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https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#1
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453211/fistulation-between-a-colonic-j-pouch-and-the-upper-vagina-in-an-irradiated-pelvis-a-rare-complication-following-low-anterior-resection-with-colonic-j-pouch-anal-anastomosis-for-rectal-cancer
#2
James Tankel, Shlomo Yellineck, Petachia Reissman
Formation of a colonic J-pouch with anastomosis to the rectal stump is an accepted form of reconstruction after low anterior resection (LAR) for rectal carcinoma. It is thought this can help prevent the onset of LAR syndrome as well as improve the quality of life in the first two years following surgery. Rectovaginal fistulation is a recognised complication of this form of surgery usually occurring because of technical failure leading to inclusion of the vaginal wall into the stapled anastomosis. We present an as of yet unreported case of fistulation between the upper horizontal staple line of a colonic J-pouch-the tip of the 'J'-which was formed extracorporeally with the posterior vaginal fornix...
February 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29449196/clinical-predictors-of-successful-vaginal-myomectomy-for-prolapsed-pedunculated-uterine-leiomyoma
#3
Serdar Aydın, Hale Göksever Çelik, Mustafa Maraşlı, Rabia Zehra Bakar
OBJECTIVE: Uterine leiomyomas are the most common pelvic tumor in women. The calculated prevalence of prolapsed pedunculated leiomyoma was 2.5% in patients who underwent surgery. Although vaginal removal is safe and effective, hysterectomy demand is questionable. We aimed to analyze the association between patient characteristics, clinical features of prolapsed pedunculated submucosal leiomyoma and the probability of successful vaginal myomectomy. MATERIALS AND METHODS: This study was conducted in 35 women who presented with prolapsed pedunculated uterine leiomyoma...
February 1, 2018: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/29443815/teaching-vaginal-hysterectomy-via-simulation-creation-and-validation-of-the-objective-skills-assessment-tool-for-simulated-vaginal-hysterectomy-on-a-task-trainer-and-performance-among-different-levels-of-trainees
#4
D R Malacarne, C M Escobar, C J Lam, K L Ferrante, D Szyld, Veronica T Lerner
OBJECTIVES: The use of simulation-based education to train surgeons is widely accepted. Although many authors describe the use of an Objective Skills Assessment Test (OSAT) to assess performance of various surgical procedures, there is a paucity of research on use of this modality to evaluate vaginal surgery skills. We created a vaginal hysterectomy procedure-specific checklist (PSC) to complete the OSAT (which is composed of a PSC and a global rating scale [GRS]). The primary objective of this study is to evaluate the performance of a novel evaluation strategy for vaginal hysterectomy using an OSAT combining PSC and GRS...
February 13, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29436798/a-road-to-the-heart-from-uterine-closet-a-case-report
#5
Aghygh Heidari, Samsam Dabiri, Feridoun Sabzi
Angiosarcomas of the uterine is a malignant and poor prognostic tumor and can either be a primary sarcoma or arising secondary to radiotherapy of a more complex tumor. Primary uterine angiosarcomas are exceptional and probably arise from embryonic vascular remnants, teratoma or from the rich uterine vasculature. We reported a rare case of primary angiosarcoma of uterine that at the time of diagnosis presented with sign and symptom of local and distant metastasis. The patient presented with dyspnea, chest pain, and history of vaginal bleeding and pelvic pain...
January 2018: Acta Medica Iranica
https://www.readbyqxmd.com/read/29433404/the-characteristics-of-hypoactive-sexual-desire-disorder-in-korean-women-who-visited-a-community-based-gynaecology-hospital-for-sexual-dysfunction
#6
Ho Ju Yun, Hyun Hee Cho
This cross-sectional study analysed the characteristics of HSDD (hypoactive sexual desire disorder) in Korean women. Two hundred and seventeen women seen for sexual dysfunction were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised (DMS IV-TR) and the Female Sexual Function Index (FSFI). A diagnosis of HSDD was more common in women in their 40 s (56%), who had previously undergone surgery for a feeling of 'wide vagina'. Both too much or too little sexual activity caused HSDD...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29432905/transvaginal-single-port-laparoscopy-pelvic-reconstruction-with-y-shaped-mesh
#7
Yisong Chen, Junwei Li, Keqin Hua
STUDY OBJECTIVE: To describe new technique of pelvic reconstruction with Y-shaped mesh assisted by transvaginal single-port laparoscopy for multiple compartments Pelvic Organ Prolapse (POP). DESIGN: Step-by-step explanation of the procedure using video. SETTING: It is more and more prudent for pelvic floor reconstruction with mesh because of mesh related complications. Learning from sacrocolpopexy with lower rate of mesh erosion (3.5%), new method of pelvic reconstruction with natural orifice transluminal endoscopic surgery is feasible...
