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Single Port Transumbilical Laparoscopic Surgery versus Conventional Laparoscopic Surgery for Benign Adnexal Masses： A Retrospective Study of Feasibility and Safety

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Chinese Medical Journal 2016年第11期129卷 1305-1310页

作者： Si-Yun Wang Ling Yin Xiao-Ming Guan Bing-Bing Xiao Yan Zhang Amanda Delgado Department of Obstetrics and gynecology Peking University First Hospital Beijing 100034 China Department of Obstetrics and gynecology Baylor College of Medicine Houston Texas 77030 USA

Background： Single port laparoscopic surgery （SPLS） is an innovative approach that is rapidly gaining recognition worldwide. The aim of this study was to determine the feasibility and safety of SPLS compared to conventional laparoscopic surgery for the treatment of benign adnexal masses. Methods： In total, 99 patients who underwent SPLS for benign adnexal masses between December 2013 and March 2015 were compared to a nonrandomized control group comprising 104 conventional laparoscopic adnexal surgeries that were performed during the same period. We retrospectively analyzed multiple clinical characteristics and operative outcomes of all the patients, including age, body mass index, size and pathological type of ovarian mass, operative time, estimated blood loss （EBL）, duration of postoperative hospital stay, etc. Results： No significant difference was observed between the the pathological results between the two groups were found to two groups regarding preoperative baseline characteristics. However, be slightly different. The most common pathological type in the SPLS group was mature cystic teratoma, whereas endometrioma was more commonly seen in the control group. Otherwise, the two groups had comparable surgical outcomes, including the median operation time （51 min vs. 52 min, P = 0.909）, the median decreased level of hemoglobin from preoperation to postoperation day 3 （10 g/L vs. 10 g/L, P = 0.795）, and the median duration of postoperative hospital stay （3 days vs. 3 days, P = 0.168）. In SPLS groups, the median EBL and the anal exsufftation time were significantly less than those of the conventional group （5 ml vs. 10 ml, P〈 0.001; 10 h vs. 22 h, P〈 0.001）. Conclusions： SPLS is a feasible and safe approach for the treatment of benign adnexal masses. Further study is required to better determine whether SPLS has significant benefits compared to conventional techniques.

关键词： Benign Adnexal Masses Single Port Laparoscopic Surgery Surgical Outcomes

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Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

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Frontiers of Medicine 2010年第1期4卷 112-116页

作者： Zhou-Fang XIONG Wei-Hong DONG Ze-Hua WANG Department of Obstetrics and gynecology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

We conducted a trial to assess the inﬂuence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-inal cross *** randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June ***-two patients were allocated to the“closure”group and 76 patients to the“nonclosure”*** showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration,reduce antibiotics requirement,increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat(Poperative complications,bowel function restoration and post-operative stay between the two groups(P>0.05).Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immedi-ate postoperative beneﬁts while unnecessarily lengthening surgical time and anesthesia *** practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.

关键词： cervical cancer radical surgery peritoneum subcutaneous tissue

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Superiority of indocyanine green-enhanced near-infrared fluorescence-guided imaging for laparoscopic lymph node dissection in patients with early-stage endometrial cancer: A retrospective cohort study

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Laparoscopic, Endoscopic and Robotic Surgery 2023年第3期6卷 103-108页

作者： Wenzhi Xu Jianqiong Li Saihua Chen Jiaren Zhang Xueyuan Chen Jianhua Yang Department of Obstetrics and gynecology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province Zhejiang University School of MedicineHangzhou 310016China Department of Obstetrics and gynecology Tiantai People's HospitalTaizhou 317200China Department of Obstetrics and gynecology Traditional Chinese Medical Hospital of YongkangYongkang 321300China

