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https://www.readbyqxmd.com/read/27926638/determining-optimal-route-of-hysterectomy-for-benign-indications-clinical-decision-tree-algorithm
#1
Jennifer J Schmitt, Daniel A Carranza Leon, John A Occhino, Amy L Weaver, Sean C Dowdy, Jamie N Bakkum-Gamez, Kalyan S Pasupathy, John B Gebhart
OBJECTIVE: To evaluate practice change after initiation of a robotic surgery program using a clinical algorithm to determine the optimal surgical approach to benign hysterectomy. METHODS: A retrospective postrobot cohort of benign hysterectomies (2009-2013) was identified and the expected surgical route was determined from an algorithm using vaginal access and uterine size as decision tree branches. We excluded the laparoscopic hysterectomy route. A prerobot cohort (2004-2005) was used to evaluate a practice change after the addition of robotic technology (2007)...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926634/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#2
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 effort to reduce the incidence of surgical site infection...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27923167/long-term-outcomes-for-different-vaginal-cuff-closure-techniques-in-robotic-assisted-laparoscopic-hysterectomy-a-randomized-controlled-trial
#3
Ziv Tsafrir, Matthew Palmer, Marisa Dahlman, A Karim Nawfal, Joelle Aoun, Andrew Taylor, Jay Fisher, Evan Theoharis, David Eisenstein
OBJECTIVE: This randomized controlled trial aimed to evaluate the outcomes of different vaginal cuff closure techniques in robotic-assisted total laparoscopic hysterectomy. STUDY DESIGN: Ninety women undergoing robotic-assisted total laparoscopic hysterectomy for benign disease were randomized to three vaginal cuff closure techniques: running 2.0 V-Lock™ (Arm 1), 0 Vicryl™ figure-of-eight (Arm 2), and running 0 Vicryl™ with Lapra-Ty(®) (Arm 3). Patients' records were reviewed for age, body mass index, smoking status and relevant co-morbidities...
November 16, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27918335/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#4
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 effort to reduce the incidence of surgical site infection...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27895842/postoperative-outcome-of-caesarean-sections-and-other-major-emergency-obstetric-surgery-by-clinical-officers-and-medical-officers-in-malawi
#5
Garvey Chilopora, Caetano Pereira, Francis Kamwendo, Agnes Chimbiri, Eddie Malunga, Staffan Bergström
BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27856389/mini-laparoscopy-of-removal-partial-adnexae-at-the-time-of-hysterectomy
#6
António Gutierrez Setúbal, João Sequeira Alves, Olga Lavado, Joana Faria
STUDY OBJECTIVE: To describe our technique of mini laparoscopic adnexectomy or salpingectomy at the time of total laparoscopic hysterectomy DESIGN: Step-by-step video explanation of our technique SETTING: The advantages of laparoscopic surgery have been widely recognised in the past two decades: improved vision, exposure, reduction in operative trauma because of smaller incisions and more gentle tissue´s handling, that result in a faster postoperative recovery. The technology development has allowed the use of smaller caliber instruments while maintaining the high standard surgical performance...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27848904/-a-postpartum-woman-with-toxic-shock-syndrome-group-a-streptococcal-infection-a-much-feared-postpartum-complication
#7
K Abbink, J C Kortekaas, M P Buise, J Dokter, S M I Kuppens, T H M Hasaart
BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical pelvic pain which was the first symptom of toxic shock syndrome as a consequence of a GAS infection. Clinical deterioration necessitated a hysterectomy. Also a fasciotomy was performed as consequence of lower extremity compartment syndrome...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27836494/associations-between-vaginal-infections-and-potential-high-risk-and-high-risk-human-papillomavirus-genotypes-in-female-sex-workers-in-western-kenya
#8
Sonia Menon, Davy Vanden Broeck, Rodolfo Rossi, Emiliono Ogbe, Stacy Harmon, Hillary Mabeya
PURPOSE: Infection with and persistence of high-risk human papillomavirus (HR HPV) are the strongest risk factors for cervical cancer. Little is known about the prevalence and role of concurrent sexually transmitted infections (STIs) found in HPV-infected female sex workers (FSW) in Africa. This study purports to test our a priori hypotheses that STIs are associated with genotypes pertaining to the α-group species 9. The objectives were to determine the prevalence of bacterial vaginosis (BV), Trichomonas vaginalis, and Candida spp in FSW, the association between these STIs and the prevalence of any potential HR and HR HPV genotypes in FSWs...
