[Contraceptive methods after gynecological and breast cancer]. / Contraception après cancer gynécologique et mammaire.

With earlier diagnosis and more effective treatments, more and more women are receiving fertility-preserving cancer therapy. Approximately 10% of breast and gynecological cancers occur in women under 40, and more than 5 000 French women under 45 develop breast cancer each year. While hormonal contraception is contra-indicated for women with a history of breast or endometrial cancer, it seems to have a protective effective in ovarian cancer. Although pregnancy is not contra-indicated after cancer, it must be planned in a timely manner, meaning that appropriate contraception is necessary in the meantime.

Salpingectomy for ectopic pregnancy by transumbilical single-site laparoscopy with the SILS system.

OBJECTIVE: To evaluate the feasibility in everyday practice and the advantages of salpingectomy for ectopic pregnancy by single-incision laparoscopic surgery with the SILS system. STUDY DESIGN: This single-center prospective observational study included 37 women requiring salpingectomy for ectopic pregnancy who underwent single-incision laparoscopic salpingectomy with the SILS system. Information about feasibility and intra- and post-operative data were collected. The data for these patients were compared with those of a control group of 40 women treated by standard laparoscopy. RESULTS: Thirty-six (97%) patients were treated successfully with the SILS system. After laparoscopic confirmation of the ectopic pregnancy, salpingectomy was performed with bipolar forceps and scissors. In one case, conversion to classic laparoscopy was performed because SILS was not feasible. Compared with the control group, operative time was longer (50 ± 35 vs 35 ± 30 min, p=0.001) but duration of hospitalization shorter with single-site laparoscopy (1.5 ± 1.5 vs 2.3 ± 1.5 days, p=0.02). CONCLUSIONS: Laparoscopic salpingectomy for ectopic pregnancy appears to be feasible in everyday practice by single-incision laparoscopic surgery with the SILS system and appears to reduce the duration of hospitalization. Larger series are necessary to confirm this conclusion.

Cornual resection for interstitial pregnancy by laparoendoscopic single-site surgery.

OBJECTIVE: To present two cases of interstitial pregnancy treated successfully by use of laparoendoscopic single-site surgery (LESS). DESIGN: Case series. SETTING: Department of obstetrics and gynecology at a tertiary health care facility. PATIENT(S): Two women with interstitial pregnancy requiring surgical treatment. INTERVENTION(S): Laparoscopy by use of LESS with the single-incision laparoscopic surgery (SILS) system. MAIN OUTCOME MEASURE(S): Feasibility of LESS with the SILS system. RESULT(S): Two patients were treated successfully by use of LESS with the SILS system. After laparoscopic confirmation of the interstitial pregnancy, a cornual resection was performed with bipolar forceps and scissors for the first patient and with an automatic stapler for the second. CONCLUSION(S): Laparoscopic treatment of interstitial pregnancy by use of LESS seems feasible. Larger series are necessary to confirm these findings.