Objective:Laparoscopic pelvic lymph node dissection(LPND),which is an effective therapy for endometrial cancer,is challenging because of the complexity of the procedure and the occurrence of postoperative *** study aimed to explore whether indocyanine green(ICG)-enhanced nearinfrared(NIR)fluorescence-guided LPND is superior to LPND in the context of early-stage endometrial ***:In this retrospective study,we included the medical records of 190 patients with early-stage endometrioid adenocarcinoma who underwent LPND at the Department of Obstetrics and gynecology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine between January 2019 and January *** on whether ICG-enhanced NIR fluorescence guidance was used,the patients were assigned to the ICG group or non-ICG *** were followed-up for one year after *** on demographic characteristics,pathological results,operative outcomes,and complications were collected and ***:The baseline characteristics were comparable between the ICG group and non-ICG group,including age,BMI,pregnancy history,and preoperative *** surgical outcomes,the patients in ICG group had significantly lower intraoperative blood loss(50 mL vs.120 mL,poperative pelvic drainage time(4.14±1.44 d vs.5.70±1.89 d,p¼0.001),shorter duration of hospital stay(5.26±1.41 d vs.7.37±1.85 d,p¼0.003),higher number of positive pelvic lymph nodes(PLNs)(1 vs.0,p¼0.003),and more PLN-positive cases(16.0%vs.3.6%,p¼0.003)than the patients in non-ICG ***,no significant differences were noted in blood transfusion requirement,operative time,hemoglobin level decreases,number of PLNs harvested,or the presence of lymphocysts between the two ***:Our study showed that ICG-enhanced NIR fluorescence-guided operation may improve the accuracy and safety of LPND.

关键词： Endometrial cancer Laparoscopic surgery Lymphadenectomy Indocyanine green Near-infrared fluorescence

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Laparoscopic sigmoid vaginoplasty in women withMayer-Rokitansky-Kuster-Hauser syndrome

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Frontiers of Medicine 2009年第3期3卷 347-351页

作者： Yi SHEN Guobin WANG Zhoufang XIONG Kaixiong TAO Zehua WANG Department of Obstetrics and gynecology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

The feasibility and clinical therapeutic effects of laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome(MRKHs)were *** records of 11 MRKHs patients who underwent laparoscopic sigmoid vaginoplasty from 2003 to 2005 were reviewed,and long-term results were evaluated by *** mean operating time was 234 min(range,130–300 min),the mean hospital stay was 9.4 days(range,7–15 days),and the mean hemoglobin drop was 1.91 g/dL(range,1.6–3.2 g/dL).A functional neovagina was created measuring 11 to 14 cm in length and twoﬁngers in breadth in all *** introitus stenosis was *** intra-operative or postoperative bowel complication *** the 3rd postoperative month,theﬁrst intercourse *** patient was lost to *** had no intercourse and was required to wear vaginal mold *** of the other nine women(100%)complained of local irritation or *** were satisﬁed with their sexual *** cosmetic results were *** laparoscopic sigmoid vaginoplasty realizes to make a functional *** main advantage is its minimal *** is an ideal procedure for MRKHs patients.

关键词： Mayer-Rokitansky-Kuster-Hauser syndrome laparoscopy sigmoid transplantation vaginoagenesis

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Using laparoscopy and hysteroscopy to treat cesarean scar defects:A systematic review and meta-analysis

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Laparoscopic, Endoscopic and Robotic Surgery 2020年第4期3卷 116-119页

作者： Jingjing Feng Qijin Zhao Hedan Wang Wen Lv Department of gynecology Tongde Hospital of Zhejiang ProvinceZhejiang Chinese Medicine UniversityHangzhou 310012China

