (barbed versus non-barbed)...
January 4, 2017: Journal of Minimally Invasive Gynecology
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