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https://www.readbyqxmd.com/read/28805608/the-utility-and-effectiveness-of-an-internal-iliac-artery-balloon-occlusion-catheter-in-surgery-for-large-cervical-uterine-fibroids
#1
Hiroshi Kaneda, Yasuhisa Terao, Yuko Matsuda, Kazunari Fujino, Takafumi Ujihira, Soshi Kusunoki, Miki Kimura, Akihiko Shiraishi, Ryohei Kuwatsuru, Satoru Takeda
OBJECTIVE: Surgery for uterine cervical fibroids is difficult because of restricted surgical access and risks such as intraoperative bleeding or injury to other organs. The internal iliac artery balloon occlusion catheter (IIABOC) provides effective hemostasis for placenta previa and atonic hemorrhage, and is increasingly used in surgery for uterine fibroids for controlling intraoperative hemorrhage. We investigated the efficacy and safety of the IIABOC for controlling intraoperative bleeding in total abdominal hysterectomies (TAH) and abdominal myomectomies (AM) for large cervical fibroids...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28805602/laparoendoscopic-single-site-myomectomy-using-conventional-laparoscopic-instruments-and-glove-port-technique-four-years-experience-in-109-cases
#2
Szu-Yu Chen, Bor-Ching Sheu, Su-Cheng Huang, Wen-Chun Chang
OBJECTIVE: To report a single surgeon's experience with 109 laparoendoscopic single-site myomectomy (LESS-M) using conventional laparoscopic instruments and a homemade glove port system. MATERIALS AND METHODS: A total of 109 consecutive women who underwent LESS-M between March 2011 and April 2015 were reviewed. RESULTS: The mean age and body mass index were 38.3 ± 6.5 years and 22.1 ± 3.0 kg/m(2). The mean diameter of the largest myoma and the mean number of myomas were 8...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28801321/massive-ascites-pelvic-mass-elevated-ca-125-and-weight-loss-think-outside-the-ovaries
#3
Jehan Khalid Mohammed Musleh, Mohammed Almulhem, Nourah Hasan Al Qahtani
A 44-year-old woman presented with 3 months' history of painless progressive abdominal distension and weight loss of more than 15 kg. Clinically a pelviabdominal mass with ascites was detected. CT scan of the pelvis and abdomen showed a subserosal leiomyoma with huge amount of ascites. Cancer Antigen (CA)-125 was 546 kU/L. Exploratory laparotomy with myomectomy was done and this was followed by dramatic improvement postoperatively.
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28783861/cotyledonoid-dissecting-leiomyoma-with-symplastic-features-case-report
#4
Fatma Cavide Sonmez, Zeynep Tosuner, Ayse Filiz Gökmen Karasu, Dilek Sema Arıcı, Ramazan Dansuk
Purpose Cotyledonoid dissecting leiomyoma is a leiomyoma variant exhibiting unusual growth patterns. We aimed to demonstrate this, as well as to point out another feature that has not been previously reported. Case Report A congested, multinodular myomectomy specimen was resected. Histologically, smooth muscle fascicles with marked vascularity and extensive hydropic degeneration were detected. A total of 2 mitoses per 10 high power fields were counted, and the Ki-67 index was of 2-3%. We encountered atypical bizarre cells that have not been previously reported...
August 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28767590/combining-situ-morcellation-with-continuous-fill-mattress-suture-in-laparoscopic-myomectomy-a-surgical-approach-of-choice-for-patients-with-large-uterine-fibroids
#5
Bo Li, Shitai Zhang, Ningye Ma, Yisheng Jiao, Yang Zhou, Sha Ni, Xue Han, Xiaomo Liu, Ling Ouyang
BACKGROUND: To investigate the efficacy and advantage of combining situ-morcellation with continuous-fill-mattress suture compared with conventional morcellation and suture in laparoscopic myomectomy. METHODS: One hundred sixteen patients who underwent laparoscopic myomectomy from March 2014 to October 2016. INTERVENTIONS: Patients were divided into combining situ-morcellation with continuous-fill-mattress suture group (n = 62) and conventional group (n = 54), and subsequent statistical analysis the clinical data of the 2 groups...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28764594/intraoperative-endoscopic-ultrasound-guidance-for-laparoscopic-excision-of-invisible-symptomatic-deep-intramural-myomas
#6
Bulent Urman, Aysen Boza, Baris Ata, Sertan Aksu, Tonguc Arslan, Cagatay Taskiran
The aim of this study was to evaluate the feasibility of intraoperative endoscopic ultrasound guidance for excision of symptomatic deep intramural myomas that are not otherwise visible at laparoscopy. Seventeen patients with symptomatic deep intramural myomas who underwent laparoscopic myomectomy with intraoperative endoscopic ultrasound guidance were followed up and reported. All myomas were removed successfully. The endometrium was breached in one patient. All patients were relieved of their symptoms and three patients presenting with infertility conceived...
