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1.
Smith AL Krivak TC Scott EM Rauh-Hain JA Sukumvanich P Olawaiye AB Richard SD 《Gynecologic oncology》2012,126(3):432-436
Objective
Minimally invasive surgical techniques decrease surgical morbidity and recovery time. Studies demonstrate similar surgical outcomes comparing robotic to laparoscopic surgery. These studies have not accounted for the incorporation of fellow education. With the dual-console da Vinci Si Surgical System®, a two surgeon approach could be performed. We sought to compare surgical outcomes at a gynecologic oncology fellowship program of traditional laparoscopic to robotic surgeries using the dual-console system.Methods
We identified patients who underwent laparoscopic or robotic surgery performed by a gynecologic oncologist from November 2009-November 2010. Robotic surgeries were conducted using the dual-console, utilizing a two surgeon approach. Surgeries involved a staff physician with a gynecologic oncology fellow. Statistical analysis was performed using student t-test and chi-squared analysis.Results
A total of 222 cases were identified. Cases were analyzed in groups: all cases identified, all cancer cases, and endometrial cancer cases only. When analyzing all cases, no statistical difference was noted in total operating room time (172 vs. 175 min; p = 0.6), pelvic lymph nodes removed (10.1 vs. 9.6; p = 0.69), para-aortic lymph nodes dissected (3.7 vs. 3.8; p = 0.91), or length of stay (1.5 vs. 1.3 days; p = 0.3). There was a significant difference in total surgical time (131 vs.110 min; p < 0.0001) and EBL (157 vs.94 ml; p < 0.0001), favoring robotic surgery. When analyzing all cancer cases, the advantage in total surgical time for robotic surgery was lost. Complications were similar between cohorts.Conclusion
Incorporating fellow education into robotic surgery does not adversely affect outcomes when compared to traditional laparoscopic surgery. 相似文献2.
Objective
Exercise is potentially protective against cancer for obese women. The objectives were to examine differences in activity, body composition, and hormones in overweight/obese women with and without endometrial cancer.Methods
Women ≥ 50 years old with a body mass index (BMI) ≥ 25 kg/m2 scheduled for abdominal hysterectomy were enrolled. Demographics, physical activity, and quality of life (QOL) data were collected. Body composition/fitness was evaluated using Air Displacement Plethysmography (BodPod) and a standardized treadmill. Adiponectin, androstenedione, leptin, estradiol, estrone, progesterone, sex hormone binding globulin, insulin and glucose were measured.Results
Thirty-eight women enrolled in this pilot study; 22 had endometrial cancer. Mean age was 58.3 years, mean BMI, fat weight and percent body fat were 41.3 kg/m2, 55 kg and 51% respectively. Fitness levels were poor; 90% of women had peak oxygen uptakes below the 10th percentile of population normals yet 80% still rated their fitness level as equivalent to other women. Women with and without cancer did not differ in age, BMI, co-morbidities, energy expenditures, body composition, hormones or QOL although glucose levels were higher in women with cancer (119.5 vs. 90.7 mg/dl; p = 0.049). Cancer subjects scored worse on every fitness measurement, reaching statistical significance for VO2peak (15.0 vs. 17.9 ml/kg/min; p = 0.033). Current exercisers had a lower BMI (p = 0.039), decreased fat weight (p = 0.024), decreased waist circumference (p = 0.05) and improved vitality compared to non-exercisers.Conclusion
Physical fitness levels were abysmal in these morbidly obese subjects and worse for cancer patients. Exercise correlated with improved body composition and vitality. 相似文献3.
