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https://www.readbyqxmd.com/read/29326183/transvaginal-natural-orifice-transluminal-endoscopic-surgery-vnotes-adnexectomy-for-benign-pathology-compared-with-laparoscopic-excision-notable-a-protocol-for-a-randomised-controlled-trial
#1
Jan Filip Baekelandt, Peter A De Mulder, Ilse Le Roy, Chantal Mathieu, Annouschka Laenen, Paul Enzlin, Steven Weyers, Ben W J Mol, Jan J A Bosteels
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) versus laparoscopy for hysterectomy (HALON). We simultaneously designed a similar randomised controlled trial (RCT) comparing vNOTES with laparoscopy for adnexectomy...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29317890/enterobius-vermicularis-in-the-endometrium-of-the-uterus-a-case-report
#2
Biserka Pigac, Silvija Mašić, Valentina Mašić
Enterobius vermicularis is an intestinal nematode of humans and the most common helminth infection. Main transmission path is direct contact between infected and uninfected person meaning ingestion of the eggs. Human infections are usually asymptomatic or manifest as perianal itching. Although ectopic locations are uncommon, Enterobius can occasionally be detected in appendix, kidney, male urinary tract and female genital tract. We present a case from Varaždin General Hospital, Varaždin, Croatia in 2012, involving a 90-yr-old female patient who underwent hysterectomy leading to accidental finding of E...
October 2017: Iranian Journal of Parasitology
https://www.readbyqxmd.com/read/29207786/recurrent-vaginal-cuff-dehiscence-in-a-treated-case-of-carcinoma-cervix
#3
Sunesh Kumar, Seema Singhal, Yamini Kansal, Dayanand Sharma
Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29195912/procedure-specific-trends-in-surgical-outcomes
#4
Jason B Liu, Julia R Berian, Yaoming Liu, Mark E Cohen, Clifford Y Ko, Bruce L Hall
BACKGROUND: Quality improvement efforts have generally focused on hospital benchmarking, and processes and outcomes shared among all operations. However, quality improvement could be inconsistent across different types of operations. The objective of this study was to identify operations needing additional concerted quality improvement efforts by examining their outcomes trends. STUDY DESIGN: Ten procedures (colectomy, esophagectomy, hepatectomy, hysterectomy, pancreatectomy, proctectomy, total hip arthroplasty, total knee arthroplasty, thyroidectomy, and ventral hernia repair) commonly accrued into the American College of Surgeons NSQIP between 2008 and 2015 were included...
November 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29185259/role-of-lymphadenectomy-in-intermediate-risk-endometrial-cancer-a-matched-pair-study
#5
Pluvio J Coronado, Agnieszka Rychlik, Maria A Martínez-Maestre, Laura Baquedano, María Fasero, Aida García-Arreza, Sara Morales, Daniel M Lubian, Ignacio Zapardiel
OBJECTIVE: To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC). METHODS: A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1-2; or cervical involvement and grades 1-2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach...
January 2018: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/29170793/clinical-predictors-and-risk-factors-for-vaginal-mesh-extrusion
#6
Usah Khrucharoen, Patkawat Ramart, Judy Choi, Diana Kang, Ja-Hong Kim, Shlomo Raz
PURPOSES: Our study aims to enhance the accuracy of the clinical diagnosis in patients with vaginal mesh extrusion following transvaginal mesh placement for pelvic organ prolapse using significant clinical parameters and risk factors. METHODS: All patients who underwent vaginal mesh removal were retrospectively reviewed from January 2000 to May 2014. Eligible patients were divided into two groups according to the presence of vaginal mesh extrusion. RESULTS: A total of 862 patients, 798 were included...
November 24, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29162766/production-and-rearing-of-germ-free-x-scid-pigs
#7
Hiromasa Hara, Hiroaki Shibata, Kazuaki Nakano, Tomoyuki Abe, Hideki Uosaki, Takahiro Ohnuki, Shuji Hishikawa, Satoshi Kunita, Masahito Watanabe, Osamu Nureki, Hiroshi Nagashima, Yutaka Hanazono
Pigs with X-linked severe combined immunodeficiency (X-SCID) caused by a mutation of the interleukin-2 receptor gamma chain gene (IL2RG) are of value for a wide range of studies. However, they do not survive longer than 8 weeks because of their susceptibility to infections. To allow longer survival of X-SCID pigs, the animals must be born and reared under germ-free conditions. Here, we established an efficient system for piglet derivation by hysterectomy and used it to obtain and maintain a germ-free X-SCID pig...