February 9, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29432076/neoadjuvant-chemotherapy-followed-by-radical-surgery-versus-concomitant-chemotherapy-and-radiotherapy-in-patients-with-stage-ib2-iia-or-iib-squamous-cervical-cancer-a-randomized-controlled-trial
#8
Sudeep Gupta, Amita Maheshwari, Pallavi Parab, Umesh Mahantshetty, Rohini Hawaldar, Supriya Sastri Chopra, Rajendra Kerkar, Reena Engineer, Hemant Tongaonkar, Jaya Ghosh, Seema Gulia, Neha Kumar, T Surappa Shylasree, Renuka Gawade, Yogesh Kembhavi, Madhuri Gaikar, Santosh Menon, Meenakshi Thakur, Shyam Shrivastava, Rajendra Badwe
Purpose We compared the efficacy and toxicity of neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin-based chemoradiation in patients with locally advanced squamous cervical cancer. Patients and Methods This was a single-center, phase III, randomized controlled trial ( ClinicalTrials.gov identifier: NCT00193739). Eligible patients were between 18 and 65 years old and had stage IB2, IIA, or IIB squamous cervical cancer. They were randomly assigned, after stratification by stage, to receive either three cycles of neoadjuvant chemotherapy using paclitaxel and carboplatin once every 3 weeks followed by radical hysterectomy or standard radiotherapy with concomitant cisplatin once every week for 5 weeks...
February 12, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29427320/demographic-features-of-female-urethra-length
#9
Andrzej Pomian, Wojciech Majkusiak, Jacek Kociszewski, Paweł Tomasik, Edyta Horosz, Aneta Zwierzchowska, Wojciech Lisik, Ewa Barcz
AIMS: To determine cohort urethral length, identify epidemiological factors influencing the parameter and to establish the percentage of cases with clinically relevant outsized urethras. METHODS: Prospective cohort study conducted in two tertiary clinical centers between 2013 and 2017. Nine hundred and twenty seven consecutive adult, Caucasian females attending outpatients' clinics were included. The urethral length has been measured in pelvic floor ultrasound examination...
February 10, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29425837/robotic-assisted-sacrocolpopexy-early-postoperative-outcomes-after-surgical-reduction-of-enlarged-genital-hiatus
#10
Megan S Bradley, Amy L Askew, Monique H Vaughan, Amie Kawasaki, Anthony G Visco
BACKGROUND: Currently, the decision to perform a concurrent posterior repair/perineoplasty at the time of robotic-assisted sacrocolpopexy is not standardized. OBJECTIVE: To compare anatomic failure after robotic-assisted sacrocolpopexy among three groups of patients categorized by their pre- and post-operative genital hiatus size. STUDY DESIGN: We performed a retrospective cohort study of women who underwent robotic-assisted sacrocolpopexy, from 1/2013 to 9/2016...
February 6, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29422425/utility-of-clinical-parameters-and-multiparametric-mri-as-predictive-factors-for-differentiating-uterine-sarcoma-from-atypical-leiomyoma
#11
Qiu Bi, Zhibo Xiao, Fajin Lv, Yao Liu, Chunxia Zou, Yiqing Shen
OBJECTIVES: The objective of this study was to find clinical parameters and qualitative and quantitative magnetic resonance imaging (MRI) features for differentiating uterine sarcoma from atypical leiomyoma (ALM) preoperatively and to calculate predictive values for uterine sarcoma. MATERIALS AND METHODS: Data from 60 patients with uterine sarcoma and 88 patients with ALM confirmed by surgery and pathology were collected. Clinical parameters, qualitative MRI features, diffusion-weighted imaging with apparent diffusion coefficient values, and quantitative parameters of dynamic contrast-enhanced MRI of these two tumor types were compared...