Lena Dain Ron Auslander Talma Rosen Yakir Segev Eyal Goldschmidt Yoram Abramov 《International journal of gynaecology and obstetrics》2010,111(2):119-121
Objective
To determine whether obstructive voiding symptoms in women with advanced pelvic organ prolapse (POP) were associated with objective bladder outflow tract obstruction.Methods
We reviewed preoperative data from patients with advanced POP who underwent surgical correction at the Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel, between December 1, 2005, and November 30, 2007. Obstructive voiding symptoms were recorded from Pelvic Floor Distress Inventory-20 questionnaires.Results
Of the 81 women aged 44-80 years who were included in the study, 40 (49.4%) reported incomplete bladder emptying preoperatively. There was no significant difference between these women and asymptomatic women in terms of demographic and clinical parameters such as age, parity, and stage of prolapse. Furthermore, there was no significant difference with regard to postvoid residual bladder volume (52.8 ± 65.8 vs 41.6 ± 41.2 mL), maximal (23.8 ± 11 vs 21.9 ± 9.6 mL/second) and average (10.3 ± 6.2 vs 9.3 ± 4 mL/second) urinary flow velocities, prevalence of increased postvoid residual volume (10.0% vs 4.8%), or obstructive urinary flow (17.5% vs 7.3%).Conclusion
Almost half of all women with advanced POP experienced incomplete bladder emptying; however, this symptom did not correlate with objective urodynamic bladder outflow tract obstruction. 相似文献4.
Poonam Phusaanantakul 《International journal of gynaecology and obstetrics》2010,110(2):145-148
Objective
To evaluate the efficacy of isosorbide mononitrate (IMN) for cervical ripening prior to first trimester surgical termination of pregnancy.Methods
A prospective, double-blind, randomized, placebo-controlled trial. Women scheduled for surgical termination of a nonviable fetus before 12 weeks of gestation from October 2008 to June 2009 were enrolled and randomly assigned to receive either 20 mg vaginally of IMN (n = 24) or a placebo (n = 24) 4 hours before suction evacuation. Cervical dilation before evacuation was assessed with 10-mm Hegar dilators followed by smaller sizes that were measured until the instrument passed freely through the internal os. Cervical dilation, adverse effects, termination complications, and patient satisfaction were the main outcomes.Results
Mean cervical dilation was not significantly different between the IMN and placebo groups (6.29 ± 0.99 mm vs 5.71 ± 1.04 mm; P = 0.05). Mean operative time did not differ between the groups (16 ± 0.07 min vs 18 ± 0.06 min; P = 0.55), nor did patient satisfaction measured by visual analogue scale (7.04 ± 1.68 vs 6.54 ± 1.22; P = 0.24).Conclusion
IMN was comparable to placebo in terms of efficacy and patient satisfaction for cervical priming prior to first-trimester termination of pregnancy. 相似文献5.
Kaiqing Lin 《International journal of gynaecology and obstetrics》2009,105(1):25-28
Objective
To evaluate reproductive outcomes in women with complete uterine septum with double cervix and vagina following resectoscope metroplasty.Methods
The pregnancy outcomes of 21 women who underwent vaginal and uterine septum resection were compared with those of 15 untreated women with similar clinical characteristics. The Fisher exact test and the Mann-Whitney test were used for statistical analysis.Results
Cycle fecundity was better (33.4% ± 28.5% vs 12.2% ± 4.7%; P = 0.046), the rate of term delivery significantly increased (P < 0.05), and the rate of spontaneous abortion decreased (P < 0.05) in the treatment group.Conclusion
Resectoscope metroplasty was found to improve the pregnancy outcomes of women having primary infertility or a history of pregnancy loss associated with a complete uterine septum with double cervix and vagina. 相似文献6.
Objective
To determine demographic and clinical conditions associated with sexual dysfunction among women of low-income status living in an urban setting.Methods
Cross-sectional study of 102 consecutive women attending an urban gynecology clinic. Women were given validated questionnaires to measure sexual function, depression, urinary incontinence, and erectile dysfunction in the partner. The association of sexual dysfunction with demographic variables, depression, urinary incontinence, and sexual function in the partner was assessed by the respondent.Results
The prevalence of sexual dysfunction was 37.3% (n = 38). Women with sexual dysfunction reported significantly lower scores on all subscales of sexual function compared with women without sexual dysfunction. Women with sexual dysfunction were more likely to be older (33 ± 11.2 vs 28.7 ± 8.6; P < 0.04), unemployed (68% vs 47%; P < 0.03), and report depression (OR 4.4; 95% CI, 1.7-11.3), urinary urge incontinence (OR 2.7; 95% CI, 1.2-7.3), and intake of multiple medications (OR 5.4; 95% CI, 1.6-20.1). On multivariate analysis, depression and urge urinary incontinence were independently associated with sexual dysfunction.Conclusion
Female sexual dysfunction is associated with the presence of depression and urge urinary incontinence in women of low-income status living in an urban setting. 相似文献7.
