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Feasibility and safety of vaginal myomectomy:analysis of 90 cases

Chinese Medical Journal 2006年第21期119卷 1790-1793页

作者： WEI Feng-hua ZHAO Xiao-dong ZHANG Yi Department of Obstetrics and Gynecology Beijing Hospital Beijing 100730 China

Background Vaginal myomectomy was firstly reported in 1994, however, it is a relatively new technique in China. The feasibility and safety of the procedure is still controversial in this country. The aim of this study was to analyze the outcomes of vaginal myomectomy in 90 patients and to investigate the feasibility and safety of the surgery. Methods From June 2001 to June 2004, 90 patients with uterine leiomyoma were treated with vaginal myomectomy in our hospital （vaginal group）. The indications, operative performance, postoperative complications, and recovery of the patients were analyzed and compared with those of 93 patients with uterine leiomyoma treated by laparotomic myomectomy from January 2000 to January 2001 （laparotomy group）. The Student＇s t test was used to compare the continuous variables between the two groups, and the chi-square test was used to compare the categorical variables. The vaginal and laparotomy groups were followed up for 10-34 months （median, 21） and 15-24 months （median, 30）, respectively. Results Vaginal myomectomy was performed successfully in 87 of the 90 patients （96.7%）. In the other 3 patients, the procedure failed and laparotomy was carded out. In both groups, the uterus was enlarged to 8-16 weeks gestational size （median, 10 gestational weeks）. The number of resected tumors was 1 - 12 （median, 2） in the vaginal group and 1-15 （median, 4） in the laparotomy group, respectively （P〉0.05）. The mean operating time, intraoperative blood loss, and postoperative hospital stay were （52± 21） minutes, （230± 44） ml, and （7.0±1.2） days in the vaginal group, and （654±32） minutes, （200±56） ml, and （7.04±1.5） days in the laparotomy group （P〉0.05）. The mean top postoperative temperature was （38.44±1.1）℃ and （37.8±0.6）℃ in the two groups respectively （P〈0.05）. Both groups had one recurrent case during the follow-up （P〉0.05）. Condusions Vaginal myomectomy is feasible and safe in treating uterine leiomyoma. To some extent, it is superior to laparot

关键词： uterine neoplasms leiomyoma surgical procedures, minimally invasive

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Evaluating the feasibility and safety of vaginal myomectomy in China

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Chinese Medical Journal 2011年第21期124卷 3481-3484页

作者： YU Xin ZHU Lan LI Lei SHI Hong-hui LANG Jing-he Department of Obstetrics and Gynecology Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China

Background Classically, myomectomy has been performed via laparotomy, but laparoscopic myomectomy has now become a valuable treatment option. Vaginal myomectomy as a minimal invasive procedure has also been evaluated; however, its feasibility and safety are controversial with few clinical trials published. This study was designed to evaluate the feasibility of vaginal myomectomy in China and to document any associated complications. Methods From January 2005 to December 2010, 43 patients with symptomatic myomas were admitted for vaginal myomectomy in Peking Union Medical College Hospital （PUMCH）. The indications, operative performance, postoperative complications and outcome of these patients were analyzed retrospectively. Results Myomectomy was performed vaginally in all patients. The mean operating time was （66.4±22.6） minutes and the mean operative blood loss and hospital stay were （78.3±64.4） ml and （4.9±3.3） days, respectively. Five （12%） patients developed febrile morbidity and experienced a high postoperative temperature （mean 38.4℃）. Postoperative fever was associated with greater operative trauma, longer operative time and greater weight of the tumor （all P 〈0.01）. The cost of surgery was RMB （820.6±339.1） Yuan （（124.3±51.4） US dollars） and the total medical cost was RMB （4880.4±1088.4） Yuan （（739.5±164.9） US dollars）. Three patients later conceived spontaneously and had uneventful vaginal deliveries. Only one patient had a tumor recurrence during the following-up period. Conclusion Vaginal myomectomy is a feasible and safe surgical procedure with low recurrence and complication rates.

