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transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease:A meta-analysis

World Journal of Gastroenterology 2015年第17期21卷 5393-5406页

作者： Bin Xu Bo Xu Wen-Yan Zheng Hai-Yan Ge Li-Wei Wang Zhen-Sun Song Bin He Department of Hepato-Biliary-Pancreatic Surgery Shanghai Tenth People’s HospitalTongji University School of Medicine Department of Anesthesiology and SICU Xinhua HospitalShanghai Jiaotong University School of Medicine Department of Surgical Intensive Care Unit Zhongshan HospitalFudan University Department of Gastrointestinal Surgery East Hospital of ShanghaiTongji University School of Medicine Department of Medical Informatics School of Public HealthJilin University

AIM:To compare the results of transvaginal cholecystectomy(TVC) and conventional laparoscopic cholecystectomy(CLC) for gallbladder ***:We performed a literature search of Pub Med,EMBASE,Ovid,Web of Science,Cochrane Library,Google Scholar,Meta Register of Controlled Trials,Chinese Medical Journal database and Wanfang Data for trials comparing outcomes between TVC and *** were extracted by two *** difference (MD), standardized mean difference(SMD),odds ratios and risk rate with 95%CIs were calculated using fixed- or random-effects *** heterogeneity was evaluated with the χ2 *** fixed-effects model was used in the absence of statistically significant *** randomeffects model was chosen when heterogeneity was ***:There were 730 patients in nine controlled clinical *** significant difference was found regarding demographic characteristics(P > 0.5),including anesthetic risk score,age,body mass index,and abdominal surgical history between the TVC and CLC *** groups had similar mortality,morbidity,and return to work after *** in the TVC group had a lower pain score on postoperative day 1(SMD:-0.957,95%CI:-1.488 to-0.426,P < 0.001),needed less postoperative analgesic medication(SMD:-0.574,95%CI:-0.807 to-0.341,P < 0.001) and stayed for a shorter time in hospital(MD:-1.004 d,95%CI:-1.779 to 0.228,P = 0.011),but had longer operative time(MD:17.307 min,95%CI:6.789 to 27.826,P = 0.001).TVC had no significant influence on postoperative sexual function and quality of *** cosmetic results and satisfaction were achieved in the TVC ***:TVC is safe and effective for gallbladder ***,vaginal injury might occur,and further trials are needed to compare TVC with CLC.

关键词： transvaginal cholecystectomy Conventionallaparoscopic cholecystectomy Natural orifice Endoscopicsurgery Meta-analyses

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transvaginal natural orifice transluminal endoscopic surgery:A novel gasless technique to hysterectomy

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第1期5卷 35-39页

作者： Suyash Naval Shubhada Jajoo Rucha Naval Jayashri Rane Naval Multi Speciality Hospital M.J.College RoadNear Bhaskar MarketJalgaon 425001India Department of Obstetrics and Gynecology Jawaharlal Nehru Medical CollegeWardha 442107India

transvaginal natural orifice transluminal endoscopic surgery(vNOTES),as a minimally invasive surgery technique,applies CO_(2) for creating pneumoperitoneum,and uses a closed system to through smoke evacuation from a dedicated outlet or *** has the potential to generate aerosol in the operation room,which can lead to an increased risk of transmission of *** technical note introduces a new technique of gasless pure vNOTES to hysterectomy using silicone face mask as a modified vNOTES port.

关键词： Hysterectomy Natural orifice transluminal endoscopic surgery transvaginal Gasless

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Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

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World Journal of Gastroenterology 2015年第47期21卷 13332-13338页

作者： Shu Zhang Zhi-Wei Jiang Gang Wang Xiao-Bo Feng Jiang Liu Jian Zhao Jie-Shou Li Department of General Surgery Jinling Hospital Medical School Nanjing University

AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer ***: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with ***: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3(range, 42-69) years, and the mean body mass index was 23.2(range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224(range, 200-298) min and 62.5(range, 50-150) m L, respectively. The mean postoperative hospital stay was 3.6(range, 3-5) d. The mean number of lymph nodes resected was 23.6(range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage ***: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients.