August 1, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28755615/abdominal-leiomyosarcomatosis-after-surgery-with-external-morcellation-for-occult-smooth-muscle-tumors-of-uncertain-malignant-potential-a-case-report
#7
Antonio Macciò, Giacomo Chiappe, Paraskevas Kotsonis, Fabrizio Lavra, Michele Serra, Roberto Demontis, Clelia Madeddu
INTRODUCTION: Although rare, cases of abdominal sarcomatosis (AS) after laparotomy/laparoscopic interventions for uterine smooth muscle tumors of uncertain malignant potential (STUMP) have been reported. PRESENTATION OF CASE: We describe a rare case of diffuse abdominal sarcomatosis in a patient that some year earlier had undergone myomectomy for a suspected uterine myoma, which was histologically proven to be a STUMP. Once the patient was admitted at our Department, she underwent a diagnostic laparoscopy that confirmed a condition of peritoneal sarcomatosis disseminated through the entire abdomen, and then a laparotomic total hysterectomy, bilateral salpingo-oophorectomy, and total omentectomy, achieving a complete cytoreduction...
July 19, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28743407/prevalence-of-undiagnosed-uterine-leiomyosarcoma-in-women-undergoing-hysterectomy-or-myomectomy-for-benign-indications
#8
Sören Lange, Nicola Pluchino, Aurore Fehlmann, Roberto Marci, Meriem Boukrid, Inès Ben Jazia, Patrick Petignat, Jean Dubuisson
OBJECTIVE: To determine the prevalence of undiagnosed uterine leiomyosarcoma (LMS) in women undergoing hysterectomy or myomectomy for suspected benign leiomyomas. STUDY DESIGN: Retrospective, single-centre, cohort study. Information for all gynaecological procedures for suspected benign leiomyomas between 1993 and 2016 was extracted from the hospital database. The prevalence of LMS was calculated by surgery type and age group. RESULTS: The prevalence of LMS was 1...
June 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28734973/minimally-invasive-approaches-to-myoma-management
#9
REVIEW
Julian A Gingold, Ndeye-Aicha Gueye, Tommaso Falcone
Patients affected by the presence of leiomyomas may incur a substantial physical, emotional, social and financial toll as well as losses in their quality of life. Although many myomas are not amenable to medical therapy or hysteroscopic resection, many others are amenable to minimally invasive surgical approaches. In patients who prefer to retain their fertility, laparoscopic myomectomy should be considered the intervention of choice. In this review we expand on the surgical techniques of both conventional laparoscopic and robotic-assisted myomectomies...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28729098/a-multicentre-retrospective-review-of-clinical-characteristics-of-uterine-sarcoma
#10
Marta Wais, Elissa Tepperman, Marcus Q Bernardini, Lilian T Gien, Waldo Jimenez, Ally Murji
OBJECTIVE: Professional societies have recently urged gynaecologists to counsel patients about the risks of encountering uterine sarcoma at fibroid surgery especially when morcellation is used. Our objective was to learn the preoperative and postoperative characteristics of patients with uterine sarcoma to better counsel patients undergoing surgery for presumably benign fibroids. METHODS: This is a multicentre, retrospective cohort study. Three academic tertiary cancer centres in Southern Ontario over a 13-year period (2001-2014)...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28725172/an-original-and-effective-technique-to-improve-exposure-in-open-surgery
#11
E Nohuz, G Chêne
BACKGROUND: Exposure, especially when the organs are enlarged, remains one of the most important issue in open surgery. Considering this constraint appears critical in the progress of the surgical procedure. We highlight our technique which affords optimal exposure and improves manipulation and extraction of enlarged organs. RESULTS: This original and effective technique is derived from an obstetrical device used to perform an assisted vaginal delivery. It improves exposure, reduces tissue manipulation, and enhances removal of the surgical specimen during hysterectomies and myomectomies...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28700441/leiomyoma-with-bizarre-nuclei-clinical-and-pathologic-features-of-30-patients
#12
Mehmet Kefeli, Sultan Caliskan, Emel Kurtoglu, Levent Yildiz, Arif Kokcu
Leiomyoma with bizarre nuclei (LBN) have significant cytologic atypia, but high mitotic rate and tumor cell necrosis are absent. Although it is a benign leiomyoma variant, recurrent cases have been described. In this study, we investigated the clinical and pathologic features of LBN and compared them with related studies. A total of 30 patients diagnosed with LBN in our department were included in this study. In all cases, clinical data (age, complaint, surgery type), macroscopic features (size, location, number of leiomyomas, necrosis, and hemorrhage), microscopic features (bizarre cell distribution, bizarre cell density, cellularity, mitotic rate, tumor margin, necrosis, nuclear pseudoinclusions, karyorrhectic nuclei, prominent eosinophilic nucleoli with perinucleolar clearing, cytoplasmic eosinophilic inclusions, staghorn vessels, and alveolar-type edema), and follow-up data (recurrence and survival period) were evaluated...
