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https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#1
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28414995/case-report-of-an-intracaval-leiomyomatosis-10-months-after-complete-hysterectomy
#2
Hannah Maria Schäfer, Andrej Isaak, Lorenz Gürke
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor, usually found in women with tumors of the reproductive organs, such as uterus myomatosous. Surgically, this case belies the call for sternotomy and two-stage surgery in caval IVL extending to the right atrium: we suggest one-stage median laparotomy as a minimal procedure with maximal benefit. PRESENTATION OF CASE: We present the case of a 60-year-old postmenopausal woman with suspected intravenous leiomyomatosis of the right internal iliac vein...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28404551/endocervical-gastric-type-adenocarcinoma-an-unrelated-hpv-tumour-difficulties-in-screening-and-diagnosis
#3
Priscila Carneiro Lima, Julio Teixeira, Guilherme Nogueira Aires, Liliana De Angelo Andrade
Gastric-type adenocarcinoma of the cervix (GAS) is an uncommon and aggressive tumour unrelated to human papillomavirus (HPV) infection with distinctive histological and immunohistochemical characteristics. GAS may be associated with lobular endocervical glandular hyperplasia (LEGH), another unusual lesion. We report a case of a 59-year-old woman with screening cytology 'AGC-Neo' and cervical conisation exhibiting cervical intraepithelial neoplasia grade 1, extensive LEGH and canal sampling with abundant mucinous cells...
April 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28363438/reducing-surgical-site-infections-after-hysterectomy-metronidazole-plus-cefazolin-compared-with-cephalosporin%C3%A2-alone
#4
Sara R Till, Daniel M Morgan, Ali A Bazzi, Mark D Pearlman, Zaid Abdelsattar, Darrell A Campbell, Shitanshu Uppal
BACKGROUND: Organisms that are isolated from vaginal cuff infections and pelvic abscesses after hysterectomy frequently include anaerobic vaginal flora. Metronidazole has outstanding coverage against nearly all anaerobic species, which is superior to both cefazolin and second-generation cephalosporins. Cefazolin plus metronidazole has been demonstrated to reduce infectious morbidity compared with either cefazolin or second-generation cephalosporins in other clean-contaminated procedures, which include both as colorectal surgery and cesarean delivery...
March 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28355765/-liposuction-combined-with-lymphatico-venous-anastomosis-for-treatment-of-secondary-lymphedema-of-the-lower-limbs-a-report-of-49-cases
#5
K Chang, S Xia, Y G Sun, J F Xin, W B Shen
Objective: To study the clinical effects of liposuction combined with lymphatico-venous anastomosis for treatment of secondary lymphedema of the lower limbs. Methods: A retrospective analysis was performed for 49 patients who had undergone liposuction combined with lymphatico-venous anastomosis to treat secondary lymphedema of the lower limbs at Department of Lymph Surgery, Beijing Shijitan Hospital from November 2013 to February 2015.All patients were female aging from 31 to 70 years with median age of (52±10)years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28347618/implementation-of-hysterectomy-pathway-impact-on-complications
#6
Faina Linkov, Amin Sanei-Moghaddam, Robert P Edwards, Paula J Lounder, Naveed Ismail, Sharon L Goughnour, Chaeryon Kang, Suketu M Mansuria, John T Comerci
OBJECTIVE: Hysterectomy is one of the most common surgical procedures in the United States. For women who need hysterectomy, it is important to ensure that minimally invasive hysterectomy procedures are used appropriately to reduce surgical complications and improve value of care. Although we previously demonstrated a reduction in total abdominal hysterectomy rates after the implementation of hysterectomy pathway treatment algorithm in 2012, this study focuses on exploring the effect of pathways implementation on surgical outcomes...
March 24, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28290977/actinomyces-related-tubo-ovarian-abscess-in-a-poorly-controlled-type-ii-diabetic-with-a-copper-intrauterine-device
#7
Ashley L Sawtelle, Nicole P Chappell, Caela R Miller
BACKGROUND: The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. CASE: A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28264580/-ethical-aspects-of-uterus-transplantation
#8
Roman Chmel, Marta Nováčková, Zlatko Pastor, Jan Matěcha, Miloš Čekal, Jiří Froněk
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#9
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
#10
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/28250728/case-report-of-ovarian-torsion-mimicking-ovarian-cancer-as-an-uncommon-late-complication-of-laparoscopic-supracervical-hysterectomy
#11
Michał Ciebiera, Arkadiusz Baran, Aneta Słabuszewska-Jóźwiak, Grzegorz Jakiel
Laparoscopic supracervical hysterectomy (LSH) is an example of a partial hysterectomy, performed due to benign gynaecological complaints. Better endoscopic instruments and operational techniques have led to a great reduction in the number of abdominal hysterectomies. It is believed that LSH is a safe and minimally invasive hysterectomy technique. The Cochrane Database meta-analysis proves the benefits of minimally invasive surgery compared with abdominal gynaecological surgery, including decreased pain, surgical-site infections and hospital stay, quicker return to activity, and fewer postoperative adhesions...