Adel Saad Helal El -Said Abdel-Hady Ehsan Refaie Maged El Shamy Raafat Abd El Fattah Abd El Magied Mashaly 《International journal of gynaecology and obstetrics》2010,108(3):233-235
Objective
To compare the effectiveness of preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during myomectomy.Methods
A total of 103 patients undergoing myomectomy were randomly allocated to undergo preliminary uterine artery ligation (52 patients) or pericervical tourniquet (51 patients). The primary outcome measure was estimated blood loss. Secondary outcomes included duration of the operation, duration of hospital stay, postoperative hemoglobin, and the need for postoperative analgesia.Results
Operative blood loss was significantly less with uterine artery ligation compared with tourniquet (433.80 ± 285.21 vs 823.23 ± 237.33 mL, P < 0.001). The mean duration of the operation was lower in the uterine artery ligation group compared with the tourniquet group (50.5 ± 8.7 vs 76.3 ± 9.4 minutes, P < 0.001). Postoperative hospital stay was significantly shorter in the uterine artery ligation group compared with the tourniquet group (4.1 ± 0.1 vs 5.1 ± 0.2 days; P < 0.001). Postoperative hemoglobin concentrations and the need for postoperative analgesia were higher in the uterine artery ligation group (P = 0.012 and P < 0.001, respectively).Conclusion
Uterine artery ligation was more effective than pericervical tourniquet as a preliminary step in reducing blood loss during abdominal myomectomy. 相似文献8.
Prolonged in utero meconium exposure impairs spatial learning in the adult rat : Central Prize Award
Sean C Blackwell Mordechai Hallak MD MPA John W Hotra BS Jerrie Refuerzo MD Robert J Sokol MD Yoram Sorokin MD 《American journal of obstetrics and gynecology》2004,190(6):1551-1555
Objective
The purpose of this study was to examine the effects of prolonged in utero meconium exposure on adult learning and memory, as measured by the Morris water maze.Study design
Timed pregnant Long-Evans rats were studied. On gestational day 20 (term, 21 days of gestation), laparotomy was performed, and each maternal animal received an injection of clear amniotic fluid or meconium-stained amniotic fluid into each gestational sac. The laparotomy incision was closed, and the animals received postoperative monitoring through delivery. On postnatal days 145 to 148, the offspring underwent Morris water maze testing. The mean (±SEM) for the latency time was reported for each day's trial and compared between groups.Results
There were significant differences between meconium-stained amniotic fluid group and clear amniotic fluid group in the mean time to platform on day 1 (82.7 ± 1.8 seconds vs 75.9 ± 3.0 seconds; P = .04), day 2 (60.5 ± 3.5 seconds vs 47. 8 ± 4.6 seconds; P = .03), and day 3 (56.5 ± 4.5 seconds vs 34.7 ± 4.4 seconds; P = .001). However, there were no differences on days 4 and 5. There were also no differences between recall and response learning trials that were done after a 12-day retention period.Conclusion
In the absence of hypoxia or infection, prolonged in utero meconium exposure is associated with a delay of spatial learning in the adult rat. 相似文献9.