Objective:Rising cesarean section rates have led to an increase in cesarean scar ***,there is no consensus regarding the gold standard for treating cesarean scar *** study aims to compare the efficacy of laparoscopy combined with hysteroscopy and hysteroscopy in treating cesarean scar ***:An electronic search of the MEDLINE,EMBASE,and Clinical *** databases was conducted in May 2020,utilizing combinations of relevant medical subject headings for“cesarean scar defect”,“laparoscope”,and“hysteroscope”.Reference lists of relevant articles and reviews were hand-searched for additional *** outcomes included menstruation after surgery,blood loss,operative time,and further ***:Eight studies with 467 patients were *** menstruation duration after surgery for the laparoscopy combined with hysteroscopy group and hysteroscopy group was *** the laparoscopy combined with hysteroscopy group trended to have less blood loss(mean difference 49.60,95%CI:42.12e57.09,poperative time(mean difference 60.40,95%CI:53.33e67.48,p<0.05)compared to hysteroscopy *** 26 out of 51 patients were able to achieve pregnancy for those choosing the laparoscopy combined with ***:Patients with cesarean scar defect should choose the appropriate technique considering their age,residual myometrial thickness,desire for further fertility,and gynecological *** current study lacked evidence to prove that laparoscopy combined with hysteroscopy is superior to hysteroscopy.

关键词： Laparoscopy Hysteroscopy Cesarean scar defect

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Induction of total laparoscopic hysterectomy adopted the marionette technique in peri-menopausal and post-menopausal CIN3 patients

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第1期5卷 15-18页

作者： Tomonori Nagai Kousuke Shigematsu Yuichiro Kizaki Yoshiko Kurose Koki Samejima Takahiro Uotani Taichi Akahori Shigetaka Matsunaga Yasushi Takai Department of Obstetrics and gynecology Saitama Medical CenterSaitama Medical UniversitySaitama350-8550Japan

Objective:When performing cervical conization in post-menopausal cervical intraepithelial neoplasia 3(CIN3)patients,the positive rate of endocervical cone margin and the incidence of postoperative cervical stenosis *** study summarized a 4-year experience of total laparoscopic hysterectomy as a treatment option for peri-menopausal and post-menopausal CIN3 patients at a single ***,it shared the refinement strategies used during the ***:This study retrospectively analyzed the medical records of CIN3 patient aged45 years and who underwent open or laparoscopic hysterectomy at our institution from January 1,2017 to December 31,***,30 CIN3 patients were enrolled and divided into abdominal hysterectomy group and laparoscopic hysterectomy based on surgery method,with 5 patients and 25 patients ***:Compared to the abdominal hysterectomy group,the perioperative blood loss(20 mL vs.220 mL,p=0.004)was less and the duration of in-hospital stay(7 d vs.11 d,poperative time(154.4±27.8 min vs.161.0±62.4 min,p=0.826)were observed between *** conization was performed in advance for 12 patients,and among them,10(83.3%)patients had positive endocervical cone *** intestinal obstructionwas noted in one abdominal hysterectomy patient,no other complications were observed in the remaining ***:Compared to conization,hysterectomy is more invasive;however,it is an acceptable treatment option for peri-menopausal and post-menopausal CIN3 *** such cases,opting for total laparoscopic hysterectomy adopted the marionette technique might be preferable because the procedure is less invasive.

关键词： Cervical intraepithelialneoplasia Cervical stenosis Total laparoscopic hysterectomy

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Feasibility and safety of vaginal myomectomy:analysis of 90 cases

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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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Neoadjuvant chemotherapy and cytoreductive surgery in epithelial ovarian cancer

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World Journal of Obstetrics and gynecology 2013年第4期2卷 153-166页

作者： Siriwan Tangjitgamol Jitti Hanprasertpong Marta Cubelli Claudio Zamagni Gynecologic Oncology unit Departmentof Obstetrics and Gynecology Faculty of Medicine Vajira HospitalUniversity of Bangkok Metropolis Bangkok 10300 Thailand Division of Gynecologic Oncology Department of Obstetrics and Gynecology Faculty of Medicine Prince of Songkla University Hat Yai Songkhla 90110 Thailand Medical Oncology unit Addarii Institute of Oncology Policlinico S. Orsola-Malpighi University Hospital 40100 Bologna Italy

