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排序方式: 共有86条查询结果,搜索用时 36 毫秒
61.
Operative laparoscopy versus open abdominal surgery: a comparative study on postoperative adhesion formation in the rat model 总被引:4,自引:0,他引:4
The aim of this study was to compare the occurrence of adhesions after a standard uterine injury inflicted by laparoscopy or by laparotomy during which microsurgical principles were observed. The cross-sectional areas of adhesions involving the uterus were assessed and the 31 rats operated upon laparoscopically were compared with the 30 rats subjected to a laparotomy. The mean area of uterine adhesions formed in the laparotomy group was 4.29 mm2 and 8.88 mm2 in the laparoscopy group. The difference was not statistically significant. The results imply that a standard tissue injury to uterine tissue, whether conducted by laparoscopy or via laparotomy, carries the same potential to induce postoperative adhesions. 相似文献
62.
V Gomel 《Fertility and sterility》1989,52(1):1-11
This reassessment of IUDs as a risk factor for PID contrasts study results from prospective and case-control studies. Except for a transient increased risk after IUD insertions, increased risk is seen mainly in case-control studies after 1973, the time of a major PID epidemic and adverse publicity related to the Dalkon Shield. Removal of oral contraceptive users from case-control studies generally reduces their reported odds ratios, frequently to borderline statistical significance for studies with high accuracy of PID diagnosis. The remaining elevated odds ratios likely relate to diagnostic bias as primary care clinicians are more likely to refer patients wearing an IUD to referral centers where case-control studies are conducted. Biased case-control studies provided evidence for expensive litigation, resulting in removal of IUDs from the American market. The Food and Drug Administration requirements for postmarketing surveillance are inadequate to provide prospective data to avoid this kind of loss. 相似文献
63.
Hisao Osada Shokichi Teramoto Hirotsune Kaijima Tomoya Segawa Osamu Miyauchi Masaji Nagaishi Makio Shozu Keiichi Kato Victor Gomel 《Journal of minimally invasive gynecology》2019,26(1):129-134
Study Objective
To evaluate the efficacy of a nonsurgical treatment for cervical pregnancy (CP) and cesarean section scar pregnancy (CSP).Design
Retrospective clinical study (Canadian Task Force classification III).Setting
Private assisted reproductive technology practice.Patients
Nineteen women with CP (n?=?16) or CSP (n?=?3), including 6 patients with positive fetal heartbeat.Intervention
Transvaginal local injection of absolute ethanol (AE) into the hyperechoic ring (lacunar space) around the gestational sac under ultrasound guidance.Measurements and Main Results
Serum beta-human chorionic gonadotropin (β-hCG) was measured at frequent intervals, and ultrasound and/or magnetic resonance imaging was used to observe the gestational sac. In 9 patients, the serum β-hCG level was effectively reduced with a single AE injection at 2 hours. In the remaining 10 patients, the level decreased but then increased in 4 and slowly decreased in the other 6; all of these 10 patients required 2 to 5 repeat AE injections. In all patients, serum β-hCG level was reduced by 50% within 3 days and decreased to <10% of the initial level within 14 days. In 18 patients (95%), the level was decreased to 1.0 mIU/mL within 40 days. Seven patients were treated on an outpatient basis. Twelve patients received no anesthesia. Five patients subsequently became pregnant, and each had a live birth. There was no recurrent CP or CSP. The procedure was successful in all 19 patients.Conclusion
This procedure is an effective treatment for CP or CSP that could be used in place of conventional surgical interventions and medical treatment using MTX. 相似文献64.
65.
Yarali H; Gomel V; Uygur D; Onculoglu C; Gedikoglu G; Gurgan T 《Human reproduction (Oxford, England)》1998,13(6):1493-1495
Electrodesiccation or chemical agents, such as thrombin and fibrin sealant,
may be used to control oozing in the peritoneal cavity. Electrodesiccation
is time consuming and associated with adjacent thermal damage. Adhesion
formation remains a concern with the use of thrombin and fibrin sealant. In
this study, adhesion formation and various histological parameters of
inflammation were evaluated following haemostasis with
electromicrodesiccation or thrombin in the rabbit model (n = 36). Following
laparotomy, the right uterine horn was subjected to a measured injury
producing sufficient oozing. After the injury was effected, the animals
were randomized to haemostasis with electromicrodesiccation (n = 18) or
thrombin (n = 18). In the first phase of the study, the histological
parameters of acute injury and haemostasis with either modality were
evaluated in two animals in each group. In the second phase, one, two and
10 animals, in each group, were submitted to second-look laparotomy on
post-operative days 2, 7, and 15, respectively and the type and extent of
adhesions were quantified. Histological parameters of inflammation as well
as the type and extent of adhesions were comparable between the two groups.