November 21, 2017: Experimental Animals
https://www.readbyqxmd.com/read/29159943/retrospective-multicenter-study-of-leaving-the-placenta-in-situ-for-patients-with-placenta-previa-on-a-cesarean-scar
#8
Kei Miyakoshi, Toshimitsu Otani, Eiji Kondoh, Shintaro Makino, Mamoru Tanaka, Satoru Takeda
OBJECTIVE: To investigate maternal outcomes after leaving the placenta in situ for placenta accreta spectrum (PAS) disorders in patients with placenta previa on a cesarean delivery scar. METHODS: The present retrospective study reviewed medical records from women with placenta previa on a cesarean scar underwent perinatal care at secondary- or tertiary-level perinatal centers in Japan between January 1, 2010, and December 31, 2014. Perinatal management was conducted based on each leading obstetrician's discretion...
November 21, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29112658/adding-azithromycin-to-cephalosporin-for-cesarean-delivery-infection-prophylaxis-a-cost-effectiveness-analysis
#9
Ashley E Skeith, Brenda Niu, Amy M Valent, Methodius G Tuuli, Aaron B Caughey
OBJECTIVE: To investigate the cost-effectiveness of adding azithromycin to standard cephalosporin regimens of cesarean delivery prophylaxis by considering the maternal outcomes in the current and potential subsequent pregnancies. METHODS: A cost-effectiveness model was created using TreeAge to compare the outcomes of using azithromycin-cephalosporin with cephalosporin alone in a theoretical cohort of 700,000 women, the approximate number of nonelective cesarean deliveries annually in the United States that occur during labor or after membrane rupture...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29109629/peripartum-hysterectomy-in-a-tertiary-care-hospital-epidemiology-and-outcomes
#10
Bharti Sharma, Pooja Sikka, Vanita Jain, Kajal Jain, Rashmi Bagga, Vanita Suri
Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies. Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29096564/management-of-peripartum-hysterectomies-performed-on-patients-with-placenta-percreta-in-a-tertiary-central-hospital
#11
Sibel Sak, Mert Barut, Adnan Incebiyik, Hacer Uyanikoglu, Nese Hilali, Muhammet Sak
OBJECTIVE: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta. METHODS: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29081383/laparoscopic-single-incision-supracervical-hysterectomy-for-extremely-large-uterus-with-bag-tissue-extraction
#12
Xiaoming Guan, Juan Liu, Yanzhou Wang, Jordan Gisseman, Zhenkun Guan, Christopher Kleithermes
OBJECTIVE: To describe the single incision laparoscopic technique with an articulated energy device for uterus larger than 20 cm. DESIGN: Stepwise demonstration of the single site surgical technique and Tissue extraction with narrated video footage (Canadian Task Force classification III). BACKGROUND: Single-incision laparoscopic hysterectomy can be difficult because of longer surgery time, steep learning curve, and the need for articulated instruments, but is especially challenging in patients with a uterus larger than 20 cm...
October 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29055174/maternal-outcomes-in-first-and-second-trimester-termination-of-pregnancy-which-are-the-risk-factors
#13
Giulia Garofalo, Anna Garofalo, Olga Sochirca, Maria Grazia Alemanno, Eleonora Pilloni, Marilisa Biolcati, Elisabetta Muccinelli, Elsa Viora, Tullia Todros
AIMS: To evaluate maternal complications of first trimester and second trimester termination of pregnancy (TOP) performed after first or second trimester positive prenatal diagnosis (PD). RESULTS: We performed a retrospective study from January 2007 to December 2011, on 844 patients, who underwent a TOP after positive amniocentesis or chorionic villus sampling (CVS) for foetal aneuploidies, performed for maternal age ≥35 years of age, positive prenatal screening (PS) or for genetic reasons...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29052067/concomitant-open-ventral-hernia-repair-what-is-the-financial-impact-of-performing-open-ventral-hernia-with-other-abdominal-procedures-concomitantly
#14
Vashisht Madabhushi, Margaret A Plymale, John Scott Roth, Sara Johnson, Alex Wade, Daniel L Davenport
BACKGROUND: Open ventral hernia repair (VHR) is often performed in conjunction with other abdominal procedures. Clinical outcomes and financial implications of VHR are becoming better understood; however, financial implications of concomitant VHR during other abdominal procedures are unknown. This study aimed to evaluate the financial implications of adding VHR to open abdominal procedures. METHODS: This IRB-approved study retrospectively reviewed hospital costs to 180-day post-discharge of standalone VHRs, isolated open abdominal surgeries (bowel resection or stoma closure, removal of infected mesh, hysterectomy or oophorectomy, panniculectomy or abdominoplasty, open appendectomy or cholecystectomy), performed at our institution from October 1, 2011 to September 30, 2014...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29034307/uterine-clostridium-perfringens-infection-related-to-gynecologic-malignancy
