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Post hysterectomy

X Melody Qu, Vikram M Velker, Eric Leung, Janice S Kwon, Mohamed A Elshaikh, Iwa Kong, Natalie A Logie, Lucas C Mendez, Louis J van der Putten, Elysia K Donovan, Adnan R Munkarah, Ericka M Wiebe, Carlos Parra-Herran, Andrew Warner, Alexander V Louie, David P D'Souza
OBJECTIVE: As the optimal adjuvant management of stage IA serous or clear cell endometrial cancer is controversial, a multi-institutional review was conducted with the objective of evaluating the appropriateness of various strategies including observation. METHODS: Retrospective chart reviews for 414 consecutive patients who underwent hysterectomy for FIGO stage IA endometrial cancer with serous, clear cell or mixed histology between 2004 and 2015 were conducted in 6 North American centers...
March 12, 2018: Gynecologic Oncology
Rocco Friebel, Katharina Hauck, Paul Aylin, Adam Steventon
OBJECTIVE: To assess trends in 30-day emergency readmission rates across England over one decade. DESIGN: Retrospective study design. SETTING: 150 non-specialist hospital trusts in England. PARTICIPANTS: 23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016. PRIMARY AND SECONDARY OUTCOMES: We examined emergency admissions that occurred within 30 days of discharge from hospital ('emergency readmissions') as a measure of healthcare quality...
March 12, 2018: BMJ Open
Brianna J Shinn, Laura J Tafe, Pantila Vanichakarn
BACKGROUND Carcinoid tumor, benign, low-grade malignant, and high-grade malignant, can be associated with the release of vasoactive substances that cause symptoms including cutaneous flushing, diarrhea, and bronchospasm. In 50-60% of patients with carcinoid syndrome, the vasoactive substances cause fibrosis of the pulmonary and tricuspid heart valves which lead to regurgitation and right-sided heart failure. The right side of the heart is usually affected because monoamine oxidases in the lungs usually inactivate the vasoactive substances...
March 12, 2018: American Journal of Case Reports
Amnon A Berger, Cathleen E Matrai, Tessa Cigler, Melissa K Frey
Breast cancer is the most prevalent cancer in the United States. With an increasing rate of survivorship and extended life span for patients with metastatic disease, the demand for palliative care is increasing. Although uncommon, metastases to gynaecologic organs have been reported and are often present with post-menopausal bleeding. Post-menopausal bleeding can become clinically significant and have a detrimental effect on quality of life. We report the case of a 70-year-old woman with symptomatic vaginal bleeding caused by breast cancer metastatic to her uterus, cervix, fallopian tubes and ovaries...
2018: Ecancermedicalscience
Dirk Schnapauff, Manon Russ, Thomas Kröncke, Matthias David
PURPOSE:  Purpose of this paper to present results of a group of 21 consecutive patients who underwent uterine artery embolization (UAE) immediately before myomectomy. Surgical myomectomy can lead to a substantial blood loss in case of large or multiple tumors due to the hypervascularization of the tumors. This may lead to multiple blood transfusion or hysterectomy. In cases were the preservation of the uterus is demanded, pre-operative embolization could reduce the risk of substantial bleeding...
March 7, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Sebastián Carranza-Lira, Edith Pablo-Cruz
Aim of the study: To evaluate the differences in the What's My M3 test between pre and postmenopausal women. Material and methods: Pre- and postmenopausal women who attended an endocrine gynaecology consultation were studied. In all them, the What's My M3? test was applied. Descriptive statistics, central tendency and dispersion measures were used. Differences between groups were assessed with Mann Whitney U test, and Spearman correlation analysis was carried out for age and time since menopause with the What's My M3? score...
September 2017: Przeglad Menopauzalny, Menopause Review
Kallol Kumar Roy, Netra Gc, Seema Singhal, Juhi Bharti, Sunesh Kumar, Dipendra K Mitra, Ruma Ray, Jyoti Meena, Perumal Vanamail
OBJECTIVE: Laparoscopic surgery is associated with reduced surgical stress response, lesser post- operative immune function, and consequent early recovery compared with conventional open surgery. There is a lack of evidence regarding the inflammatory stress response with the use of different energy devices. The present study was conducted to evaluate and compare the inflammatory response in total laparoscopic hysterectomy (TLH) using three different energy devices. MATERIAL AND METHODS: A prospective randomized controlled study was conducted in 60 women with abnormal uterine bleeding undergoing TLH...