De Bonis M Sabatini L Galeazzi LR Torricelli M Calzoni P Fineschi D Novembri R Severi FM Petraglia F 《European journal of obstetrics, gynecology, and reproductive biology》2012,160(2):142-146
Objectives
The clinical relevance of protein S deficiency in pregnant women remains controversial. Major debate exists regarding which parameter (total protein S antigen, free protein S antigen or functional protein S) should be evaluated in order to define protein S deficiency. The present study aimed to identify which of these parameters correlate with intrauterine growth restriction (IUGR).Study design
A retrospective case-control study of women with IUGR (n = 27) and healthy controls (n = 123) in the third trimester of pregnancy.Results
The maternal serum of women in the IUGR group had significantly lower levels of functional and free protein S compared with the control group: 54.07 ± 24.72% vs 65.20 ± 17.95% (p < 0.005) and 42.88 ± 11.01% vs 56.64 ± 13.30% (p < 0.0001), respectively. No significant correlation was found between total protein S and IUGR.Conclusions
Levels of functional and free protein S are correlated with IUGR. 相似文献10.
Objectives
The purpose of this study was to investigate the 3 years follow-up results regarding the recurrence pattern of robot-assisted laparoscopic radical hysterectomies and pelvic lymphadenectomies in the early stage cervical carcinoma patients and compare the results with both total laparoscopic radical hysterectomy and abdominal radical hysterectomy groups.Methods
A total of 68 patients underwent radical hysterectomy and pelvic lymphadenectomy for early stage cervical carcinoma management. All cases (35 robot-assisted, 7 cases laparoscopy and 26 with laparotomy) were operated by the same surgeon at the Norwegian Radium Hospital. All cases were retrospectively reviewed to compare demographics, peri-operative variables such as mean operative time, estimated blood loss, lymph node counts, complications and follow-up results.Results
The mean operating times (skin-to-skin) for patients undergoing robot-assisted laparoscopic radical hysterectomy (RALRH), total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH) were 263 ± 70, 364 ± 57 and 163 ± 26 min respectively. Patients receiving laparotomy had shortest operative time, followed by those undergoing RALRH and then laparoscopy (p < 0.0001 for both). Estimated blood loss was significantly reduced in robot-assisted surgeries compared to surgeries involving laparoscopy and laparotomy (82 ± 74 ml vs. 164 ± 131 ml (p < 0.0001) and 595 ± 284 ml (p = 0.023), respectively). The mean follow-up times were 36 ± 14.4, 56.4 ± 14 and 70 ± 21 months in patients who underwent RALRH, TLRH and ARH respectively. Until now there have been 5 recurrences and one cervical cancer related death in the robot-assisted group and no recurrences in both the laparoscopy and the laparotomy group.One patient died due to primary lung cancer in the laparoscopic group and other patient died due to primary pancreatic cancer in the laparotomy group.Conclusions
Robot-assisted laparoscopic radical hysterectomy and pelvic lymph node dissection is feasible and more precise because the instruments provide better flexibility and 3-D vision. We must proceed cautiously, however, if a new treatment modality appears to present an increased recurrence rate. Therefore, patients submitted to robot-assisted laparoscopic radical hysterectomy should be followed carefully and RALRH would be encouraged as protocol setting until the long-term oncological outcome data are available. 相似文献11.
Antonio Malvasi Dan Farine Carlo Cavallotti Roberta Martignago 《International journal of gynaecology and obstetrics》2009,105(2):131-135
Objective
To determine the effect of closure or non-closure of the visceral peritoneum at cesarean delivery on uterine scar formation assessed at repeat cesarean delivery.Methods
Women undergoing initial cesarean delivery were allocated into 2 groups: group 1 underwent visceral peritoneal closure, while in group 2 the visceral peritoneum was not closed. At repeat cesarean delivery 4 specimens from the initial uterine scar were collected and assessed by light microscopy and scanning electron microscopy.Results
In group 1, 57% of women had adhesions compared with 20.6% in group 2 (P < 0.05). Light microscopy revealed reactive mesothelial hyperplasia (51.8% vs 13.7%), submesothelial fibrosis (48.1% vs 6.8%), and neoangiogenesis of mesothelial stroma (44.4% vs 12%) in group 1 and group 2 patients, respectively (P < 0.05). Scanning electron microscopy showed more patients with pericytes on the surface of microvessels in group 1 compared with group 2 (26.3 ± 1.4 vs 11.5 ± 1.1 patients; P < 0.05).Conclusion
Closure of the visceral peritoneum at cesarean delivery may produce an inflammatory reaction and adhesions, evidenced by reactive and regenerative mesothelial hyperplasia and submesothelial fibrosis. 相似文献12.
