[Total laparoscopic hysterectomy--indications and complications of 158 patients]. / Calkowite laparoskopowe wyciecie macicy--wskazania i powiklania u 158 pacjentek.

INTRODUCTION: Hysterectomy is one of the most common gynecological procedures. Development of modern laparoscopic techniques made it a crucial tool in contemporary gynecology both in diagnosis and treatment. Increasing experience and improved laparoscopic instruments enabled gynecologists to extend indications for laparoscopic procedures as well as the range of the operation itself. AIMS: 1) to present data (particularly perioperative) of patients who underwent laparoscopic hysterectomy 2) to analyze various information including: indication for the procedure, surgery duration, evaluation of different parameters like: volume of the excised uterus, postoperative HB and HCT drop, length of hospital stay as well as short- and long-term complications. MATERIAL AND METHODS: The analysis included peri- and postoperative data of 158 patients who underwent laparoscopic hysterectomy. Indication for hysterectomy and duration of operation were analyzed. Uterine volume, postoperative HB and HCT drop, time of hospital stay and complications were evaluated. In the study a description of the method of laparoscopic hysterectomy was presented. RESULTS: Mean time of procedure was 68 min. (58-135 min.). Basing on operational protocols, the time of operation was measured from the moment laparoscopy started until the patient was fully awake after anesthesia. No adjustments were made for longer anesthetic recovery period. Estimated blood loss was 166.6 ml. Mean HB drop was 1.29 g/dl (0, 1-3 g/dl). Mean volume of the excised uterus was 108.24 cm3 (25.27-440.86 cm3). In 44 patients (27.84%) bilateral salpingo-oophorectomy was performed. In 4 cases (2.53%) there was an indication for postoperative antibiotics. None of the patients required blood transfusion or conversion to open surgery or the need to re-operate. Mean hospital stay after the surgery was 2.9 days. Overall, only 2 patients suffered long-term complications (1.26%): three weeks after the surgery urethro-vaginal fistulas occurred due to thermal injury to the ureter. That complication was noted during the first year of using this technique. Between 2008 and 2011 that type of adverse effect was not reported. CONCLUSIONS: The analysis included perioperative and postoperative data of 158 patients who underwent laparoscopic hysterectomy. Data suggest that patients benefit from this procedure which is safe, associated with short postoperative recovery time, minimal blood loss and low complication rate, as well as good plastic result. We recommend laparoscopic hysterectomy as an alternative to open hysterectomy in cases when it can be safely performed.

Changes in the Mineral Composition of Rat Tissues Induced by Breast Cancer and Dietary Supplementation.

BACKGROUND/AIM: The aim of the study was to determine the effect of various diets with zinc or zinc in combination with resveratrol or genistein on mineral contents of the serum, urine, liver, kidney and heart in rats with chemically-induced mammary carcinoma. MATERIALS AND METHODS: The manuscript presents the tissues and body fluids content of iron, calcium, zinc, magnesium and copper in control rats or rats treated with 7,12-dimethyl-1,2-benz[a]anthracene to induce mammary carcinogenesis, under four dietary conditions: standard feed, Zn supplemented feed (6.9 mg Zn/ml), Zn and resveratrol (0.2 mg/kg body) supplemented feed, or Zn and genistein (0.2 mg/kg body) supplemented feed. RESULTS: The content of calcium and copper highly varied depending on the tissue and the type of dietary supplement (no change for zinc and magnesium). Irrespective of the diet used, the chemical induction of mammary cancer caused a decrease in iron concentration in most samples analysed. Only supplementation of the rats' diet with zinc and genistein induced no changes in iron distribution in the serum, urine, liver, kidney and heart. CONCLUSION: Further research using various levels of zinc and genistein in the diet should be conducted to determine how the development and progression of cancer is linked to iron content in cells and its ability to accumulate in tumour tissue.

The effect of zinc and phytoestrogen supplementation on the changes in mineral content of the femur of rats with chemically induced mammary carcinogenesis.

The aim of this study was to assess skeletal effects of zinc or zinc with phytoestrogen (resveratrol or genistein) supplementation in an animal model of rats with DMBA-induced mammary carcinogenesis. The changes in bone parameters such as the length and mass were examined, as well as the changes in concentrations of selected minerals: calcium, magnesium, zinc, iron and phosphorus. Moreover, the investigations focused on finding the differences between the levels of iron and zinc in other tissues: the liver, spleen and serum of the examined rats. Fifty-six female Sprague-Dawley rats, 40 days old, were divided into four groups, regardless of the diets: standard (77mg Zn kg/food), zinc (4.6mg/mL via gavage), zinc (4.6mg/mL) plus resveratrol (0.2mg/kgbw), and zinc (4.6mg/mL) plus genistein (0.2mg/kgbw) for a period from 40 days until 20 weeks of age. The study rats were also treated with 7,12-dimethyl-1,2-benz[a]anthracene (DMBA) to induce mammary carcinogenesis. The applied diet and the advanced mammary cancer did not affect macrometric parameters of the rats' bones, but they strongly affected their mineral content. It was found that mammary cancer, irrespectively of the applied diet, significantly modified the iron level in the femur, liver, spleen and serum of the examined rats. In addition, zinc supplementation significantly lowered the levels of calcium, magnesium and phosphorus in the femur of rats with mammary cancer as compared with respective levels in the control group. So, it was found that additional supplementation with zinc, which is generally considered to be an antioxidant, with the co-existing mammary carcinoma, increased the unfavorable changes as concerns the stability of bone tissue. The appropriate combination of zinc and phytoestrogens (resveratrol or genistein) could help prevent or slow bone loss associated with a range of skeletal disorders in breast cancer.

Copper and resveratrol attenuates serum catalase, glutathione peroxidase, and element values in rats with DMBA-induced mammary carcinogenesis.

In this paper, a hypothesis was assessed whether or not the intoxication with copper and supplementation with copper plus resveratrol would result in changes in the activities of catalase and glutathione peroxidase and moreover if the characteristic changes would appear in concentrations of copper, iron, calcium, magnesium, and zinc in the serum of rats with chemically induced carcinogenesis. Female Sprague-Dawley rats were divided into study groups which, apart from the standard diet, were treated with copper (42.6 mg Cu/kg food as CuSO4·5H2O) or copper plus resveratrol (0.2 mg/kg body) via gavage for a period from 40 days until 20 weeks of age. In cancer groups, the rats were treated with a dose of 80 mg/body weight of 7,12-dimethyl-1,2-benz[a]anthracene (DMBA) given in rapeseed oil at 50 and 80 days of age to induce mammary carcinogenesis. The control groups included the rats kept in the same conditions and fed with the same diet as the animals from the study groups, but not DMBA-treated. The activity of catalase significantly decreased in groups of rats with mammary carcinogenesis that were supplemented with copper (p < 0.05) or copper plus resveratrol (p < 0.001) in comparison with the control groups that received the same diets. In cancer groups of nonsupplemented rats, the increase of glutathione peroxidase activity was observed. The process of carcinogenesis and the applied supplementation significantly altered the concentrations of trace elements in serum, in particular as concerns iron and copper. The mean serum iron levels in rats with breast cancer were significantly lower than those in the control groups (p < 0.001). The mean serum copper levels significantly decreased in the groups of rats with mammary carcinogenesis that were supplemented with copper or copper plus resveratrol in comparison with the control groups that received the same diets (p < 0.001). The characteristic changes in iron content and the zinc/copper and zinc/iron ratios in blood may be used as one of the prognostic factors in breast cancer research.