[Laparoscopic sterilization]. / Laparoskopisk sterilisation

PIP: 44 women, 24-43 years of age, underwent laparoscopic sterilization. 16 has only sterilization, 24 had sterilization in conjunction with abortion performed by vacuum aspiration, and 4 were performed in the puerperium. Biopsies of the coagulated Fallopian tubes were discontined because definite histological determination of coagulation was impossible; thereafter, each tube was coagulated in 2 places. Care had to be taken with the patients in the puerperium because of the enlarged uterus. The women had had an average of 4.2 pregnancies. The entire operation lasted approximately 20 minutes and the average hospitalization length was 5.2 days. 82% of the patients later underwent hysterosalpingography (HSG). The sterilization was not complete with 1 patient. There were no complications of the laparoscopy, but 2 complications of the abortions. 4 patients who showed open Fallopian tubes 10 weeks after the operation showed clased tubes 14-32 weeks later; the HSG should be taken at least 12 weeks after the laparoscopy.^ieng

Invasive cancer in the vulvar region.

During the past 25 years there has been a tenfold increase in the incidence of vulvar cancer in Denmark. For this reason a material of 195 patients treated during the period 1960-77 is reviewed. There had been a considerable delay in treatment, due partly to the patients and partly to the doctor first seen. The five-year survival rate was 63.3%, corrected 84.2%. The prognosis is highly influenced by the size of the tumor, its appearance, the presence of unilateral or bilateral metastasization to the inguinal nodes, the histological type, and localization of the tumor. On the basis of these features, it is possible to single out groups having a particularly poor prognosis in whom the surgical treatment is insufficient and ought to be supplemented. Clinical assessment of the inguinal lymph nodes carries a considerable uncertainty, yet the FIGO staging is based mainly upon this assessment. This goes some way towards explaining why no prognostic differences were found between stages I, II, and III. Postoperative staging based upon the histological diagnosis would provide greater prognostic certainty.