Lauren E. GiugaleNicola Di Santo Mark E. SmolkinLaura J. Havrilesky Susan C. Modesitt 《Gynecologic oncology》2012,127(2):326-331
Objective
To assess the impact of obesity severity on hysterectomy outcomes for uterine hyperplasia/cancer.Methods
The data from women undergoing hysterectomies for endometrial hyperplasia/uterine cancer with a BMI ≥ 30 kg/m2 were abstracted from records at the University of Virginia and Duke University following IRB approval. Univariate and multivariate statistical analyses were performed.Results
Mean age of the 659 patients was 58.1 yrs; mean body mass index (BMI) was 43 kg/m2. Women were grouped based on BMI: 39.6% (261) were obese (30-39 kg/m2), 41.7% (275) were morbidly obese (40-49 kg/m2) and 18.7% (123) were super obese (≥ 50 kg/m2). Minimally invasive surgical procedures (MIS) were attempted in 280 patients with a conversion rate of 16.1%; BMI was higher in the converted group (47.3 vs. 40.6 kg/m2; p < 0.001). As obesity group increased, there was a decreased frequency of lymphadenectomy (63.8% vs. 37.1% vs. 20.3%; p < 0.001), increased blood loss (242 vs. 281 vs. 378 mL; p < 0.001) and fewer nodes removed (p < 0.001). On multivariate analysis, type of surgery (open vs. MIS) and obesity classification were independently and significantly associated with wound complications (p < 0.001) and the presence of postoperative complications (p < 0.001, p = 0.003). Surgical staging with lymphadenectomy was significantly associated with obesity (p < 0.001) but not procedure type (p = 0.11). Blood transfusion (p < 0.001), hospital readmission (p = 0.025), and ileus (p < 0.001) were significantly associated with open procedures but not obesity. There were no significant differences in progression-free or disease-specific survival based on obesity group.Conclusion
Women with BMI's exceeding 40 kg/m2 have worse surgical outcomes than their less obese counterparts. 相似文献13.
Concentraciones de interleucina 1 beta en pacientes con preeclampsia y embarazadas normotensas sanas
E. Reyna J. MejiaN. Reyna D. TorresJ. Santos J. Perozo 《Clínica e investigación en ginecología y obstetricia》2011,38(4):128
Objective
To compare concentrations of interleukin-1 beta in patients with preeclampsia and healthy normotensive pregnant women.Material and methods
One hundred patients were selected. Fifty preeclamptic patients were selected as cases (group A) and 50 healthy pregnant women with a similar age and body mass index to those in the study group were selected as controls (group B). Blood samples for interleukin-1 beta determination were collected in all patients before labor and immediately after diagnosis in the study group.Results
No significant differences were found in maternal age, gestational age or body mass index at sample collection (p=ns). Significant differences were observed between groups in mean values of systolic and diastolic blood pressure (p<0.05). Interleukin-1 beta concentrations were significantly higher in group A than in group B (18.2±7.3 pg/ml compared with 13.6±5.4 pg/ml; p<0.05) and showed a slight, positive and significant correlation with values of systolic blood pressure and diastolic blood pressure (p<0.05).Conclusions
Concentrations of interleukin-1 beta were significantly higher in preeclamptic patients than in healthy normotensive pregnant women. 相似文献14.