November 8, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27833981/m%C3%A3-llerianosis-of-the-urinary-bladder-a-rare-case-report-and-review-of-the-literature
#9
Marius Stanimir, LuminiŢa Cristina ChiuŢu, Sébastien Wese, Amelia Milulescu, Răducu Nicolae Nemeş, Ovidiu Gabriel Bratu
The aim of this paper is to report a very rare case of müllerianosis (endosalpinx, endometrium, and endocervix) in a post-menopausal woman. Müllerianosis of the bladder is a very rare disease, which affects mainly the women of the reproductive age group, but with a good prognosis if the transitional bladder carcinoma is resolved. We present the case of a 64-year-old woman complaining of left lower abdomen pain, repeated lower and upper tract urinary infections, emergency urinary incontinence and hematuria...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27824755/risk-factors-and-outcomes-for-conversion-to-laparotomy-of-laparoscopic-hysterectomy-in-benign-gynecology
#10
Courtney S Lim, Erika L Mowers, Nichole Mahnert, Bethany D Skinner, Neil Kamdar, Daniel M Morgan, Sawsan As-Sanie
OBJECTIVE: To estimate the incidence and factors for conversion to laparotomy in women scheduled for laparoscopic hysterectomy for benign gynecologic indications and to examine the effect of conversion on patient outcomes. METHODS: A retrospective cohort study of a Michigan multicenter prospective database was abstracted from January 1, 2013, through July 2, 2014. Participants were collected from an all-payer quality and safety database maintained by the Michigan Surgical Quality Collaborative...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27810554/the-performance-and-safety-of-bilateral-salpingectomy-for-ovarian-cancer-prevention-in-the-united-states
#11
Gillian Elizabeth Hanley, Jessica Nell McAlpine, Celeste Leigh Pearce, Dianne Miller
BACKGROUND: Ovarian cancer is the leading cause of death due to gynecologic malignancy and the fifth most common cause of cancer deaths in developed countries. Recent evidence has indicated that the most common and lethal form of ovarian cancer originates in the distal fallopian tube, and recommendations for surgical removal of the fallopian tube (bilateral salpingectomy) at the time of other gynecologic surgeries (particularly hysterectomy and tubal sterilization) have been made, most recently by the American Congress of Obstetricians and Gynecologists...
November 1, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27794173/vesicovaginal-fistulas-in-the-developed-world-an-analysis-of-disease-characteristics-treatments-and-complications-of-surgical-repair-using-the-acs-nsqip-database
#12
Marissa C Theofanides, Wilson Sui, Elisabeth M Sebesta, Ifeanyi Onyeji, Justin T Matulay, Doreen E Chung
AIMS: To analyze patient characteristics, complications, and surgical trends in vesicovaginal fistulas (VVF) from a national database. METHODS: Current Procedural Terminology was used to identify patients undergoing VVF repair from the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database. Characteristics and treatments were identified. Logistic regression was used to identify characteristics associated with complications. RESULTS: From 2006 to 2013, 200 patients underwent VVF repair...
