检索结果-南通市图书馆

Combination of hysteroscopy and laparoscopy in gynecologic operation:an analysis of 65 cases

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 1998年第11期 42-44页

作者：夏恩兰冯力民段惠兰段华

Objective To introduce the procedures, preliminary experience, and advantages of operation using combination of hysteroscopy and laparoscopy. Methods Sixty five women underwent transcervical resection of endometrium (11), myoma (38), polyp (2), septa (9), adhesion (1) or foreign body (4). All had the indications for simultaneous laparoscopic monitoring and operation. They were first diagnosed laparoscopically to decide the type of laparoscopic operation. Then they were treated hysteroscopically and finally received laparoscopic operation. Results Laparoscopic examinations confirmed the original diagnoses, revealed the causes of pelvic pain in 8 patients, and detected ovarian cyst, endometriosis, and pelvic adhesion in 5. Two cases of uterine perforation were found by laparoscopic monitoring. Thirty laparoscopic operations included removal or puncture of ovarian cyst, lysis of adhesion, coagulation of endometriosis, Rubin's test, and partial salpingectomy. The postoperative course was smooth and the operative result was satisfactory. Conclusions Operations using combination of hysteroscopy and laparoscopy are safe and effective. They also reduce the pain, and save the time and money of patients. Laparoscopic monitoring may detect uterine perforation in time.

关键词： hysteroscopy and laparoscopy operation gynecologic Combination analysis

Modified Triple P Approach by gynecologic Oncologist-Led Team for Placenta Accreta Spectrum Improves the Outcome: Non-Randomized Controlled Trial

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Open Journal of Obstetrics and Gynecology 2019年第7期9卷 1039-1049页

作者： Mohammad Am Ahmed Mostafa M. Khodry gynecologic Oncology Unit South Valley University Qena Egypt Obstetrics and Gynecology Department South Valley University Qena Egypt

Introduction: Placenta Accreta Spectrum (PAS) is associated with significant maternal and fetal morbidity and mortality. The ideal conservative management still does not exist. We aimed to compare the outcome of cesarean section for PAS by a gynecologic oncologist-led team using the modified triple P approach and by a non-gynecologic oncologist-led team. Material and Methods: This is non-randomized controlled trial. Group A had Cesarean Section by gynecologic oncologist. gynecologic oncologist-led team did all Cesarean Section following a modified triple P approach. The first P is for “Plan” the uterine incision. The second P for “Pelvic” devascularization by internal iliac artery ligation. The third P is for Placenta non-separation with resection of the myometrium. Group B had Cesarean Section by non-gynecologic oncologist-led team. The main outcome measures were the need for hysterectomy, amount of blood loss, and the management-related complications. Results: Group A had significantly less estimated blood loss, and received less number of backed RBCs units, and less operative time than group B. The uterus is preserved in all cases of group A and in 50% of cases of group B. The overall maternal morbidity rate was 17.5% in group A and 72.2% in group B. Conclusion: This study provides evidence that the modified triple P approach for PAS by gynecologic oncologist-led team presents lower maternal morbidity in comparison to surgery by non-gynecologic oncologist-led team.

关键词： Placenta Accreta gynecologic Oncologist Surgery Outcome

Evaluation of a public expense-covered gynecologic screening program in Japan 2005-2009

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Obstetrics and Gynecology 2011年第2期1卷 21-24页

作者： Hiroshi Takagi Satoshi Ichigo Kazutoshi Matsunami Atsushi Imai 不详

Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gynecologic findings and compare them with the literatures reported from general hospitals and self-paid check-up programs. Methods: Medical records of Japanese women, who underwent gynecological examinations at public expense between 2005 and 2009, were retrospectively reviewed. Results: Of the cervical smears from 2850 women aged 21 - 82 years, 33 (1.1%) were classified as dysplastic and malignant changes: 28 of low-grade squamous intraepithelial lesion (LSIL), 3 high-grade squamous intraepithelial lesion (HSIL), 2 atypical squamous cells of undeterimined significance (ASC-US). No case of cervical squamous cell carcinoma or adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in less than 1% of cases. Most of participants (98%) revealed no gynecologic abnormalities. Conclusion: Annual gynecologic screening and proper follow-up programs even against asymptomatic women may remarkably reduce the probability of (pre)malignant disease.