JA Rakowski TA Tran S Ahmad JA James LA Brudie PJ Pernicone MJ Radi RW Holloway 《Gynecologic oncology》2012,127(1):98-101
Objective
Uterine manipulators are a useful adjunct for robotic-assisted radical hysterectomy (RARH), but some surgeons avoid their use for fear of altering pathology or interpretation of lymphovascular space involvement (LVSI). We retrospectively compared clinico-pathological data and tumor pathology from patients with cervical cancer operated by laparotomy vs. RARH.Methods
Charts from cervical cancer patients who underwent radical hysterectomy from January-1997 to June-2010 were reviewed for tumor histology, grade, FIGO stage, lymph node status, LVSI, depth of invasion, and tumor size. A ConMed V-Care® uterine manipulator was used in all robotic cases. H&E stained slides from 20 robotic and 24 open stage IB1 cases with LVSI reported in the original pathology were re-reviewed by a blinded pathologist for analysis of tissue artifacts and LVSI.Results
Two-hundred-thirty-six cases (185 open, 51 robotic) with stages IA2, IB1 and IB2 cervical cancer were reviewed. No significant differences in histology (squamous cell carcinoma, 65% vs. 51%; p = 0.1), IB1 lesion size (≤ 2 cm, 62% vs. 61%, p > 0.1), LVSI (34% vs. 39%, p > 0.1), and depth of stromal invasion (p > 0.1) was found between open and robotic groups. Histologic examination of all IB1 cervical carcinomas revealed a higher degree of surface disruption [45% (9/20) vs. 12.6% (3/24), p = 0.038] and artifactual “parametrial carryover” [65% (13/20) vs. 29% (7/24), p = 0.037] in robotic vs. open groups, respectively, but no significant differences in the rate of LVSI.Conclusion
RARH cases that utilized a uterine manipulator did not show any clinico-pathological differences in depth of invasion, LVSI, or parametrial involvement compared to open cases. 相似文献15.
José Ramón Urdaneta-Machado Ana Margarita Uhia GonzálezMaritza Cepeda de Villalobos Mery Guerra VelásquezNasser Baabel-Zambrano Alfi de Jesús Contreras-Benítez 《Progresos de Obstetricia y Ginecología》2011,54(10):511-517
Objective
To compare the effectiveness of uterine conization in high-grade cervical squamous intraepithelial lesions (HSIL) by means of surgical electrical excision with Trucone loop or Leep loop.Subjects and methods
We performed a comparative study that included 150 patients, aged between 20 and 45 years, with a diagnosis of HSIL. All patients underwent uterine conization with diathermy loop. The patients were separated into two groups according to the type of loop used.Results
Both loops were effective in the management of HSIL but significant differences were found in favor of the Trucone loop in surgical time (X: 3.7 ± 0.52, p < 0.01), lesser margin involvement (100% free margins, p < 0.05) and a lower frequency of residual lesions (94.7%, p > 0.01).Conclusions
Both diathermy loops were effective in the treatment of HSIL but the frequency of complications and residual lesions was lower with the Trucone loop. 相似文献16.
Cohen JG Sherman AE Kiet TK Kapp DS Osann K Chen LM O'Sullivan PS Chan JK 《Gynecologic oncology》2012,125(1):8-13
Objectives
While mentoring has been associated with research productivity, the specific characteristics of successful mentoring have not been well studied. Thus, we performed a case-control study to identify characteristics of successful mentoring programs.Methods
Institutions were divided based on number of plenary research presentations at an annual society meeting over 6 years. Case institutions (Group A) had more presentations vs. controls (Group B). A survey of professors and research fellows assessed characteristics of their mentoring program. Chi-square and logistic regression analyses were performed.Results
Of 159 surveyed, response rates were 46% for professors and 51% for fellows. Compared to Group B, Group A was more likely to have: an additional year of protected fellowship research training (62% vs. 24%; p = 0.003), an established program to connect a mentor and mentee with similar research interests (52% vs. 27%; p = 0.049), methods to provide feedback to mentors (62% vs. 29%; p = 0.01), require mentee research progress reports (45% vs. 21%; p = 0.047), and report ease of identifying a mentor (90% vs. 69%; p = 0.046). On multivariate analyses, the additional year of research training (OR = 7.53, 95% CI: 2.10-27.09; p = 0.002) and ease at identifying a research mentor (OR = 7.45, 95% CI: 1.44-38.6; p = 0.017) remained as independent factors associated with higher research productivity.Conclusions
Our data suggest that programs can enhance research productivity with the incorporation of accountability features including formalized reports of progress and mentorship feedback in fellowship training. Facilitating the identification of a mentor and providing an additional year of research may be independent factors associated with research productivity. 相似文献17.