July 11, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28696085/does-fibroids-surgery-by-endoscopy-or-laparotomy-represent-a-malignancy-threat
#13
Liselotte Mettler, Khulkar Abdusattarova, Ibrahim Alkatout
BACKGROUND: 1) to estimate the incidence of unsuspected uterine sarcoma in patients after myomectomies and hysterectomies for benign uterine fibroids. 2) to assessed the incidence of uterine sarcomas among patient who had uterine fibroids or a suspicion of uterine sarcoma before undergoing the surgical procedures. METHODS: Retrospective study in single center university hospital. Patient 's records with uterine fibroids and uterine sarcoma from 2003 to 2015 collected...
July 10, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28694681/patients-knowledge-and-perceptions-of-morcellation
#14
Erika L Mowers, Courtney S Lim, Bethany Skinner, Nichole Mahnert, Sara R Till, Sawsan As-Sanie
BACKGROUND AND OBJECTIVES: Morcellation has received increased media and professional attention, but it remains unclear how much the average patient knows about this topic. We sought to evaluate patients' knowledge of morcellation, assess their perceptions of the risks and benefits, and determine how these perceptions affect their decision regarding the route of surgery. METHODS: Anonymous paper surveys were administered to 500 patients attending gynecologic appointments at the University of Michigan...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28691348/rare-complication-of-fibroids-in-pregnancy-spontaneous-fibroid-rupture
#15
Alim Swarray-Deen, Shirley A Mensah-Brown, Jerry Coleman
Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Emergency laparotomy confirmed massive intra-abdominal hemorrhage from the ruptured capsule of a 10-cm subserosal fibroid. A myomectomy was performed. Her postoperative recovery period was uneventful...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28685713/improved-fertility-following-enucleation-of-intramural-myomas-in-infertile-women
#16
Yu-Cui Tian, Jian-Hong Wu, Hong-Mei Wang, Yin-Mei Dai
BACKGROUND: The relationship between intramural myomas and fertility remains unclear. The main debate rests on whether cavity-distorting intramural myomas (CDMs) adversely affect fertility more than non-CDMs. We aimed to compare the effects of enucleating non-CDMs and CDMs on fertility improvement in females with unexplained infertility. METHODS: We prospectively recruited 83 women undergoing myomectomy for unexplained infertility with intramural myomas between June 2008 and November 2012 and classified them into non-CDMs group (n = 45) and CDMs group (n = 38)...
July 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28678389/caesarean-myomectomy-te-or-not-te
#17
Karl S J Oláh
Many years ago as a trainee I removed a subserosal fibroid during a caesarean section that was hanging by a thin stalk on the back of the uterus. The berating I received was severe and disproportionate to my crime. The rule was that myomectomy performed at caesarean section was not just frowned upon, but expressly forbidden. This article is protected by copyright. All rights reserved.
July 5, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28662989/radiofrequency-thermal-ablation-for-uterine-fibroids-long-term-clinical-outcomes-and-reinterventions
#18
Helene Iversen, Margit Dueholm
STUDY OBJECTIVE: To assess the long-term efficacy and rate of reintervention after ultrasound-guided radiofrequency thermal ablation (RFA) for uterine fibroids. DESIGN: A retrospective follow-up, cohort study (Canadian Task Force Classification II-2) SETTING: University hospitals and private clinics. PATIENTS: Between November 1, 2007 and February 26, 2010, 66 consecutive women underwent ultrasound-guided RFA. INTERVENTIONS: Patients underwent abdominal or vaginal ultrasound-guided RFA and were contacted for a long-term follow-up to complete the Uterine Fibroid Symptom and Quality of Life Score questionnaire (UFS-QOL) and optional ultrasound and examination...
June 26, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28649392/blood-cadmium-and-volume-of-uterine-fibroids-in-premenopausal-women
#19
Shinhee Ye, Hye Won Chung, Kyungah Jeong, Yeon-Ah Sung, Hyejin Lee, So Yun Park, Hyunjoo Kim, Eun-Hee Ha
BACKGROUND: A number of studies have found associations between heavy metals and uterine fibroids, but the results are inconsistent. Here, we conducted this research to demonstrate the relationships between blood heavy metal concentrations and uterine fibroid volume as well as the rate of uterine fibroid presence. METHODS: In a cross-sectional study, we collected data from 308 premenopausal women aged 30-49 years in Seoul; uterine fibroids are ascertained by past history of myomectomy and pelvic ultrasonography...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28646578/the-impact-of-a-novel-transendometrial-approach-for-caesarean-myomectomy-on-obstetric-outcomes-of-subsequent-pregnancy-a-longitudinal-panel-study
#20
S Y Huang, S W Shaw, S Y Su, W F Li, H H Peng, P J Cheng
OBJECTIVE: To evaluate the obstetric and surgical outcomes of a novel transendometrial approach for myomectomy during caesarean section in subsequent pregnancies. DESIGN: Longitudinal panel study. SETTING: Chang Gung Memorial Hospital, Taiwan, with approximately 5000 births per annum. POPULATION: Pregnant women complicated with uterine myoma. METHOD: Sixty-three pregnant women who received transendometrial myomectomy during the first caesarean delivery reported a subsequent live pregnancy and planned an elective repeat caesarean delivery...
June 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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