March 1, 2018: Journal of the Turkish German Gynecological Association
Chunhua Zhang, Hongyan Li, Changting Zuo, Xietong Wang
AIM: To evaluate the efficacy of conservative treatment with methotrexate against placenta increta by two different routes of administration through retrospective analysis. METHODS: A total of 54 women diagnosed with placenta increta after vaginal delivery were enrolled in this retrospective study. The participants accepted conservative management with methotrexate through either intravenous injection or local multi-point injection under ultrasound guidance. The treatment was considered effective if no hysterectomy was mandatory during the follow-up period...
February 27, 2018: Journal of Obstetrics and Gynaecology Research
Caleb J Fan, Hung-Lun Chien, Matthew J Weiss, Jin He, Christopher L Wolfgang, John L Cameron, Timothy M Pawlik, Martin A Makary
BACKGROUND: Despite strong evidence demonstrating the clinical and economic benefits of minimally invasive surgery (MIS), utilization of MIS in the Medicare population is highly variable and tends to be lower than in the general population. We sought to compare the post-operative and economic outcomes of MIS versus open surgery for seven common surgical procedures in the Medicare population. METHODS: Using the 2014 Medicare Provider Analysis and Review Inpatient Limited Data Set, patients undergoing bariatric, cholecystectomy, colectomy, hysterectomy, inguinal hernia, thoracic, and ventral hernia procedures were identified using DRG and ICD-9 codes...
February 26, 2018: Surgical Endoscopy
Christos Iavazzo, Evelyn Eleni Minis, Ioannis D Gkegkes
Single-incision approach in robotic gynecology is a relatively new concept. The role of single-port systems in robotic hysterectomy, their advantages and disadvantages, as well as the technical challenges, are still under investigation. A systematic review was performed by searching in PubMed and Scopus databases. In 810 out of 1225 patients, hysterectomy was performed for non-neoplastic disease. Single-Site ® was the most common port system. Duration of the procedure and relative blood loss ranged from 60 to 311 min and 7 to 750 ml, respectively...
February 16, 2018: Journal of Robotic Surgery
Ahmed M Soliman, Eric Surrey, Machaon Bonafede, James K Nelson, Jane Castelli-Haley
INTRODUCTION: The prevalence of endometriosis and the need for treatment in the USA has led to the need to explore the contemporary cost burden associated with the disease. This retrospective cohort study compared direct and indirect healthcare costs in patients with endometriosis to a control group without endometriosis. METHODS: Women aged 18-49 years with endometriosis (date of initial diagnosis = index date) were identified in the Truven Health MarketScan® Commercial database between 2010 and 2014 and female control patients without endometriosis were matched by age and index year...
February 15, 2018: Advances in Therapy
Christopher C DeStephano, Anita H Chen, Michael Heckman, Nicolette T Chimato, Paulami Guha, Mariana Espinal, Tri A Dinh
OBJECTIVE: Demonstrate the process for establishing or refuting validity for the Limbs and Things hysterectomy model. DESIGN: Prospective study using Kane's framework for establishing validity (Canadian Task Force Classification: II-2). SETTING: Laparoscopic hysterectomy (TLH) assessments completed in the operating room (OR) and simulation at three academic medical centers. PARTICIPANTS: OB/GYN residents (n=26 post-graduate year 3-4), a gynecologic oncology fellow (post-graduate year 5), and a gynecology oncology attending...
February 9, 2018: Journal of Minimally Invasive Gynecology
Lori R Berkowitz, Kaitlyn James, Emil Petrusa, Carey York-Best, Anjali J Kaimal
OBJECTIVE: To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. DESIGN: After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH...
February 5, 2018: Journal of Surgical Education
Patrícia R Pinto, Teresa McIntyre, Vera Araújo-Soares, Armando Almeida, Patrício Costa
Chronic post-surgical pain (CPSP) is a well-recognized potential complication with negative personal, social and healthcare consequences. However, limited data exists on CPSP and on the course of pain over time after hysterectomy. Using data from a prospective cohort study on a consecutive sample assessed at 4 time points, pre-surgery (T1), 48 hours (T2), 4 months (T3), and 5 years post-surgery (T4), we sought to examine women's post-surgical pain trajectories using assessments of pain at T3 and T4. Additionally, this study aimed to investigate pre-surgical and post-surgical risk factors associated with an unfavourable pain trajectory (PT)...