关键词： Cervical Smear Screening Transvaginal Sonography gynecologic Check-up Oncology

Postoperative Nausea and Vomiting Prophylaxis with Ondansetron in Diagnostic gynecologic Laparoscopy: Preemptive versus Preventive Method

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Advances in Reproductive Sciences 2017年第1期5卷 1-9页

作者： Simin Atashkhoei Eissa Bilehjani Solmaz Fakhari Faraji-Azad Hanieh Department of Anesthesiology Tabriz University of Medical Sciences Tabriz Iran Tabriz University of Medical Sciences Tabriz Iran

Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value gynecologic laparoscopy.

关键词： gynecologic Laparoscopy PONV Ondansetron Preemptive Preventive

Pseudo-or real progression? An ovarian cancer patient under nivolumab:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Oncology 2019年第7期10卷 247-255页

作者： Mona Passler Eliane T Taube Jalid Sehouli Klaus Pietzner Department of Gynecology Competence Center for Ovarian Cancer(EKZE)Charité-University MedicineBerlin 13353Germany Institute of Pathology CharitéUniversity HospitalBerlin 10117Germany

BACKGROUND Checkpoint-Inhibition has revolutionized the treatment for several entities such as melanoma and renal cell carcinoma.The first encouraging experience in ovarian cancer was reported for nivolumab,a fully humanized anti-programmed death-1 antibody.Pseudoprogression is a new phenomenon associated with these novel immuno-oncologic agents.It can be explained by infiltrating leucocytes and edema that result in a temporary increase in tumor size and delayed subsequent shrinkage due to tumor cell destruction.CASE SUMMARY We report on a 47-year old patient with platinum-resistant ovarian cancer that was treated off-label with nivolumab 3mg/kg iv d1q14d.She first experienced classic pseudoprogression with inguinal lymph node swelling after cycle two and subsequent shrinkage.After 6 cycles she presented with rectal bleeding and progressive disease was diagnosed due to new tumor infiltration into the rectum.CONCLUSION Clinicians should be aware of pseudoprogression,its underlying mechanisms and strategies to discriminate pseudo-from real progression in ovarian cancer.

关键词： Case report Nivolumab Clinical oncology Checkpoint inhibition gynecologic oncology Pseudoprogression Immunooncology

gynecological tumors in patients with Peutz-Jeghers syndrome (PJS)

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Genetics 2011年第3期1卷 65-69页

作者： Arisa Ueki Iori Kisu Kouji Banno Megumi Yanokura Kennta Masuda Yusuke Kobayashi Akira Hirasawa Daisuke Aoki 不详

Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsible gene is a tumor suppressor, STK11/LKB1, on chromosome 19p13.3. PJS complicates with benign and malignant tumors in various organs. In gynecology, there has been a particular focus on complications of PJS with sex cord tumor with annular tubules (SCTAT) and minimal deviation adenocarcinoma (MDA), which are rare diseases. Approximately 36% of patients with SCTAT are complicated with PJS and these patients are characterized by multifocal, bilateral, small and benign lesions that develop into tumors with mucinous to serous ratios of 8:1. In addition, 10% of cases of MDA are complicated with PJS and mutation of STK11, the gene responsible for PJS, has a major effect on onset and prognosis. The disease concept of lobular endocervical glandular hyper-plasia (LEGH) has recently been proposed and LEGH is thought to be a potential premalignant lesion of MDA, however, the relationship between PJS and LEGH remains unclear. Several case reports of PJS patients complicated with gynecological tumors have been published and further studies are needed to determine the underlying

关键词： gynecologic Tumor Minimal Deviation Adenocarcinoma Peutz-Jeghers Syndrome Sex Cord Tumor STK11/LKB1

Retrospective Cohort Study on Acute Care in Obstetrics and Gynecology: Analogies and Differences When Compared to Emergency Medicine

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Obstetrics and Gynecology 2017年第4期7卷 473-485页

作者： Giuseppe Chiossi Stefano Palomba Sara Balduzzi Maged M. Costantine Angela I. Falbo Anna M. Ferrari Giovanni B. La Sala Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston TX USA Department of Obstetrics and Gynecology Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy Statistics Unit Department of Oncology Hematology and Respiratory Diseases University of Modena and Reggio Emilia Modena Italy Department of Emergency Medicine Arcispedale Santa Maria Nuova IRCCS Reggio Emilia Italy University of Modena and Reggio Emilia via Università 4 Modena Italy

Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.