We conclude that local application of thrombin is not associated with a
statistically greater degree of post-operative adhesions when compared to
electromicrodesiccation.
相似文献
66.
Roberta Corona Maria Mercedes Binda Leila Adamyan Victor Gomel Philippe R. Koninckx 《Gynecological surgery》2017,14(1):21
Background
Microsurgical tenets and peritoneal conditioning during laparoscopic surgery (LS) decrease postoperative adhesions and pain. For a trial in human, the strong beneficial effects of N2O needed to be confirmed in open surgery (OS).Results
In a mouse model for OS, the effect of the gas environment upon adhesions was evaluated. Experiment I evaluated desiccation and the duration of exposure to CO2, N2O or CO2 + 4%O2. Experiment II evaluated the dose-response curve of adding N2O to CO2. Experiment III compared humidified CO2 + 10% N2O during LS and OS.In OS, 30- and 60-min exposure to non-humidified CO2 caused mortality of 33 and 100%, respectively. Mortality was prevented by humidification, by dry N2O or dry CO2 + 4%O2. Adhesions increased with the duration of exposure to CO2 (p < 0.0001) and decreased slightly by humidification or by the addition of 4% O2. N2O strongly decreased adhesions at concentrations of 5% or greater. With humidified CO2 + 10% N2O, adhesion formation was similar in OS and LS.Conclusions
The drug-like and strong beneficial effect of low concentrations of N2O is confirmed in OS.67.
68.
V Gomel 《American journal of surgery》1976,131(3):319-323
In the last seven years laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist. Other specialities have been relatively slow in recognizing its value. Laparoscopy has wide applications in general surgery. It is a useful tool in blunt abdominal trauma and often prevents laparotomy. In patients with acute abdominal conditions, when findings are atypical, uncertainty in diagnosis may be resolved by laparoscopy. In patients with malignant disease it permits assessment of the extent of the lesion and enables accurate selection of the mode of therapy. Numerous procedures per laparoscopy, including biopsies, division of adhesions, cholangiography and collection of samples for bacteriologic studies, may be carried out simultaneously. Complication associated with the procedure are few but may be severe. These can be avoided by careful adherence to proper technic. 相似文献
69.
To assess the contribution of chromosome anomalies to the high failure of in vitro fertilization (IVF), 94 unfertilized eggs from 43 women participating in the IVF program were cytogenetically investigated. The mean age of the oocyte donors was 33.6 years. Chromosome karyotypes were obtained in 65 of 94 oocytes: 34 oocytes (52.3%) had a normal haploid chromosome complement; 10 (15.4%) were hypohaploid; 7 (10.8%) were hyperhaploid; 8 were diploid; and 6 were hypodiploid or hyperdiploid (from 36 to 53). Eleven eggs showed prematurely condensed chromosomes of the G1-phase from sperm, as well as a set of maternal metaphase II chromosomes. These results are compared to similar reports in the literature. 相似文献
70.
Objective: To review the diagnostic and therapeutic roles of laparoscopy in women of reproductive age with acute and chronic pelvic pain.Data Identification: Studies relating to the use of laparoscopy in women with acute and chronic pelvic pain were identified through the literature and MEDLINE searches.Conclusion(s): Laparoscopy has an important place in the management of conditions that cause acute pelvic pain in women of reproductive age, including ectopic pregnancy, pelvic inflammatory disease, tubo-ovarian abscess, and adnexal torsion. The procedure frequently facilitates the diagnosis and provides the necessary access for surgical treatment. Prompt diagnosis and effective management prevent complications and help preserve fertility. The role of laparoscopy in women with chronic pelvic pain is more controversial and limited, but abnormal laparoscopic findings are detected in approximately 60% of those who have undergone a multidisciplinary investigation and received a tentative clinical diagnosis. The access provided by laparoscopy permits the effective surgical treatment of many of the conditions encountered, including endometriosis, pelvic adhesions, ovarian lesions, and symptomatic uterine retroversion. 相似文献