December 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and%C3%A2-prevention
#12
REVIEW
Holly L Steiner, Eric A Strand
Surgical-site infections (SSIs) represent a well-known cause of patient morbidity as well as added health care costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28192735/risk-factors-for-postoperative-urinary-tract-infection-following-midurethral-sling-procedures
#13
Melike Doganay, Sabri Cavkaytar, Mahmut Kuntay Kokanali, Irfan Ozer, Orhan Seyfi Aksakal, Salim Erkaya
OBJECTIVE: To identify the potential risk factors for urinary tract infections following midurethral sling procedures. STUDY DESIGN: 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28182855/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#14
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effot to reduce the incidence of surgical site infection...
February 6, 2017: AANA Journal
https://www.readbyqxmd.com/read/28182668/cross-sectional-study-of-mode-of-delivery-and-maternal-and-perinatal-outcomes-in-mainland-china
#15
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/28174186/avoiding-misdiagnosis-cystic-calcified-brain-metastases-of-uterine-cervical-cancer-mimicking-neurocysticercosis
#16
Jacopo Fantini, Arianna Sartori, Paolo Manganotti
The radiological finding of multiple calcified brain lesions is atypical for brain metastases and in absence of a clear evidence of disseminated neoplastic disease the differential diagnosis may be difficult. Calcified brain metastases (CBM) are rarely encountered in clinical practice and they mostly arise from lung, breast and gastrointestinal primitive tumours. Only one case of uterine cervical carcinoma (UCC) with CBM has been reported so far. We describe the case of a 41-year-old Caucasian woman with a history of hysterectomy and bilateral salpingo-oophorectomy for UCC 3 years prior to observation and no evidence of neoplastic recurrence that developed cystic CBM...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28169182/reproductive-disorders-of-marsupials
#17
REVIEW
Cathy A Johnson-Delaney, Angela M Lennox
Marsupial reproduction differs significantly in anatomy and physiology from that of placental mammals. The gastrointestinal and urogenital tracts empty into a cloaca. Reproductive parameters include gestation and pouch time, as the fetus develops outside of the uterus. Captive marsupials discussed include sugar gliders), short-tailed opossums, Virginia opossums, and Tammar and Bennett's wallabies. Common disease conditions include joey eviction, pouch infections, mastitis, metritis, prostatitis, penile necrosis, and neoplasia...
February 4, 2017: Veterinary Clinics of North America. Exotic Animal Practice
https://www.readbyqxmd.com/read/28110586/prediction-of-maternal-near-miss-in-placenta-previa-a-retrospective-analysis-from-a-tertiary-center-in-ankara-turkey
#18
Bora Coskun, Iltac Akkurt, Rıza Dur, Mehmet O Akkurt, Seval Y Ergani, Ozerk T Turan, Bugra Coskun
AIM: To determine risk factors for severe complications during and after cesarean delivery (CD) in placenta previa (PP). METHODS: We reviewed retrospectively collected data from women with PP who underwent CD during a 6-year study period. We identified the complicated group based on the modified WHO near-miss criteria. Complicated and noncomplicated groups were compared considering clinical, laboratory, and sonographic features. RESULTS: Thirty-seven of 256 cases classified as near miss consisting of 14 peripartum hysterectomies, 12 uterine balloon placements, 10 great artery ligations, and four B-lynch suture placement procedures without maternal mortality...
February 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28004013/aberrant-expression-of-interleukin-6-and-its-receptor-in-fallopian-tubes-bearing-an-ectopic-pregnancy-with-and-without-tubal-cytomegalovirus-infection
#19
Ahmed Mohamed Ashshi
Cytomegalovirus (CMV) has recently been suggested as a potential risk factor for the development of ectopic pregnancy (EP) following upper genital tract infection in women. However, little is known about its associated underlying pathogenic mechanisms. This was a prospective case-control study that measured the prevalence of CMV infection in Fallopian tubes (FT) bearing an EP and its effects on the tubal expression of interleukin (IL)-6 and its signaling molecules, which are known to play significant roles in the immune response against CMV infection as well as embryo implantation...
December 2016: Virusdisease
https://www.readbyqxmd.com/read/28002311/committee-opinion-no-685-care-for-transgender-adolescents
#20
(no author information available yet)
Gender nonconforming youth are an underserved population who obstetrician-gynecologists are seeing increasingly in their practices. Currently, there are large gaps in training, knowledge, and comfort with transgender patients among obstetrician-gynecologists. The purpose of this document is to review current recommendations that apply to an obstetrician-gynecologist. It is important for obstetrician-gynecologists to be aware of the social and mental health risks for the transgender population. Consensus guidelines support initiating medical therapy after an adolescent has an established diagnosis of transgender identity and has reached Tanner stage II development...
January 2017: Obstetrics and Gynecology
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