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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
#1
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...
November 7, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29147439/uterine-smooth-muscle-tumor-of-uncertain-malignant-potential-clinicopathologic-sonographic-characteristics-follow-up-and-recurrence
#2
Besim Haluk Bacanakgil, Mustafa Deveci, Emine Karabuk, Zeynep Soyman
Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is rare tumor, and regarded as sub-classification in uterine smooth muscle tumors between benign and malignant criteria. In this study, we evaluated characteristics of cases with STUMP diagnosis in a 10-year period. Methods: We retrospectively evaluated medical records of patients with histopathological STUMP diagnosis in Istanbul Training and Research Hospital, a tertiary center. We analyzed preoperative demographic, clinical features and postoperative follow-up...
June 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29146388/the-role-of-pelvic-ultrasound-in-preoperative-evaluation-for-laparoscopic-myomectomy
#3
Clarissa Frascà, Gianmarco Tuzzato, Alessandro Arena, Eugenia Degli Esposti, Margherita Zanello, Diego Raimondo, Renato Seracchioli
STUDY OBJECTIVE: To determine the accuracy of pelvic ultrasonography (US) in preoperative evaluation before laparoscopic myomectomy. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Tertiary level referral center of minimally invasive gynecologic surgery, Sant'Orsola University Hospital, Bologna, Italy. PATIENTS: One hundred and one of the 125 women undergoing laparoscopic myomectomy from September 2015 to May 2016 were included...
November 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29142447/a-prospective-randomized-study-comparing-unipolar-versus-bipolar-hysteroscopic-myomectomy-in-infertile-women
#4
Kallol K Roy, Sandeep Metta, Yamini Kansal, Sunesh Kumar, Seema Singhal, Perumal Vanamail
Study Objective: To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia. Design: Randomized, prospective, parallel, comparative, single-blinded study. Design Classification: Canadian Task Force classification I. Setting: Tertiary care institute. Patients: Sixty women with submucous myoma and infertility...
July 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#5
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29133752/proportion-of-uterine-malignant-tumors-in-patients-with-laparoscopic-myomectomy-a-national-multicenter-study-in-china
#6
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/29129517/comparison-of-three-different-hemostatic-devices-in-laparoscopic-myomectomy
#7
Hui-Yu Huang, Yu-Cheng Liu, Yi-Chieh Li, Hsin-Hong Kuo, Chin-Jung Wang
BACKGROUND: To compare conventional electrosurgery, LigaSure (Valleylab, Boulder, CO), and Harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH) in terms of perioperative and postoperative outcomes during laparoscopic myomectomy (LM). METHODS: We retrospectively studied 817 women with symptomatic fibroids who underwent LM between January 1997 and September 2015. Three different instruments were used separately during surgery. The number and weight of removed fibroids, blood loss, operative time, postoperative decrease in the hemoglobin level, and length of hospital stay were measured for statistical analysis...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29129378/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a%C3%A2-new-approach-to-myomectomy
#8
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. DESIGN: Stepwise explanation of the technique with the use of original video footage. SETTING: Hospital. PATIENT(S): Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. INTERVENTION(S): In case of a posterior myoma, a 2...
November 9, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29126743/benign-and-malignant-pathology-of-the-uterus
#9
REVIEW
V Tanos, K E Berry
The diagnosis of a uterine myoma size and location can be very precise when a 3D sonograph and knowledge are available. The majority of fibroids are asymptomatic, and expectant management is recommended. In young patients, fibroids cause infertility and in middle-aged women, abnormal uterine bleedings. Laparoscopic myomectomy is the preferred way of surgery for IM and SS fibroids, versus hysteroscopy for SM fibroids. In both cases, the size, number of fibroids and the surgeon's experience determine the limitations of the MIGS...
October 16, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29112662/perioperative-complications-of-cesarean-delivery-myomectomy-a-meta-analysis
#10
Vasilios Pergialiotis, Ilias Sinanidis, Ioannis-Evangelos Louloudis, Theodoros Vichos, Despina N Perrea, Stergios K Doumouchtsis
OBJECTIVE: To assess the association of myomectomy during cesarean delivery with intraoperative and perioperative maternal morbidity. DATA SOURCES: We searched MEDLINE (1966-2017), Scopus (2004-2017), ClinicalTrials.gov (2008-2017), EMBASE (1980-2017), and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases. METHODS OF STUDY SELECTION: We selected all observational studies that reported outcomes on patients undergoing myomectomy at the time of cesarean delivery...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29103894/robot-assisted-myomectomy
#11
REVIEW
Celine Lonnerfors
Uterine fibroids are the most common tumors of the uterus and the female pelvis and are associated with substantial morbidity for several women. In women with a wish to preserve fertility, a myomectomy is the surgical procedure of choice when medical therapy is inadequate. Despite evidence that minimally invasive surgery is preferable to laparotomy, most myomectomies are still performed by laparotomy. Robotic surgery was introduced to overcome some of the difficulties associated with laparoscopic surgery. A myomectomy is a suture-intensive surgery where the properties of a surgical robot have been suggested to be of particular value...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29079463/a-multicenter-study-evaluating-the-effect-of-ulipristal-acetate-during-myomectomy
#12
Ally Murji, Marta Wais, Sabrina Lee, Alice Pham, Melissa Tai, Grace Liu
STUDY OBJECTIVE: To compare surgical experience at myomectomy between patients with fibroids pretreated with ulipristal acetate versus no pretreatment. DESIGN: Prospective, observational, multicenter study of myomectomy procedures by any route (hysteroscopic, laparoscopic or laparotomy). DESIGN CLASSIFICATION: Canadian Task Force Classification II-2. SETTING: Five university-affiliated hospitals including tertiary care and community sites...