February 5, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29417285/surgical-laparoscopic-treatment-of-bowel-endometriosis-with-transvaginal-resection-of-the-rectum-using-ultrasonically-activated-shears-a-retrospective-cohort-study-with-description-of-technique
#12
F Rampinelli, P Donarini, C Visenzi, S Ficarelli, G Ciravolo
BACKGROUND: To asses the results of laparoscopic surgical treatment of bowel endometriosis with transvaginal resection of the rectum employing ultrasonic energy retrospective study. METHOD: 100 patients with symptoms of narrowing or partial obstruction of colon were submitted to laparoscopic resection of rectosigmoid tract through a vaginal route. Length of surgery, blood loss, histopathological extent of rectal invasion, surgical complications, and length of hospital stay were the main analyzed outcomes...
February 7, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29414828/endoscopy-and-laparoscopy-in-disorders-of-sex-development
#13
Kianusch Tafazzoli, Lutz Wünsch, Marie Bouteleux, Judith Lindert, Tim Schulz, Wiebke Birnbaum, Louise Marshall, Olaf Hiort, Ludger Tüshaus
Endoscopy and laparoscopy are used for the assessment of disorders of sex development (DSD) and therapeutic interventions. Endoscopy (urethra-cystoscopy, vaginoscopy) is especially useful when vaginal or urethral surgery is planned. It is also valuable for the assessment of complications. Laparoscopy is used to identify sex ducts and gonads and to perform minimally invasive abdominal and pelvic surgery. This article reviews clinical indications, limitations, findings, and their reporting. It further discusses the impact of these findings on care in typical clinical situations...
February 8, 2018: Sexual Development: Genetics, Molecular Biology, Evolution, Endocrinology, Embryology, and Pathology of Sex Determination and Differentiation
https://www.readbyqxmd.com/read/29411339/evaluation-of-complications-developing-during-and-after-transvaginal-ultrasound-guided-oocyte-retrieval
#14
Selin Özaltın, Serkan Kumbasar, Kadir Savan
OBJECTIVES: To investigate the complications of the oocyte retrieval procedure currently used in in vitro fertilisation. MATERIAL AND METHODS: We examined 1.031 patients who underwent oocyte retrieval in the IVF unit of our hospital for complications developed during and after the procedure. RESULTS: No complications developed related to sedation or general anaesthesia. Vaginal bleeding was observed in 3.1% of the patients. There was no intra-abdominal bleeding or pelvic organ injuries requiring surgery...
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29410143/transvaginal-notes-myomectomy-a-novel-route-for-uterine-fibroid-removal
#15
Juan Liu, Qiongyan Lin, Kelly Blazek, Binhua Liang, Xiaoming Guan
BACKGROUND: Transvaginal surgery is the most minimally invasive surgery for a gynecologic procedure, but it has the limitation of lack of exposure and limited surgical space when utilizing traditional vaginal surgical instrumentation, such as in a hysterectomy for a uterus without descent or for a myomectomy. Transvaginal Nature Orifice Translumenal Endoscopic Surgery (NOTES) offers the similar benefits of traditional vaginal surgery, but also expands the horizon of transvaginal surgery by allowing the surgeon to perform procedures that are typically limited to an abdominal approach...