October 29, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27743480/conservative-management-of-abnormally-invasive-placenta-an-untold-factor-to-consider
#13
Shigeki Matsubara
Conservative management (leaving the placenta in situ) for abnormally invasive placenta (AIP: accreta, increta, percreta) has been repeatedly discussed in AOGS (1, 2). Delayed hemorrhage and infection are important adverse events. Especially, delayed hemorrhage required hysterectomy 3-9 months post-cesarean section in 22-58% of cases (1, 3), often performed as an emergency surgery (1, 3). Although delayed hysterectomy is not always associated with massive bleeding, a magnetic resonance imaging (MRI) showed marked gadolinium enhancement (marked blood flow) in the placental-bed-myometrium on post-cesarean day 34 (4), suggesting that hemorrhage may be serious during delayed hysterectomy at least up to one month post-cesarean...
October 14, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27723550/vaginal-cuff-closure-technique-and-the-risk-for-infected-pelvic-hematoma-after-vaginal-hysterectomy
#14
Ido Feferkorn, Meirav Schmidt, Yakir Segev, Ariel Zilberlicht, Ron Auslender, Yoram Abramov
OBJECTIVES: Infected pelvic hematoma is a relatively common complication of vaginal hysterectomy, manifesting with postoperative pain and fever which often necessitate surgical drainage. We aimed to assess the effect of the surgical technique for vaginal cuff closure on the incidence of this complication. STUDY DESIGN: Until March 31, 2010, our surgical protocol for vaginal hysterectomy included complete vaginal cuff closure. After this date, all surgeries were performed using another technique, by which a patent tract was left at the vaginal cuff for drainage of blood, secretions and debris...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27696346/the-effectiveness-of-the-levonorgestrel-intrauterine-system-in-obese-women-with-heavy-menstrual-bleeding
#15
Valentina Shaw, Alain C Vandal, Christin Coomarasamy, Alec J Ekeroma
INTRODUCTION: To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. METHODS: Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-IUS and had a body mass index (BMI) of >30 kg/m(2) were recruited between May and December 2014. The women completed two validated tools (Menstrual Impact Questionnaire and the Pictorial Bleeding Assessment Chart) at recruitment, 6 and 12 months follow-up...
December 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27682744/insurance-type-and-major-complications-after-hysterectomy
#16
Carolyn Weaver Swenson, Neil S Kamdar, Helen Levy, Darrell A Campbell, Daniel M Morgan
OBJECTIVES: The aim of this study was to investigate the relationship between primary insurance type and major complications after hysterectomy. METHODS: A retrospective analysis was performed on women with Medicaid, Medicare, and private insurance who underwent hysterectomy from January 1, 2012, to July 1, 2014, and were included in the Michigan Surgical Quality Collaborative. Major complications within 30 days of surgery included the following: deep/organ space surgical site infection, deep venous and pulmonary thromboembolism, myocardial infarction or stroke, pneumonia or sepsis, blood transfusion, readmission, and death...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27681810/thoracoabdominal-necrotising-soft-tissue-infection-secondary-to-enterocutaneous-fistulae-a-case-report
#17
R L Lassiter, E L Simmerman, J Sol Oh, C J Mentzer, N E Burkart, S B Holsten
OBJECTIVE: Necrotising soft tissue infection is a rare surgical emergency, which requires immediate and aggressive surgical debridement. Following control of the infection, patients are often left with large defects, with wound reconstruction and closure creating significant challenges. Here we describe a case of extensive thoracoabdominal necrotising soft tissue infection and provide a discussion on the standard of care and treatment based on a current literature review. METHOD: A 53-year-old female presented with bilious and feculent discharge from her surgical incision two weeks after a total abdominal hysterectomy...
October 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27679082/an-attempt-to-prevent-vaginal-stump-infection-after-total-laparoscopic-hysterectomy
#18
A Tani
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27678927/association-between-endometriosis-and-surgical-site-infection-in-women-undergoing-hysterectomy
#19
I Chen, R Mallick, S S Singh, L Hopkins, D Schramm
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27678910/surgical-site-infection-reduction-initiative-following-abdominal-hysterectomy
#20
M L Nimaroff, D Nahar, D Armellino, A Khameraj
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
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