关键词： uterine neoplasms leiomyoma gynecologic surgical procedures vaginal myomectomy

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Dextran uterine artery embolization to treat fibroids

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Chinese Medical Journal 2002年第8期115卷 1132-1136,145页

作者：王杰张国英施海彬冯耀良王卫东王永利刘嘉茵南京医科大学第一附属医院放射科南京210029 南京医科大学第一附属医院妇产科南京210029

OBJECTIVES: To analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 38 patients. METHODS: Thirty-eight volunteers (age range, 24-48 years; mean, 37.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, and pelvic pain) were randomly included in this study. The fibroids were single in 32 patients and multiple in 6 patients. According to the tumor location, subserous fibroids were found in 4 patients and interstitial or submucosal fibroids in 34. Tumor size was from 2 to 10.9 cm in diameter. We performed embolization with a single Headhunter catheter using the right-femoral artery approach, injection of dextran microspheres (225-450 micro m), and an absorbable gelatin sponge. Follow-up included clinical and sonographic examinations at one-month intervals for 6 months.　 RESULTS: Embolization was successfully performed in all patients. Post-procedural pain control was good in 35 (92%) patients. In most patients, symptoms were improved at 3 months (36/38, 95%). Clinical failure of the treatment occurred in only 2 patients (2/38, 5%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization was 68%. The tumor had vanished in five submucosal fibroid patients. Histopathological tests showed that the tumor was degenerative as fibrosis and hyalinosis.　 CONCLUSIONS: uterine artery embolization with dextran microspheres is a micro-invasive method for the treatment of uterine fibroids. It is clinically effective in most patients and induces a progressive reduction in the size of fibroids. Based on this study, we believe that this new technique is much more suitable for submucosal fibroids with massive menorrhagia.

关键词： Embolization, Therapeutic Adult Dextrans Female Follow-Up Studies Humans Leiomyoma Middle Aged uterine neoplasms Uterus

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Epithelioid trophoblastic tumor of the uterus:a report of three cases

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Chinese Medical Journal 2007年第8期120卷 729-730页

作者： LIU Qi SHI Qun-li ZHANG Jian-min LI Yan DU Yi-ming SHEN Shi-ming MA Heng-hui MENG Kui Department of Obstetrics and Gynecology Nanjing Jinling Hospital Nanjing University Nanjing 210002 China

Epithelioid trophoblastic tumor （ETT） of the uterus is a rare tumor introduced recently, which is distinct from placental site trophoblastic tumor （PSTT） and choriocarcinoma with the histological appearance of resembling low-grade squamous cell carcinomas. Definition and treatment of this disease is still not very clear because of its very low incidence and epithelioid trophoblastic lesions. ETT generally behaves in a benign fashion with metastatic and death rates about 25% and 10%, respectively, Here we report three cases of ETT, in which one had metastasis and eventually died from the disease.

关键词： uterine neoplasms trophoblastic neoplasms pathology

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Treatment of uterine fibroid with triptorelin before hysterectomy

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Chinese Medical Journal 1998年第1期111卷 67-70页

作者： Loong EP Lo KW Chinese Univ Hong Kong Prince Wales Hosp Dept Obstet & Gynaecol Shatin NT Peoples R China

OBJECTIVE: To study the effects of pretreatment with triptorelin on uterine fibroid before abdominal hysterectomy. METHODS: Fifteen premenopausal Chinese women with symptomatic uterine fibroids requiring hysterectomy were recruited in the study. All patients received monthly intramuscular injections of 3.75 mg triptorelin for three months prior to abdominal hysterectomy. RESULTS: There was significant reduction in the serum levels of oestradiol (68.6%), progesterone (95.6%) and luteinizing hormone (73.9%) and in uterine (45.0%) and fibroid (68.0%) volumes. The serum level of follicle-stimulating hormone and haemoglobin concentration were not significantly different. CONCLUSIONS: Shrinkage of uterine fibroids can be achieved in women who are rendered hypoestrogenic with monthly injections of triptorelin for three months. This treatment modality may be of value prior to hysterectomy or myomectomy especially when the fibroid is large.

