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https://www.readbyqxmd.com/read/28631712/-the-molecular-mechanisms-and-morphological-manifestations-of-leiomyoma-reduction-induced-by-selective-progesterone-receptor-modulators
#1
T A Demura, Z V Revazova, E A Kogan, L V Adamyan
AIM: to investigate the molecular mechanisms and morphological substrate of reduced uterine leiomyoma in patients receiving the selective progesterone receptor modulator (SPRM) ulipristal acetate for 3 months, by estimating the immunohistochemical expression of the markers steroid receptor coactivator 1 (SRC-1), nuclear receptor corepressor 1 (NCoR-1), ER, PgR, Ki-67, p16, TGF-β, and VEGF in tumor tissue. SUBJECTS AND METHODS: The investigation enrolled 75 women with uterine leiomyoma, menorrhagias, and anemia...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28624174/the-performance-gap-for-residents-in-transfer-of-intracorporeal-suturing-skills-from-box-trainer-to-operating-room
#2
Patrice Crochet, Aubert Agostini, Sophie Knight, Noémie Resseguier, Stéphane Berdah, Rajesh Aggarwal
OBJECTIVE: Training on laparoscopic box trainer (BT) improves suturing skills in the operating room (OR). Optimal laboratory training should provide trainees with an adequate level of skills that can be transferred to the OR with no decline in performances. This study aimed to compare OR intracorporeal suturing performances of residents who trained with a fundamentals of laparoscopic surgery (FLS) BT vs. those of experienced laparoscopists. DESIGN: This was a prospective observational study...
June 14, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28612938/silent-uterine-rupture-occluded-by-intestinal-adhesions-following-laparoscopic-myomectomy-a-case-report
#3
Riho Fukutani, Junichi Hasegawa, Tatsuya Arakaki, Tomohiro Oba, Masamitsu Nakamura, Akihiko Sekizawa
We present a rare asymptomatic case in which intestinal adhesions covered and occluded a site of uterine rupture, which was found during cesarean section. The patient had undergone laparoscopic myomectomy 5 years previously. However, detailed antenatal ultrasound and magnetic resonance imaging examinations revealed no uterine or placental abnormalities. It is thought that uterine rupture was not detected due to intestinal adhesions, which had occurred following the previous surgery. The present case suggests that women who conceive after laparoscopic myomectomy may be at risk of silent uterine rupture...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28591045/the-efficiency-and-safety-of-tranexamic-acid-for-reducing-blood-loss-in-open-myomectomy-a-meta-analysis-of-randomized-controlled-trials
#4
Dongdong Wang, Lixia Wang, Yifei Wang, Xinyan Lin
OBJECTIVE: This meta-analysis aimed to perform a meta-analysis including randomized controlled trials (RCTs) to assess the efficiency and safety of tranexamic acid (TXA) for reducing blood loss and transfusion requirements in patients undergoing open myomectomy. METHODS: A systematic search was performed in Medline (1966-2017.03), PubMed (1966-2017.03), Embase (1980-2017.03), ScienceDirect (1985-2017.03,) and the Cochrane Library. Study evaluated the efficiency and safety of TXA in myomectomy was selected...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28586771/can-in-bag-manual-morcellation-represent-an-alternative-to-uncontained-power-morcellation-in-laparoscopic-myomectomy-a-randomized-controlled-trial
#5
Clarissa Frascà, Eugenia Degli Esposti, Alessandro Arena, Gianmarco Tuzzato, Elisa Moro, Valentina Martelli, Renato Seracchioli
AIMS: The study aimed to evaluate feasibility and safety of in-bag manual morcellation compared to uncontained power morcellation during laparoscopic myomectomy. METHODS: A total of 72 women undergoing laparoscopic myomectomy were randomized into 2 treatment groups: 34 patients underwent in-bag manual morcellation (experimental group) and 38 were submitted to uncontained power morcellation (control group). The primary end point was the comparison of morcellation operative time (MOT)...
June 7, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28585608/hysteroscopic-myomectomy-can-lead-to-intrauterine-adhesions-and-infertility
#6
Afifa Riaz, Ahsan Zil-E-Ali
No abstract text is available yet for this article.