October 24, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29078975/laparoscopic-myomectomy-and-morcellation-a-review-of-techniques-outcomes-and-practice-guidelines
#13
REVIEW
Laura M Glaser, Jaclyn Friedman, Susan Tsai, Angela Chaudhari, Magdy Milad
Laparoscopic myomectomy is a minimally invasive surgical approach to treat symptomatic uterine fibroids in women wishing for a uterine-sparing procedure. With careful patient selection, these procedures are associated with favorable reproductive outcomes and low perioperative morbidity. Current available methods for specimen retrieval include power and hand morcellation. The 2014 FDA safety warnings regarding power morcellation arose from concerns about the spread of occult malignancy and prompted widespread use of containment systems that may limit spread of myometrial cells...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29066658/successful-maternal-and-perinatal-outcomes-in-a-term-pregnancy-with-giant-abdominopelvic-leiomyomatosis
#14
Jai Bhagwan Sharma, Alka Kriplani, Monica Gupta, Vathulru Seenu
A 30-year-old second gravida with history of laparoscopic myomectomy and one previous caesarean section was admitted at 31 weeks and 2 days period of gestation (POG) with a diagnosis of diffuse abdominopelvic leiomyomatosis and moderate anaemia. After correction of anaemia with intravenous iron and erythropoietin, laparotomy was performed at 37 weeks POG. A healthy female baby weighing 2.9 kg was delivered by classical caesarean section followed by hysterectomy in view of multiple fibroid uterus with uncontrolled bleeding...
October 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29061369/unsuspected-uterine-sarcoma-in-an-urban-hospital-does-surgical-approach-matter
#15
Marianne N DiNapoli, Mireille D Truong, Johanna K Halfon, William M Burke
STUDY OBJECTIVE: To compare the incidence of unsuspected uterine sarcoma based on surgical approach: open versus minimally invasive approaches for myomectomies and hysterectomies. DESIGN: Retrospective chart review of demographic data, preoperative characteristics, operative details, and pathology results from the electronic medical record. DESIGN: Classification: II-3 SETTING: A large, urban, academic medical center. PATIENTS: All women undergoing myomectomy or hysterectomy performed for benign indications by a benign gynecologic surgery between 2010 and 2014...
October 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29052017/fertility-after-uterine-artery-embolization-of-fibroids-a-systematic-review
#16
REVIEW
K Karlsen, A Hrobjartsson, M Korsholm, O Mogensen, P Humaidan, P Ravn
PURPOSE: The impact of uterine artery embolization (UAE) for the purpose of diminishing the effect of uterine fibroids on fertility is unclear. We have investigated the reported rates of pregnancy and miscarriage after treatment of uterine fibroids with UAE. MATERIALS AND METHODS: We searched for relevant information in PubMed and Embase for randomized controlled trials (RCT), controlled clinical trials, comparative before-after trials, cohort studies, case-control studies and case series where UAE treatment of premenopausal women was performed for uterine fibroids with and where a control intervention was included...
October 20, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29043711/the-many-guises-of-endometriosis-giant-abdominal-wall-endometriosis-masquerading-as-an-incisional-hernia
#17
Chiara Petrosellini, Sala Abdalla, Tayo Oke
Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare...
January 2018: International Journal of Fertility & Sterility
https://www.readbyqxmd.com/read/29037554/the-role-of-resveratrol-on-full-thickness-uterine-wound-healing-in-rats
#18
Oya Sayin, Serap Cilaker Micili, Asli Goker, Gonca Kamaci, Bekir Ugur Ergur, Osman Yilmaz, Gul Guner Akdogan
OBJECTIVE: Healing of the uterus after cesarean section and myomectomy operation is clinically important. In this study, we aimed to investigate the effects of resveratrol (3,5,4'-o-trihydroxystilbene) on the wound healing process of the uterus in rats treated with resveratrol following full thickness injury of the uterus. MATERIALS AND METHODS: Twenty-one female wistar albino rats were divided randomly into three groups (1) control group with no intervention (2) injury group with uterine full thickness injury (3) resveratrol group with uterine full thickness injury and treated with resveratrol...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29036173/pre-treatment-with-gnrha-or-ulipristal-acetate-prior-to-laparoscopic-and-laparotomic-myomectomy-a-systematic-review-and-meta-analysis
#19
REVIEW
Inge de Milliano, Moniek Twisk, Johannes C Ket, Judith A Huirne, Wouter J Hehenkamp
BACKGROUND: Myomectomy has potential risks of complications. To reduce these risks, medical pre-treatment can be applied to reduce fibroid size and thereby potentially decrease intra-operative blood loss, the need for blood transfusion and emergency hysterectomy. The aim of this systematic review and meta-analysis is to study the effectiveness of medical pre-treatment with Gonadotropin-releasing hormone agonists (GnRHa) or ulipristal acetate prior to laparoscopic or laparotomic myomectomy on intra-operative and post-operative outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/29032253/laparoscopic-dissection-of-extensive-secondary-disseminated-peritoneal-leiomyomatosis-dpl
#20
Karicha Mairaing, Kuan-Gen Huang
STUDY OBJECTIVE: To demonstrate a minimal invasive surgical (MIS) technique for curative excision of extensive secondary disseminated peritoneal leiomyomatosis (DPL). SETTING: In MIS, the myoma has to be divided into small fragments for piecemeal retrieval through a small incision [1], a widely used technique is morcellation (confined or unconfined) [2]. Disseminated peritoneal leiomyomatosis (DPL) is a rare sequel following laparoscopic morcellation. Since this entity is rarely reported, this video demonstrates laparoscopic technique for safe removal of DPL post laparoscopic myomectomy and morcellation...
October 12, 2017: Journal of Minimally Invasive Gynecology
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