关键词： Gastric cancer Robotic surgery transvaginal Natural orifice specimen extraction

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Role of transvaginal contrast-enhanced ultrasound in the early diagnosis of endometrial carcinoma

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Chinese Medical Journal 2012年第3期125卷 416-421页

作者： Liu Ying Tian Jia-wei Xu Yi Cheng Wen Harbin Med Coll Dept Ultrasound Affiliated Hosp 2 Harbin 150086 Heilongjiang Peoples R China Harbin Med Coll Dept Ultrasound Affiliated Hosp 3 Harbin 150081 Heilongjiang Peoples R China

Background Endometrial carcinoma is one of the most common gynecological malignancies among *** diagnosis and correct preoperative evaluation of myometrial invasion are necessary to improve the *** study aimed to determine whether features and time-intensity curves （TIC） of transvaginal contrast-enhanced ultrasound （CEUS） differ from those of conventional ultrasound for endometrial carcinoma,and to further explore the clinical role of transvaginal CEUS in the early diagnosis of endometrial *** Forty women with a normal uterus and seventy-nine patients with endometrial carcinoma were examinedby the transvaginal CEUS with SonoVue （Bracco,Imaging B.V,Switzerland）.The enhancement patterns and TIC of lesions were *** results of CEUS were compared with those of conventional ultrasound and *** In the early and late enhanced stages,the intensity of enhancement of the normal endometrium was always lower than that in the myometrium,and the boundary between normal endometrium and myometrium was clear.A total of 65.8% （52/79） of lesions presented with inhomogeneous enhancement,34.2% （27/79） presented with homogeneous enhancement; 60.8% （48/79） presented with hyperechoic enhancement,27.8% （22/79） presented with isoechoic enhancement,and 11.4% （9/79） presented with hypoechoic *** average arrival time,time to peak,rise time,half-wash out time of lesions were shorter than of normal endometrium （P 〈0.05）.The average peak intensity,relative rise in intensity,half-wash out intensity of lesions were higher than of normal endometrium （P〈0.05）.There were 49 （must be and may be present） cases of endometrial carcinoma by ultrasound （US）; 24 cases were consistent with pathology results,16 cases were underestimated and 9 cases were *** were 72 （must be and may be present） cases of endometrial carcinoma by CEUS; 53 cases were consistent with pathology results,12 cases were underestimated and 7 cases were overe

关键词： endometrial carcinoma transvaginal contrast ultrasound diagnosis

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Comparison of Bishop score and cervical length measurement through transvaginal ultrasound as prediction against labor induction

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Asian pacific Journal of Reproduction 2018年第6期7卷 280-284页

作者： Finianty Raynelda Efendi Lukas Sriwijaya Qadar Maisuri T Chalid Department of Obstetrics and Gynecology Faculty of MedicineUniversity of HasanuddinMakassarIndonesia Wahidin Sudirohusodi Hospital MakassarIndonesia

Objective:To compare the Bishop score and cervical length measured by transvaginal ultrasound concerned with prediction over the success of labor ***:This cross-sectional observational analytical study was conducted from May 2017 to October 2017 at several teaching hospitals of Obstetrics and Gynecology Department, Faculty of Medicine Hasanuddin University of Makassar, India. There were 110 samples of pregnant women undergoing labor induction process including 79 samples of successful induction and 31 samples of induction failure. The data analysis used Pearson Chi-square test and multivariate logistic regression to see the effect of Bishop score and measurement of cervical length with successful induction of ***: Number of samples with successful labor induction with Bishop score 2.98 cm was 67 (84.8%), with rate ratio=3.124 andP=0.000. Multivahate analysis of logistic regression was found to be more influential in the predicted success of labor induction (P=0.014 with Bishop score transvaginal ultrasound.

关键词： Bishop score Cervical length Labor induction transvaginal ultrasound

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transvaginal Ultrasonographic Measurement of Lower Uterine Segment in Term Pregnant Patients with Previous Cesarean Section

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Open Journal of Obstetrics and Gynecology 2015年第11期5卷 646-653页

作者： Anitha Thomas Grace Rebekah Reeta Vijayaselvi Ruby Jose Christian Medical College Vellore India