关键词： Acute Care Obstetric Urgencies gynecologic Urgencies Obstetrics and Gynecology Triage Emergency Department

Association between Early Marriage and Other Sociomedical Characteristics with the Cervical Pap Smear Results in Iraqi Women

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Advances in Sexual Medicine 2015年第4期5卷 73-82页

作者： May Kasim Khalaf Faris Anwer Rasheed Saad Abdulrahman Hussain Al-Elweyia Maternity Teaching Hospital Baghdad Iraq Department of Obstetrics and Gynecology Al-Kindy Medical College University of Baghdad Baghdad Iraq Department of Pharmacology and Toxicology College of Pharmacy University of Baghdad Baghdad Iraq

Background: The standard screening test for cervical cancer is the Pap smear and cervical cancer is a significant health issue worldwide. Early sexual activity, multiple sexual partnerships, parity, young age at first pregnancy and early marriage are traditional risk factors for developing cervical cancer. The aim of the present study was to assess the effect of early marriage in on the results of Pap smear in Iraqi women. Methods: A cross-sectional study was carried out on 200 women who attended the Women Health Clinic of Al-Elwiya Maternity Teaching Hospital, Baghdad for the period from November 2013 to April 2014. Data were collected through direct interview and a prepared questionnaire including patients’ characteristics and Pap smear results. Results: Mean age of studied women was 39.9 ± 11.4 years and mean age of marriage was 19 ± 5 years. Abnormal Pap results were reported in 63.5% of them. A significant association was observed between abnormal Pap smear and each of age 20 - 30 years, ≤18 years age at marriage, marriage duration >10 years, irregular menstrual cycle, tubal ligation and abnormal medical history (P < 0.05). Conclusions: Early marriage was strongly associated with abnormal Pap smear results in Iraqi women.

关键词： Pap Smear Early Marriage Medical History gynecologic Complications

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Obstetrics and Gynecology 2015年第5期5卷 280-285页

作者： Rebecca L. James Marilyn Alejandro-Rodriquez Elba Adriana Perez Jeffrey Mangel MetroHealth Medical Center Cleveland OH USA

Background: 2-octyl cyanoacrylate (2OCA) high viscosity tissue adhesive (Medline Industries, Inc., Mundelein, IL) is a liquid topical skin adhesive. 2OCA offers the same design features and clinical utility in terms of flexibility, strength, and low complication rate as the commercially available 2OCA tissue adhesives. Additionally, 2OCA features high viscosity allowing for better control during the application process, polymerization without the use of an external activator, and a distinctive violet color for ease of application visualization. Objective: The aim of this prospective case series is to descriptively report clinical data with the application of 2OCA as a topical incision closure system in female pelvic surgery. The primary outcomes included: incisional pain, incisional dehiscence, and post-operative bleeding. The secondary outcome included drying times of the adhesive with regard to incision length. Methods: A prospective open-label observational case series study was conducted to evaluate the use of 2OCA in surgical wound closure of the topical skin in adult patients undergoing gynecologic surgical procedures. A total of 50 adult women undergoing gynecologic surgery were enrolled. 2OCA was applied only by surgeons who had undergone product training to the incisions in a standardized, protocol-defined fashion. Drying times for the adhesive and photography were recorded intraoperatively. Post treatment follow-up was conducted with queries of pain level, incisional dehiscence, and incisional bleeding immediately post-operatively, 48 hours, 5 - 10 days and 14 days post-treatment. Adverse events were documented. Results: 2OCA was applied to a total of 154 incisions from the 50 patients enrolled to the study. The procedures included: 16 laparoscopic total hysterectomies, 4 diagnostic laparoscopies, 2 laparoscopic myomectomies, 2 laparoscopic bilateral or unilateral salpingo-oophorectomies, 5 total robotic-assisted laparoscopic surgeries (2 total hysterectomies, 1 supracervical hysterectomy, 1 sacrocolpop

关键词： Female Pelvic Surgery gynecologic Surgery Octyl Cyanoacrylate Surgical Incision Skin Closure