February 1, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29410107/laparoscopic-vs-transvaginal-cuff-closure-after-total-laparoscopic-hysterectomy-a-randomized-trial-by-the-italian-society-of-gynecologic-endoscopy
#16
Stefano Uccella, Mario Malzoni, Antonella Cromi, Renato Seracchioli, Giuseppe Ciravolo, Francesco Fanfani, Fevzi Shakir, Salvatore Gueli Alletti, Francesco Legge, Roberto Berretta, Giacomo Corrado, Lucia Casarella, Paolo Donarini, Margherita Zanello, Emanuele Perrone, Baldo Gisone, Enrico Vizza, Giovanni Scambia, Fabio Ghezzi
BACKGROUND: Vaginal cuff dehiscence following hysterectomy is considered an infrequent but potentially devastating complication. Different possible techniques for cuff closure have been proposed to reduce this threatening adverse event. OBJECTIVE: Aim of the present randomized study has been to compare laparoscopic and transvaginal suture of the vaginal vault at the end of a total laparoscopic hysterectomy (TLH), in terms of incidence of vaginal dehiscence and vaginal cuff complications...
January 31, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29408741/a-swedish-population-based-evaluation-of-benign-hysterectomy-comparing-minimally-invasive-and-abdominal-surgery
#17
Nina K Billfeldt, Christer Borgfeldt, Håkan Lindkvist, Jan-Henrik Stjerndahl, Maud Ankardal
OBJECTIVE: The aim was to evaluate surgical routes for benign hysterectomy in a Swedish population, including abdominal and minimally invasive surgery. STUDY DESIGN: Prospectively collected data from the Swedish National GynOp Registry 2009-2015: 13 806 hysterectomy cases were included: abdominal (AH, n = 7485), vaginal (VH, n = 3767), conventional laparoscopic (LH, n = 1539) and robotically-assisted (RAH, n = 1015). RESULTS: The VH group had the shortest operation time at 75 min, AH 97 min and RAH 104 min...
February 3, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29406579/intraoperative-interventions-for-preventing-surgical-site-infection-an-overview-of-cochrane-reviews
#18
REVIEW
Zhenmi Liu, Jo C Dumville, Gill Norman, Maggie J Westby, Jane Blazeby, Emma McFarlane, Nicky J Welton, Louise O'Connor, Julie Cawthorne, Ryan P George, Emma J Crosbie, Amber D Rithalia, Hung-Yuan Cheng
BACKGROUND: Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro-organisms into incisions; and optimising the patient's own bodily functions to promote best recovery...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29402122/detailed-analysis-of-research-and-practice-in-the-life-of-a-pediatric-surgeon-in-east-central-europe-in-the-20th-century-an-example-of-prof-zofia-umiastowska-sawicka
#19
REVIEW
Przemyslaw Wolak, Andrzej Wincewicz, Anna Porębska, Stanislaw Sulkowski, Agnieszka Wincewicz-Price, Jonathan Price
Professor Zofia Umiastowska Sawicka laid the foundations for modern pediatric surgery in Poland, first in Bialystok, and subsequently in Kielce. She was a student of Prof. Jan Kossakowski from Warsaw Medical University to be counted among his most talented and skilled disciples. Professor Umiastowska became the head of the first Department of Pediatric Surgery in Bialystok, which was later incorporated into the Medical Academy of Bialystok. In 1977 she moved to Kielce to run the Department of Pediatric Surgery until her retirement in 1991...
December 2017: Acta Medico-historica Adriatica: AMHA
https://www.readbyqxmd.com/read/29398588/preliminary-report-surgical-outcomes-following-genitoplasty-in-children-with-moderate-to-severe-genital-atypia
#20
K J Bernabé, N J Nokoff, D Galan, D Felsen, C E Aston, P Austin, L Baskin, Y-M Chan, E Y Cheng, D A Diamond, R Ellens, A Fried, S Greenfield, T Kolon, B Kropp, Y Lakshmanan, S Meyer, T Meyer, A M Delozier, L L Mullins, B Palmer, A Paradis, P Reddy, K J Scott Reyes, M Schulte, J M Swartz, E Yerkes, C Wolfe-Christensen, A B Wisniewski, D P Poppas
INTRODUCTION: Prior studies of outcomes following genitoplasty have reported high rates of surgical complications among children with atypical genitalia. Few studies have prospectively assessed outcomes after contemporary surgical approaches. OBJECTIVE: The current study reported the occurrence of early postoperative complications and of cosmetic outcomes (as rated by surgeons and parents) at 12 months following contemporary genitoplasty procedures in children born with atypical genitalia...
February 1, 2018: Journal of Pediatric Urology
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