Background: With an aim to reduce the rates of repeat cesarean section in women with a previous scar, prediction of scar rupture or dehiscence is important. If we could predict the risk of rupture by measuring the scar thickness closer to term, we could pursue a trial of scar safely. Aims: To evaluate the use of ultrasound measured thickness of lower uterine segment as one of the predictors of scar rupture or dehiscence in labour and establish a cut off beyond which trial of labour can be attempted safely. Methodology: 187 randomly selected pregnant women with history of one previous cesarean section in the past who satisfied the inclusion criteria, attending the outpatient clinic over a period of six months, at a tertiary level teaching institution in southern India were selected and counseled to undergo a transvaginal measurement of the scar region. These women were then followed up until delivery and the outcome of trial of scar, successful vaginal delivery, rupture or dehiscence of uterus was analysed in relation to the scar thickness and various other contributing factors. Results: 187 women with history of previous cesarean section, attending the outpatient clinic were randomly chosen to undergo trans vaginal scan at term. 52 underwent elective cesarean section and 135 went through trial of scar. The median cut-off of the lower uterine segment in this study population of 135 was 2.4 mm. The sensitivity was 90.9%, specificity was 43.5%, positive predictive value was 12.5%, and negative predictive value was 98.3% at this cut-off for scar rupture or dehiscence. Conclusions: The lower uterine scar thickness could be a useful tool to predict scar rupture. This could aid in making decisions regarding induction of labour with oxytocin in women with previous cesarean section.

关键词： TOLAC transvaginal Ultrasonography Scar Thickness

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transvaginal 3D Ultrasound Evaluation of Post-Cesarean Section Uterine Diverticulum

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 698-702页

作者： Cui-Lan Li Xue-Tang Mo Kai-Xuan Deng Dun-Jin Chen Xing-Cheng Gao Jin-Guo Zhai Yi-Ming Liao Hui-Ru Dai Xiang Cai The Third Affiliated Hospital of Guangzhou Medical University & Key Laboratory for Major Obstetric Diseases of Guangdong Province & Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes Guangzhou China Department of Computer Science Hong Kong Baptist University Hong Kong China

Objectives: This study focused on evaluating the value of transvaginal 3D ultrasound for the diagnosis and prognostic assessment of post-cesarean section uterine diverticulum. Materials and Methods: We retrospectively analyzed the data from 32 patients with post-cesarean section uterine diverticulum over three recent years. In all patients, transvaginal 3D ultrasound was used to measure the size of the uterine diverticulum and the thickness of the lower uterine segment (LUS) and myometrium. Patients with a LUS with a myometrial thickness under 4 mm underwent resection and repair surgery;those with a LUS with a myometrial thickness over 4 mm underwent hysteroscopic resection. The postoperative sonograms were compared with preoperative images to evaluate the efficacy of various treatments. Results: The mean length, width and depth of the uterine diverticula were 18.30 ± 2.80 mm, 9.14 ± 3.20 mm and 11.49 ± 2.71 mm, respectively. The average LUS myometrial thickness was 3.40 ± 0.80 mm (with a range of 1.6 mm - 6.3 mm). After surgery, two patients’ sonograms still showed diverticula at the post-cesarean section scar, measuring 6 mm × 7 mm × 6 mm and 6 mm × 8 mm × 4 mm. There were significant differences in the size of uterine diverticula between preoperative and postoperative sonograms (P transvaginal 3D ultrasound is an accurate method for detecting post-cesarean section uterine diverticulum and is helpful for assessing surgical options and prognosis. The LUS myometrial thickness, which is considered as an optional index of post-cesarean section uterine diverticulum, should be measured routinely.

关键词： Post-Cesarean Section Uterine Diverticulum transvaginal 3D Ultrasound LUS Myometrial Thickness

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A Comparative Observational Study of the Use transvaginal Ultrasound and Hysteroscopy for the Detection of Uterine Cavity Pathologies in Women with Abnormal Uterine Bleeding

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Open Journal of Obstetrics and Gynecology 2017年第5期7卷 511-519页

作者： Mervat Ali Mohamed Elsersy Department of Obstetrics & Gynecology Faculty of Medicine Alexandria University Alexandria Egypt

Background: 70% of all gynecological consultations are for abnormal uterine bleeding. Any approach to optimal management begins with an appropriate diagnosis. 40% of premenopausal women with abnormal uterine bleeding were found to have some intrauterine pathology. This study aims to compare the diagnostic value of transvaginal ultrasonography in comparison to hysteroscopy in detecting uterine abnormalities in patients with abnormal uterine bleeding. Methods: Retrospective observational cross sectional study of 250 women presented with abnormal uterine bleeding. The patients who fulfilled the selection criteria and have been sequentially investigated by transvaginal ultrasound (TVS) and hysteroscopy were included. Results: 90% of patients were from 35 - 49 yrs. 81.2% of patients have body mass index above 25 kg/m2. transvaginal ultrasound (TVS) compared well with high sensitivity as regards normal endometrium. (TVS) missed 4 patients of endometrial polyps and one patient of sub mucous fibroid. Three patients of adenomyosis were only diagnosed by (TVS);they were reported as being normal by hysteroscopy. Conclusion: (TVS) is considered as an excellent approach to the initial evaluation of uterine pathologies in patients with abnormal uterine bleeding.