关键词： Adult Chemotherapy, Adjuvant Female Humans Hysterectomy Injections, Intramuscular Leiomyoma Luteolytic Agents Middle Aged Preoperative Care Triptorelin uterine neoplasms

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Reconsider the safety of laparoscopic surgery in endometrial cancer

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Gynecology and Obstetrics Clinical Medicine 2022年第1期2卷 1-5页

作者： Yibo Dai Zhiqi Wang Jianliu Wang Departnent of Obstetrics and Gynecology Peking University People's HospialBeijing China

General introduction The 20th century witmessed the development of laparoscopic surgical technologies and its successful applications in gynecological and general *** 1901,Russian doctor Dimitri Ott,for the first time,inspected the human a bdominal cavity with a speculum through a small incision,which marked the origin of the concept of minimally invasive techniques."During the following decades,clinical diagnosis of intra-abdominal lesions was performed by some doctors in Europe and the *** instuments similar to modern *** it was until 1980s that modem sense laparoscopic surgeries,induding laparoscopic appendicectomy and laparoscopic cholecystectomy,were *** 1989,*** Harry performned the first laparoscopic hysterectomy,'which is regarded as a comerstone in the history of gynecologic ***,laparoscopic surgery rapidly stepped into the mainstream of gynecology practice during the 1990s,delivered for both benign and malignant *** from the 2000s,the master-slave mode ro-botic system,exemplified by the da Vinci@robot,has been accepted wordwide,and currently,robot assisted laparoscopic approaches have taken up a major proportion of general,urologic and gynecologic sur-geries,especially in developed countries.5 From a historical perspective,the broad application of laparoscopic surgeries nowadays stands on solid foundations established in decades of technical revolutions and refinements.

关键词： uterine neoplasms Laparoscopic surgery Molecular typing Survival uterine manipulator

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Treatment of Hysteromyoma by Acupuncture-moxibustion plus Tuina: A Report of 33 Cases

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Journal of Acupuncture and Tuina Science 2003年第5期1卷 52-53页

作者： HU Zhen-xia CUI Yi-jun Tuina Department of Shanghai TCM Hospital Shanghai China 200071

Guided by TCM treatment on the basis of syndrome differentiation, the author has treated 33 cases of hysteromyoma, which are divided into stagnation of liver-qi and blood stasis (SLQBS) type, and qi-deficiency and blood stasis (QDBS) type, by acupuncture-moxibustion and Tuina. After 3 therapeutic courses, the total effective rate is 81.8%. The therapeutic effect has no close relationship with the TCM syndrome differentiation. Key Words Acupuncture-Moxibustion - Massage - uterine neoplasms - Tuina Author: HU Zhen-xia (1961-), female, senior consultant doctorTranslator: CUI Yi-jun

关键词： Acupuncture-Moxibustion Massage uterine neoplasms Tuina

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Malignant neoplasms of the uterus following radiation therapy for cervical carcinoma: a clinical study of 47 cases

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The Chinese-German Journal of Clinical Oncology 2009年第6期8卷 356-359页

作者： Shaokang Ma Lingying Wu Department of Gynecologic Oncology Caner Hospital Peking Union Medical College Chinese Academy of Medical Sciences Beijing 100021 China

Objective： To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods： Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results： The median age at uterine neoplasms diagnosis was 62 years （range： 38-77 years）, and the median latency period from initial therapy to development of uterine neoplasms was 14 years （range： 5-35 years）. Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma （UPSC）. Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows： stage Ⅰb, 1 case; stage Ⅰc, 2 cases; stage Ⅱ, 6; stage Ⅲa, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 （include 3 UPSC patients）, seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences （23.3%）, at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients occurred recurrence （35.9%）, at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion： The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.

关键词： cervix neoplasms radiotherapy uterine neoplasms second neoplasms

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Intravenous Leiomyomatosis——Report of Two Cases

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Chinese Medical Sciences Journal 2004年第1期19卷 55-55页

作者：冯光兴景吉林兰风贺 Department of Cardiac Surgery Hebei Provincial People's Hospital

The first patient was a 38 years old female who was diagnosed leiomyoma of uterus and underwent a total hysterectomy 3 years ago. In the operation, the tumor was found to extend into left iliac vein from uterus in sha... 详细信息

关键词： Adult Female Follow-Up Studies Heart neoplasms Humans Leiomyoma Leiomyomatosis Pelvic neoplasms Pulmonary Artery Reoperation uterine neoplasms Vascular neoplasms Vena Cava, Inferior

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