Yu HT Huang HY Soong YK Lee CL Chao A Wang CJ 《European journal of obstetrics, gynecology, and reproductive biology》2010,152(2):172-175
Objective
To assess whether the laparoscopist's experience can affect ovarian reserve and pregnancy outcome in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) patients who previously underwent laparoscopic conservative treatment for ovarian endometriomas.Study design
One hundred and forty-nine IVF-ICSI cycles with infertile patients who previously underwent laparoscopic conservative treatment for ovarian endometriomas were enrolled. There were 76 cycles with an inexperienced surgeon and 73 cycles with an experienced surgeon.Results
The number of antral follicle count (7.5 ± 3.8 vs. 9.6 ± 6.6; p = 0.011), and live-born rate per cycle (9.3% vs. 32.9%; p < 0.001) were significantly lower in the inexperienced group comparing with the experienced group. However, the mean number of oocytes, fertilization rate, mean number of embryos transferred, rate of good-quality embryos transferred, implantation rate and clinical pregnancy were similar between both groups.Conclusions
The experience of the laparoscopist may affect ovarian reserve and live-born rate after treating ovarian endometrioma in infertile women with IVF-ICSI. 相似文献18.
Yeo-Jung Moon Sei-Kwang Kim 《International journal of gynaecology and obstetrics》2011,112(2):122-125
Objective
To compare the treatment outcomes of Burch colposuspension and transobturator tape (TOT) when each is combined with abdominal sacrocolpopexy (ASC) to treat stress urinary incontinence (SUI) with pelvic organ prolapse (POP).Methods
Consecutive cases of Burch colposuspension and TOT combined with ASC were retrospectively reviewed. Patients with SUI and POP beyond stage III—according to the POP-quantification system—were included.Results
Mean hospital stay was longer in the Burch group (n = 49) than in the TOT group (n = 60) (11.3 vs 7.8 days; P < 0.001), as was operation time (202.7 vs 170.1 minutes; P < 0.001); furthermore, there were higher rates of urinary retention (53.1% vs 11.7%; P < 0.001), de novo urgency (18.4% vs 3.3%; P = 0.01), and recurrent SUI (18.4% vs 1.7%; P = 0.003) in the Burch group. The cure rate was significantly higher in the TOT group than in the Burch group (98.3% vs 69.7%; P < 0.001).Conclusion
The use of TOT with ASC resulted in higher cure rates and better functional outcomes than did Burch colposuspension with ASC. 相似文献19.
Jung Hun Lee Seung Wook Jeon Se Jin Lee 《European journal of obstetrics, gynecology, and reproductive biology》2010,153(1):81-84
Objective
To describe our initial experience with single-port laparoscopic myomectomy (SP-LM) using transumbilical GelPort access and the surgical technique used, and to evaluate the safety and feasibility of this procedure.Study design
A prospective observational study was performed at a university teaching hospital from January 2009 to December 2009. Fifteen patients with symptomatic subserosal or superficial intramural myomas (≤8 cm) underwent SP-LM.Results
The mean age and body mass index were 35.0 ± 8.6 years and 22.6 ± 2.6 kg/m2. Two patients had a history of previous abdominal surgery, consisting of one and two cesarean deliveries. The mean operating time, hemoglobin change, return of bowel activity, and length of hospital stay were 81 ± 21.5 min, 1.1 ± 0.5 g/dL, 34.3 ± 5.9 h, and 3.1 ± 0.5 days, respectively. In one patient (6.7%), SP-LM was converted to two-port LM. There were no surgical or wound complications in any patient, and the histopathological result was leiomyoma in all the cases.Conclusion
SP-LM is feasible in selected patients with symptomatic myoma. 相似文献20.
C Crivellaro M Signorelli L Guerra E De Ponti A Buda C Dolci C Pirovano S Todde R Fruscio C Messa 《Gynecologic oncology》2012,127(1):131-135