关键词： transvaginal Ultrasound Hysteroscopy Abnormal Uterine Bleeding Cross Section Observational Study Endometrial Polyp

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Comparison of transvaginal Ultrasound, Saline Infusion Sonohysterography versus Diagnostic Hysteroscopy in Evaluation of Endometrial Cavity Pathology amongst Women with Abnormal Uterine Bleeding in Low Resource Setting

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Open Journal of Obstetrics and Gynecology 2020年第5期10卷 644-656页

作者： Jayni Dedhia Gichuhi J.Wanyoike Ojwang B.Shadrack Madadi M.Obimbo Rafique B.Parkar Elijah Kwasa Department of Obstetrics&Gynaecology University of NairobiNairobiKenya Department of Anatomy University of NairobiNairobiKenya Consultant Obstetrician&Gynecologist NairobiKenya Consultant Radiologist NairobiKenya

Introduction: Hysteroscopy is currently the gold-standard protocol for evaluating patients with abnormal uterine bleeding (AUB). Unfortunately, though accurate, its adoption in low-resource countries such as in Africa is limited due to lack of equipment and qualified personnel. As such, there is a need for an alternative diagnostic procedure that is as accurate as hysteroscopy, but also affordable, easy to administer, and acceptable by women with endometrial pathologies. transvaginal Sonography (TVS) and Saline Infusion Sonohysterography (SIS) are proposed. However, their diagnostic accuracy versus hysteroscopy has not been determined in low resource setting. Objective: To compare the diagnostic efficacy of TVS and SIS versus diagnostic hysteroscopy in evaluation of endometrial pathology among pre-menopausal and post-menopausal women and to determine the etiology of AUB amongst these women. Methodology: A prospective cohort study was done at a hospital in Nairobi, Kenya between May and September 2019. Forty patients with AUB were recruited using consecutive sampling, and women who consented were recruited. The etiology of AUB was recorded. All participants underwent TVS, SIS and Diagnostic Hysteroscopy (DH) evaluation in the first half of the menstrual cycle and the findings recorded on a patient’s information sheet. The sociodemographic and bleeding characteristics of patients and the outcomes of TVS, SIS, and DH evaluations were also recorded and the data was analysed using version 5 of the Software for Statistics and Data Science (STATA). Summary statistics on the etiology of AUB were presented and the sensitivity of TVS and SIS versus DH as the gold-standard evaluated using two by two tables and the ROC curve. Results: The mean age of participants was 38.1 ± 8.8 years, range of 25 - 71 years. Heavy Menstrual Bleeding (HMB) was reported in 70.0% of participants, while about 12.0%, 7.5%, and 7.5% had post-menopausal bleeding, amenorrhea, and hypomenorrhea. The inc

关键词： Abnormal Uterine Bleeding transvaginal Sonography Saline Infusion Sonohysterography Hysteroscopy

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A Patient with Tubo-Ovarian Abscess with Endometriosis after transvaginal Oocyte Retrieval

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 445-451页

作者： Tsutomu Muramoto Ryo Koike Department of Obstetrics and Gynecology Showa University Fujigaoka Hospital Yokohama Japan

Ultrasound-guided oocyte retrieval is a standard procedure for ovum pick up (OPU) during in vitro?fertilization. Possible complications include tubo-ovarian abscesses (TOAs) in the fallopian tubes, and endometriosis may be associated with increasing?the severity of pelvic infection. A 35-year-old?woman who had been treated for infertility and endometriosis presented with abdominal pain that appeared several days after OPU. There were no significant changes in the size of both ovaries and fallopian tubes. A week later, transvaginal echography revealed right oviduct enlargement. Because conservative treatment with antibiotics before this revelation had not been successful, laparoscopy was performed for abscess drainage and/or excision of the adnexa. Intraoperative findings were an abscess in the right adnexa involving the ovary and fallopian tube. Preservation of the right fallopian tube was difficult due to the risk of prolonged infection, and a right appendectomy was performed. The diagnosis was a right TOA. Severe cases of pelvic infection after OPU may cause infertility. The presence of endometriosis may aggravate the infection, but the relationship between the extent of the endometriosis and the severity of the infection is not known. Even if the endometriosis is mild, as it was in this patient, surgical treatment should be considered if a severe infection occurs after OPU and conservative treatment is not effective.

关键词： Tubo-Ovarian Abscess transvaginal Oocyte Retrieval Endometriosis

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