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28585458/safety-of-cesarean-myomectomy-in-women-with-single-anterior-wall-and-lower-uterine-segment-myomas
#7
Radmila Sparić, Antonio Malvasi, Saša Kadija, Aleksandar Stefanović, Svetlana Spremović Radjenović, Jela Popović, Aleksandra Pavić, Andrea Tinelli
OBJECTIVE: Cesarean myomectomy (CM) is a safe procedure in selected cases. Nevertheless, literature lacks clear guidelines on patient selection. We aimed to evaluate CM safety in patients with single anterior wall and lower uterine segment (LUS) myomas. METHODS: The authors selected pregnants at term, scheduled for CSs, with single anterior wall or LUS myomas. All their clinical, demographic, obstetric, and surgical parameters were recorded. RESULTS: Thirty-six women had a CM (study group), and 17 had a CS without myoma removal (control group)...
June 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28584568/hypovolemic-shock-and-hemoperitoneum-from-spontaneous-avulsion-of-a-large-pedunculated-uterine-leiomyoma
#8
Daniel J Mizrahi, Chhavi Kaushik, Robert Adamo
Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus...
March 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28580061/disseminated-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-morcellation
#9
Neil Anand, Marci Handler, Ahsan Khan, Allison Wagreich, Sean Calhoun
Uterine leiomyomas (fibroids) are common benign neoplasms, which develop from the muscular tissue of the uterus with an estimated incidence of 20-40% in women of reproductive age. In the early nineties, power morcellators were introduced and became commonly used during hysterectomy for symptomatic fibroids. However, if all fragments are not removed, they may parasitize to other blood supply and present as abdominal or pelvic masses. Unfortunate cases have also been reported in which uterine sarcomas seeded throughout the abdomen and pelvis secondary to morcellation...
December 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28567195/abdominal-myomectomy-a-retrospective-review-of-determinants-and-outcomes-of-complications-at-the-university-of-ilorin-teaching-hospital-ilorin-nigeria
#10
Kikelomo T Adesina, Beatrice O Owolabi, Hadijat O Raji, Adebunmi O Olarinoye
BACKGROUND: The aim of this study was to describe the pattern, outcomes, and determinants of perioperative complications of abdominal myomectomy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. METHODS: This was a retrospective review of cases of abdominal myomectomy between January 2010 and December 2013. Data were obtained from ward and operating theatre case records and analysed using SPSS version 20. The continuous variables were analysed with Student's t-test...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28566135/how-to-set-up-a-robotic-assisted-laparoscopic-surgery-center-and-training-of-staff
#11
REVIEW
John P Lenihan
The use of computers to assist surgeons in the operating room has been an inevitable evolution in the modern practice of surgery. Robotic-assisted surgery has been evolving now for over two decades and has finally matured into a technology that has caused a monumental shift in the way gynecologic surgeries are performed. Prior to robotics, the only minimally invasive options for most Gynecologic (GYN) procedures including hysterectomies were either vaginal or laparoscopic approaches. However, even with over 100 years of vaginal surgery experience and more than 20 years of laparoscopic advancements, most gynecologic surgeries in the United States were still performed through an open incision...
May 10, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28552622/minilaparotomy-versus-laparoscopic-myomectomy-after-cessation-of-power-morcellation-rate-of-wound-complications
#12
Ariel K Dubin, Julia Wei, Shannon Sullivan, Natalia Udaltsova, Eve Zaritsky, Miya P Yamamoto
STUDY OBJECTIVE: After the FDA statement warning against electronic morcellation devices, gynecologic surgeons are performing laparoscopic and robotic myomectomies with minilaparotomy incisions for tissue morcellation and removal. No data exists focusing on the superficial wound complications as a result of these larger incisions. The objective of this study is to compare the rate of wound complications for myomectomy via minilaparotomy vs laparoscopic or robotic myomectomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2)...
May 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28551090/role-of-robotic-surgery-in-treating-fibroids-and-benign-uterine-mass
#13
REVIEW
Suejin Kim, Thanh Ha Luu, Natalia Llarena, Tommaso Falcone
Fibroid uterus can be managed medically, surgically, or through non-extirpative procedures, depending on the clinical situation. Myomectomy may be beneficial, especially to those desiring to preserve the uterus and/or fertility, with outcomes comparable to those of hysterectomy, with a laparoscopic approach being favored when feasible. For definitive therapy, hysterectomy can be pursued where the surgical approach should be individualized. Comparison of robotic-assisted laparoscopic approach shows that the robotic approach may be favored for cases with higher complexity and multiple fibroids in myomectomy; however, no clear advantage is seen with hysterectomy at this time, necessitating further research in the area of robotics for hysterectomy in benign uterine mass treatment to justify the cost...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28536870/benign-metastasizing-leiomyomas-following-myomectomy-and-uterine-artery-embolization
#14
Jessica Yoon, James B Spies, Theresa M Caridi
Benign metastasizing leiomyomas (BMLs) are rare sequelae of common uterine leiomyomas and most frequently found in the lungs. Most cases of BMLs occur with a history of prior gynecologic procedures; however, none have yet been reported in association with uterine artery embolization (UAE). This case report highlights the disease course for a 48-yo female with a history of both myomectomy and UAE for uterine fibroids who presented later with bilateral pulmonary BMLs. Though the pathophysiology of BMLs is poorly understood and this case is confounded by prior myomectomy, it does bring into question whether UAE has a role in BML development...
