The role of oral oil administration in displaying the chylous tubes and preventing chylous leakage in laparoscopic para-aortic lymphadenectomy.

BACKGROUND AND OBJECTIVES: This study is aimed to investigate the possibility of preoperative oral oil administration in displaying the chylous tubes and preventing chylous leakage in laparoscopic para-aortic lymphadenectomy. MATERIALS AND METHODS: In this retrospective nonrandomized study, of the 30 patients with gynecological malignancies who had indications for laparoscopic para-aortic lymphadenectomy up to renal vessels, 15 were administered preoperative oral oil (oil a administration) (control group) at our hospital between September 2017 and June 2018. The chylous tube displaying rates, incidences of chylous leakage, and other perioperative data of the two groups were compared. RESULTS: Successful display of chylous tubes was observed in 93.3% (14/15) patients in the oil administration group. The chylous leakage was zero in the oil administration group, and 33.3% (5/15) in the control group. The postoperative drainage duration (4.1 ± 1.0 days vs 7.6 ± 1.4 days, P = 0.000), somatostatin application time (0 day vs 5.9 ± 0.8 days), and postoperative hospital stay (6.0 ± 2.3 days vs 9.1 ± 2.1 days, P = 0.001) were significantly shorter in the oil administration group. The total cost is lower in the oil administration group (4972.52 ± 80.54 dollars vs 6260.80 ± 484.47 dollars, P = 0.000). CONCLUSIONS: Preoperative oil administration is a feasible and effective method to display the chylous tubes and to prevent the chylous leakage in para-aortic lymphadenectomy.

Long-term treatment outcomes of transvaginal mesh surgery versus anterior-posterior colporrhaphy for pelvic organ prolapse.

BACKGROUND: In spite of rapid growth in the use of vaginally placed mesh in pelvic reconstructive surgery, there are few reports on the long-term efficacy and safety of mesh-augmented repairs. AIMS: To compare the long-term outcomes of modified pelvic floor reconstructive surgery with mesh (MPFR) versus traditional anterior-posterior colporrhaphy (APC) for the treatment of pelvic organ prolapse (POP). METHODS: This retrospective cohort study involved 158 women who underwent surgical management of prolapse with MPFR (n = 84) or APC (n = 74) in the period between January 2007 and June 2008. Main outcome measures included pelvic organ prolapse quantification measurement, Short Form-20 Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) questionnaires, perioperative outcomes, complications and a personal interview about urinary and sexual symptoms. Statistical analysis included comparison of means (Wilcoxon test or Student's t-test) and proportions (χ(2) test). RESULTS: Anatomical success rate for MPFR and APC was 88.1 versus 64.9% (P = 0.001), with a median follow-up of 55 versus 56 months (range 49-66 months, P = 0.341). Both operations significantly improved quality of life, and a greater improvement was seen in MPFR group than in APC group (P = 0.013). Complication rates did not differ significantly between the two groups. The mesh erosion rate was 3.6%. CONCLUSION: Modified pelvic floor reconstructive surgery with mesh had better anatomical and functional outcomes than APC at 4-5 years postoperation, as an alternative, cheap and effective treatment option to mesh kits for the management of POP.

[Regulatory effect of ligustrazine and Radix astragalus on RANTES and receptor CCR5 expression in the genesis and development process of endometriosis].

OBJECTIVE: To investigate the regulatory effect of ligustrazine and Radix Astragalus (Chinese drugs for supplementing qi and activating blood circulation) on uterine mucosa stromal cyto-chemotactic factor RANTES and receptor CCR5 expression. METHODS: The eutopic and ectopic endometrial stromal cells (EMSC) isolated and purified from 10 patients with ovarian endometrial cyst were selected as the experimental group, while those from 10 patients with benign lesion were selected as the control group. After they were intervened by different factors, including astragalus injection (AI), ligustrazine injection (LI), AI + LI, and Danazol, the expression levels of RANTES and CCR5 in the cells were detected by ELISA and RT-PCR. RESULTS: RANTES expressions in eutopic and ectopic EMSC were different insignificantly (P > 0.05). The ectopic EMSC RANTES expression was 13.602 +/- 3.358 ng/L and eutopic EMSC RANTES was 12.850 +/- 7.997 ng/L in the positive control group, which was significantly higher than that in the negative control group (both being 0.027 +/- 0.016 ng/L, P <0.05), and the ectopic EMSC expressions after intervened with Chinese drugs were significantly lower than that in the positive control group (P <0.05). CCR5 expression in ectopic EMSC was 0.759 +/- 0.039 ng/L, which was higher than that in eutopic EMSC (0.249 +/- 0.026 ng/L, P <0.05). Ectopic EMSC CCR5 expression was higher in the positive control group than that in the negative control group (0.759 +/- 0.039 ng/L vs 0.478 +/- 0.094 ng/L, P <0.05). Similar situation also was shown between the positive and negative control groups in terms of eutopic EMSC CCR5 expression (0.249 +/- 0.026 ng/L vs 0.131 +/- 0.021 ng/L, P < 0.01), and the expression was significantly lower in all the Chinese drugs treated EMSC groups as compared with that in the positive control group (P < 0.01). CONCLUSION: CCR5 expression was higher in ectopic EMSC than that in eutopic EMSC. Ligustrazine and Radix Astragalus could down-regulate the auto-secretion of RANTES and CCR5 in patients with endometriosis.