February 5, 2018: Pain
Allan S Lichtman, William Parker, Barbara Goff, Neeraj Mehra, Eliane M Shore, Guylaine Lefebvre, Alexander Chiang, John Lenihan, Henk W R Schreuder
STUDY OBJECTIVE: To assess improvement of cognitive surgical knowledge of laparoscopic hysterectomy in post-graduate year (PGY) 1 and 2 gynecology residents who used an interactive computer-based Laparoscopic Hysterectomy Trainer. DESIGN: Multicenter prospective, randomized, controlled study (Canadian Taskforce Classification I). SETTING: Five Departments of Obstetrics and Gynecology: Keck School of Medicine of USC; University of California-Los Angeles; University of Washington; University of British Columbia; University of Toronto...
February 1, 2018: Journal of Minimally Invasive Gynecology
Stefano Uccella, Mario Malzoni, Antonella Cromi, Renato Seracchioli, Giuseppe Ciravolo, Francesco Fanfani, Fevzi Shakir, Salvatore Gueli Alletti, Francesco Legge, Roberto Berretta, Giacomo Corrado, Lucia Casarella, Paolo Donarini, Margherita Zanello, Emanuele Perrone, Baldo Gisone, Enrico Vizza, Giovanni Scambia, Fabio Ghezzi
BACKGROUND: Vaginal cuff dehiscence following hysterectomy is considered an infrequent but potentially devastating complication. Different possible techniques for cuff closure have been proposed to reduce this threatening adverse event. OBJECTIVE: Aim of the present randomized study has been to compare laparoscopic and transvaginal suture of the vaginal vault at the end of a total laparoscopic hysterectomy (TLH), in terms of incidence of vaginal dehiscence and vaginal cuff complications...
January 31, 2018: American Journal of Obstetrics and Gynecology
Q Reboul, A Mehdi, C Chauleur
OBJECTIVES: To study the feasibility and patient satisfaction for vaginal hysterectomy in a new outpatient procedure. METHODS: This retrospective study was directed in CHU de Saint-Étienne, Loire, France. All patient who underwent a vaginal hysterectomy in outpatient procedure were included from January 2014 and January 2017. Descriptive data were collected and all patients were called back for satisfaction study. RESULTS: Sixty-five patients were included...
February 2, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Wan Mohd Nazaruddin Wan Hassan, Anafairos Md Nayan, Azmi Abu Hassan, Rhendra Hardy Mohamad Zaini
Background: Abdominal hysterectomy (AH) is painful. The aim of this study was to compare intrathecal morphine (ITM) and epidural bupivacaine (EB) for their analgaesia effectiveness after this surgery. Methods: Thirty-two patients undergoing elective AH were randomised into Group ITM (ITM 0.2 mg + 2.5 mL 0.5% bupivacaine) (n = 16) and Group EB (0.25% bupivacaine bolus + continuous infusion of 0.1% bupivacaine-fentanyl 2 μg/mL) (n = 16).The procedure was performed before induction, and all patients subsequently received standard general anaesthesia...
December 2017: Malaysian Journal of Medical Sciences: MJMS
Rodolfo Milani, Matteo Frigerio, Francesca L Vellucci, Stefania Palmieri, Federico Spelzini, Stefano Manodoro
BACKGROUND: Post-hysterectomy vaginal vault prolapse repair is a challenge for pelvic floor surgeons. Native-tissue repair procedures imply lower costs and reduced morbidity. Our study aims to evaluate operative data, complications, objective, subjective and functional outcomes of transvaginal native-tissue repair for post-hysterectomy vaginal vault prolapse. We also investigated differences among available techniques. METHODS: Retrospective study including patients with symptomatic vaginal vault prolapse (≥ stage 2), previously treated with transvaginal vault suspension through native-tissue repair...
January 26, 2018: Minerva Ginecologica
Douglas A Gibson, Frances Collins, Fiona L Cousins, Arantza Esnal Zufiaurre, Philippa T Saunders
Endometrial cancer (EC) is the most common gynaecological malignancy. Obesity is a major risk factor for EC and is associated with elevated cholesterol. 27-Hydroxycholesterol (27HC) is a cholesterol metabolite that functions as an endogenous agonist for Liver X Receptor (LXR) and a selective estrogen receptor modulator (SERM). Exposure to estrogenic ligands increases risk of developing EC however the impact of 27HC on EC is unknown. Samples of stage 1 EC (n=126) were collected from post-menopausal women undergoing hysterectomy...
January 25, 2018: Endocrine-related Cancer
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