May 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28528932/robot-assisted-gynaecological-cancer-surgery-complications-and-prevention
#15
REVIEW
Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28523198/uterine-fibroid-torsion-during-pregnancy-a-case-of-laparotomic-myomectomy-at-18-weeks-gestation-with-systematic-review-of-the-literature
#16
Annachiara Basso, Mariana Rita Catalano, Giuseppe Loverro, Serena Nocera, Edoardo Di Naro, Matteo Loverro, Mariateresa Natrella, Salvatore Andrea Mastrolia
Uterine myomas are the most common benign growths affecting female reproductive system, occurring in 20-40% of women, whereas the incidence rate in pregnancy is estimated from 0.1 to 3.9%. The lower incidence in pregnancy is due to the association with infertility and low pregnancy rates and implantation rates after in vitro fertilization treatment. Uterine myomas, usually, are asymptomatic during pregnancy. However, occasionally, pedunculated fibroids torsion or other superimposed complications may cause acute abdominal pain...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28515917/total-laparoscopic-hysterectomy-for-large-uterine-cervical-myoma
#17
Kentaro Nakayama, Mayu Tsukao, Masako Ishikawa, Tomoka Ishibashi, Kohei Nakamura, Kaori Sanuki, Hitomi Yamashita, Ruriko Ono, Toshiko Minamoto, Satoru Kyo
Ureterolysis is a surgical method with a high level of difficulty, which may be necessary when performing total laparoscopic hysterectomy (TLH) for large cervical myoma, despite the benign nature of this tumor. The aim of the present study was to introduce techniques that are commonly applied in malignant tumor surgery in order to safely perform TLH for large cervical myoma. Between 2014 and 2016, TLH was performed at the Shimane University Hospital (Izumo, Japan) in 153 patients with benign tumors, including 25 cases with a large uterus (uterine weight ≥500 g)...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28498262/sarcoma-risk-in-uterine-surgery-in-a-tertiary-university-hospital-in-germany
#18
Sudip Kundu, Manuel Zachen, Hermann Hertel, Peter Hillemanns, Philipp Soergel
OBJECTIVES: There is a risk to incidentally spread uterine malignancies, especially sarcoma, if tissue is morcellated during hysterectomy or myoma enucleation. In the last years, a worldwide discussion has been started about this problem. However, the risk seems to be very small in recent studies. This study aims at further investigating the risk of disseminating uterine malignancy during uterine surgery in a tertiary university hospital in Germany. METHODS: In a retrospective setting, all cases of uterine myometrial surgery (hysterectomies and myomectomies) in our clinic during a period of 10 years were identified using clinical databases...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28491174/diagnosis-of-abnormally-invasive-posterior-placentation-the-role-of-mr-imaging
#19
Madison R Kocher, Douglas H Sheafor, Evelyn Bruner, Charles Newman, Julio Fernando Mateus Nino
Abnormally invasive placentation is becoming more common with a recent increase in cesarean sections and maternal age, among other risk factors. Ultrasonography is the first line-imaging, but it can be difficult to diagnose when limiting factors are present. Failure to recognize this serious placental abnormality precludes us from making the appropriate plan for the delivery and consequently can lead to fatal results. In this report, we present a case in which magnetic resonance imaging was used to diagnose posterior placenta increta missed by multiple sonographic examinations in a patient with previous myomectomies, and we also include a review of the literature on this topic...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28487176/feasibility-of-reduced-port-robotic-surgery-for-myomectomy-with-the-da-vinci-%C3%A2-surgical-system
#20
Jeong Jin Kim, Chahien Choi, Su Hyun Nam, Woo Young Kim
STUDY OBJECTIVE: To present our initial experience with reduced port robotic surgery (RPRS) for myomectomy using Octo-Port. DESIGN: Prospective and noncomparative study. (Canadian Task Force classification II-3). SETTING: University hospital. PATIENTS: Nineteen consecutive patients with symptomatic uterine fibroids desiring conservative minimally invasive robotic surgery from October 2015 to December 2016 INTERVENTIONS: An 8...
May 6, 2017: Journal of Minimally Invasive Gynecology
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