Comparison of Laparoscopic Myomectomy with and without Uterine Artery Occlusion in Treatment of Symptomatic Multiple Myomas.

OBJECTIVE: Uterine artery occlusion (UAO) is a minimally invasive approach often used to treat symptomatic uterine myomas. This study aimed to compare the clinical effects of laparoscopic UAO (LUAO) in combination with laparoscopic myomectomy (LM) with LM alone to treat symptomatic multiple uterine myomas. METHODS: This was a prospective observational study. In total, 122 patients with symptomatic multiple uterine myomas underwent LUAO + LM or LM alone between April 2015 and October 2017. The surgical procedure time, blood loss, highest postoperative temperature, hospital length of stay, number of removed myomas, surgical complications, and recurrence rate of the two groups were compared. RESULTS: Mean blood loss was significantly lower in the LUAO + LM group compared with the LM group (177.97 ± 104.09 mL vs 258.10 ± 119.55 mL, p < 0.05). No significant difference in surgical procedure time, hospital length of stay, highest postoperative temperature, and surgical complications was found between the LUAO + LM group and LM group. The number of removed myomas was considerably higher in the LUAO + LM group than in the LM group (4[4-7] vs 3[3-5], p < 0.05). The recurrence rate in the LUAO + LM group was considerably lower than that in the LM group (6.2% vs 25.9%). CONCLUSION: LUAO in combination with LM was associated with higher surgical quality and lower recurrence of myomas compared with LM alone. LUAO in combination with LM is recommended for women with symptomatic multiple uterine myomas who wish to retain their uteruses.

[Antitumor effects of photodynamic tumor cell lysates on rat epithelial ovarian cancer in vivo].

OBJECTIVE: To study the antitumor effects of photodynamic therapy (PDT) treated by ovarian cancer cell lysates in rat epithelial ovarian cancer in vivo. METHODS: Female Fischer344 rats of 6 - 8 weeks were allocated to four groups (n = 8 each): PDT group (inoculated intraperitoneal with PDT tumor cell lysates), freeze/thaw group (inoculated intraperitonealy with freeze-thaw tumor cell lysates), normal saline group (inoculated intraperitoneal with normal saline) and control group. Rat epithelial ovarian cancer NuTu19 cells were injected into all rats by intraperitoneal at day 7, while injected with normal saline in control group. The number of tumor specific interferon-gamma (IFN-gamma) secreting splenocytes was quantified by enzyme linked immunospot (ELISPOT) assay, the cytotoxic T lymphocyte (CTL) activity of splenocytes was measured by lactate dehydrogenase (LDH) analysis and tumor growth and the survival time of rats were also observed. RESULTS: Stimulated by PDT tumor cell lysates, the number of tumor specific IFN-gamma secreting splenocytes in PDT group, freeze/thaw group, normal saline group and control group were 448.8 +/- 34.2, 211.2 +/- 47.9, 43.3 +/- 11.1, 16.1 +/- 2.4 respectively, which were significant differences among of them (P < 0.05). Stimulated by freeze/thaw tumor cell lysates, the number of tumor specific IFN-gamma secreting splenocytes in four groups were 151.7 +/- 22.6, 188.7 +/- 53.0, 18.2 +/- 12.2, 8.8 +/- 7.7 respectively, which were not significant differences among of them (P > 0.05). Cytotoxicity of splenocytes of PDT group increased significantly than that in other three groups (P < 0.05). Except rats in control group were all alive until the experiment ended, the mean survival time of other rats were 234 d in PDT group, 171 d in freeze/thaw group and 168 d in normal saline group, which in PDT group was significantly higher than those in freeze/thaw group and normal saline group (P < 0.05). CONCLUSIONS: Rats treated by PDT tumor cell lysates could produce antitumor effects in vivo, which shown that induce tumor-specific immune response and prolong the life span.

[Comparison of clinical characteristics of extraovarian peritoneal serous papillary carcinoma with papillary serous ovarian carcinoma].

OBJECTIVE: To study the differences of clinical characteristics between patients with extraovarian peritoneal serous papillary carcinoma (EPSPC) and those with papillary serous ovarian carcinoma (PSOC). METHODS: Fourteen patients with EPSPC and 50 patients with PSOC who were admitted to Peking Union Medical College Hospital from 1984 to 2002 were retrospectively analyzed, and their clinical features, chemosensitivities and survival rate were compared. RESULTS: Patients with EPSPC were significantly older than those with PSOC (mean age 62.7 years versus 53.6 years, P < 0.01). The chemo-resistant rate (83%) in EPSPC was significantly higher than that (38%) of the PSOC (P < 0.05). The 1-, 2-, and 3-year survival rates (72%, 10%, 0%) in the EPSPC were significantly lower than those (95%, 79%, 62%) of the PSOC (P < 0.05). CONCLUSION: EPSPC are likely to occur in older women, have higher chemo-resistance and poorer prognosis compared with PSOC.