#15
Kevin M Kremer, Megan E McDonald, Michael J Goodheart
Uterine gas gangrene caused by Clostridium perfringens is a serious, often life-threatening infection that is rarely encountered in the practice of gynecologic oncology. However, the hypoxic nature of gynecologic cancers due to necrosis and/or prior radiation therapy creates a microenvironment optimal for proliferation of anaerobic bacteria such as the Clostridium species. Early recognition and aggressive treatment with IV antibiotics and surgical debridement remain the cornerstones of management in order to decrease morbidity and mortality...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/29020828/timing-of-antibiotic-prophylaxis-in-cesarean-section-retrospective-difference-in-differences-estimation-of-the-effect-on-surgical-site-infection
#16
Assaf Ben Shoham, Maskit Bar-Meir, Alexander Ioscovich, Arnon Samueloff, Yonit Wiener-Well
BACKGROUND: Cesarean section (CS) is one of the most common surgical procedures performed worldwide. Surgical-site-infection (SSI) occurs in approximately 5-10% of CS. The benefit of prophylactic antibiotics for prevention of SSI has been demonstrated in the literature. The optimal timing of antibiotic prophylaxis (prior to surgical incision versus after cord clamping) was investigated in recent studies. In January 2014, the Israeli Ministry of Health introduced a national quality measure which monitors the administration of prophylactic antibiotics in CS...
October 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28975014/the-relative-burden-of-menopausal-and-postmenopausal-symptoms-versus-other-major-conditions-a-retrospective-analysis-of-the-medical-expenditure-panel-survey-data
#17
Annlouise R Assaf, Andrew G Bushmakin, Nina Joyce, Michael J Louie, Michael Flores, Margaret Moffatt
BACKGROUND: The direct costs associated with menopausal and postmenopausal symptoms (hereafter "menopausal symptoms") may include the costs of physician and emergency department visits, medications, laboratory testing, and the management of side effects. However, much remains unknown about the costs related to menopausal symptoms, including how they compare with the costs of other diseases that are common among menopausal women. OBJECTIVE: To compare the economic burden of menopausal symptoms with other select prevalent chronic conditions among a nationally representative sample of US menopausal women aged 45 to 65 years...
September 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28951655/impact-of-a-fellowship-trained-minimally-invasive-gynecologic-surgeon-on-patient-outcomes
#18
Nisse V Clark, Harneet S Gujral, Kelly N Wright
BACKGROUND AND OBJECTIVES: As the performance of minimally invasive hysterectomy has increased in the United States, the need to apply outcomes measures has also increased. This study was conducted to determine the impact of a fellowship-trained minimally invasive gynecologic surgery (MIGS) specialist on patient outcomes after laparoscopic hysterectomy (LH) in a gynecology department. METHODS: This is a retrospective review of 218 patients who underwent a laparoscopic hysterectomy for benign indications at a suburban academic-affiliated tertiary care hospital with a broad patient base from 2010 to 2014...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28932266/risk-factors-for-surgical-site-infections-in-obstetrics-a-retrospective-study-in-an-ethiopian-referral-hospital
#19
Teshager Mamo, Tilaye Workneh Abebe, Tesfaye Yitna Chichiabellu, Antehun Alemayehu Anjulo
BACKGROUND: Pregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients. METHOD: Facility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28914703/length-of-catheter-use-after-hysterectomy-as-a-risk-factor-for-urinary-tract-infection
#20
Natalie E Karp, Emily K Kobernik, Neil S Kamdar, Amanda M Fore, Daniel M Morgan
OBJECTIVES: The aims of this study were to determine the effect of length of postoperative catheterization on risk of urinary tract infection (UTI) and to identify risk factors for postoperative UTI. METHODS: This was a retrospective case-control study. Demographic and perioperative data, including duration of indwelling catheter use and postoperative occurrence of UTI within 30 days of surgery, were analyzed for hysterectomies using the Michigan Surgical Quality Collaborative database...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
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