Ovarian cancer is one of the leading causes of death among gynecological cancers. This is because the majority of patients present with advanced stage disease. Primary debulking surgery(PDS) followed by adjuvant chemotherapy is still a mainstay of treatment. An optimal surgery, which is currently defined by leaving no gross residual tumor, is the goal of PDS. The extent of disease as well as the operative setting, including the surgeon's skill, infl uences the likelihood of successful debulking. With extensive disease and a poor chance of optimal surgery or high morbidity anticipated, neoadjuvant chemotherapy(NACT) prior to primary surgery is an option. Secondary surgery after induction chemotherapy is termed interval debulking surgery(IDS). Delayed PDS or IDS is offered to patients who show some clinical response and are without progressive disease. NACT or IDS has become more established in clinical practice and there are numerous publications regarding its advantages and disadvantages. However, data on survival are limited and inconsistent. Only one large randomized trial could demonstrate that NACT was not inferior to PDS while the few randomized trials on IDS had inconsistent results. Without a defi nite benefi t of NACT prior to surgery over PDS, one must carefully weigh the chances of safe and successful PDS against the morbidity and risks of suboptimal surgery. Appropriate selection of a patient to undergo PDS followed by chemotherapy or, preferably, to have NACT prior to surgery is very important. Some clinical characteristics from physical examination, serum tumor markers and/or fi ndings from imaging studies may be predictive of resectability. However, no specific features have been consistently identifi ed in the literature. This article will address the clinical data on prediction of surgical outcomes, the role of NACT, and the role of IDS.

关键词： Advanced stage ovarian cancer Neoadjuvant chemotherapy Interval debulking surgery

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Natural orifice transluminal endoscopic surgery in gynecology:What do we know till now?

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gynecology and Obstetrics Clinical Medicine 2021年第2期1卷 62-67页

作者： Graziella Moufawad Obey Albaini Stephanie Farah Karl Jallad Department of Obstetrics and gynecology Lebanese American University Medical CenterBeirutLebanon Department of Clinical Research Lebanese American University Medical CenterBeirutLebanon Obstetrics and gynecology and Surgery Gilbert and Rose-Marie Chagoury School of MedicineLebanese American University Medical CenterBeirutLebanon

Surgical advancements are focusing currently on minimally invasive techniques,the latest of which is natural orifice transluminal endoscopic *** this approach is feasible through different natural orifices,the vaginal approach is the one which gained attention the most,given the vaginal flexibility and the ability to access pelvic and abdominal *** to gynecologists,general surgeons were precedents for using the vaginal orifice as a port of surgical ***,this vaginal approach is being more frequently implemented during gynecological surgeries *** of natural orifice transluminal endoscopic surgery include scarless surgery,better exposure,reduced pain scores,less peri-operative complications,shorter hospital stay and improved patient *** article provides an idea on the application of vaginal natural orifice transluminal endoscopic surgery in gynecology along with future potentials.

关键词： orifice surgery organs

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HALF-CUTTING METHOD during Hysterectomy for Large Uterine Cervical Myoma

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Open Journal of Obstetrics and gynecology 2021年第9期11卷 1196-1201页

作者： Yosuke Fukui Yuki Yamada Seiji Mabuchi Department of Obstetrics and gynecology Nara Medical University Kashihara Japan Department of gynecology Osaka International Cancer Institute Osaka Japan

Hysterectomy for large uterine cervical myoma is a challenging surgical procedure due to the limited operative field for lateral and posterior dissections. Existing procedures such as performing myomectomy before hysterectomy or performing retrograde hysterectomy remain suboptimal in expanding the operative field, especially in cases with a huge cervical myoma. In this report, we introduce a new procedure, the “HALF-CUTTING METHOD” which can be used to obtain an adequate surgical field during hysterectomy.

关键词： HALF-CUTTING METHOD Cervical Myoma Hysterectomy Surgical Field

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