[Complications of tubal sterilization]. / Komplikationen der Tubensterilisation.

PIP: In Europe and the US, tubal sterilization by laparoscopy has become the most widely used technique for female sterilization. The overall rate of intra- and postoperative complications differs between 0.145% and 0.85% in the numerous studies which have been done. This means 1 severe complication in 120-700 laparoscopic sterilizations. The lethality of tubal sterilization by laparoscopy lies between 3-10 deaths/100,000 interventions. The so-called "post-tubal ligation syndrome" is a rare complication. The overall pregnancy rate after tubal sterilization is 3-10/1000 women. The rate of ectopic pregnancy is very high and varies between 13.6% and 90%. Only 5% of the sterilized women show dissatisfaction. Several factors are relevant with regard to psychological sequelae and must be considered before tubal sterilization can be performed. 1 of the most important is the individual comprehensive counselling of the female or the couple prior to the sterilization.^ieng

[Major gynecologic surgery in the geriatric patient]. / Grössere gynäkologische Operationen bei der geriatrischen Patientin.

A retrospective analysis of 256 important interventions in geriatric gynecologic patients (over 70 years of age) was carried out. There were 77 vaginal, 86 abdominal, 9 combined abdomino-vaginal and 82 breast operations. Minor (131) and major (31) complications are described in detail. Two postoperative deaths accounted for a mortality rate of 0.8% in these patients. It is emphasized, that on the premises of a thorough evaluation of the possible treatments, a modern anesthesiologic technique, a well devised operative strategy and the modern postoperative care we can nowadays justify extensive surgery even in the very old gynecologic patient.

[Perioperative prevention of thromboembolism in gynecology]. / Perioperative Thromboembolie-Prophylaxe in der Gynäkologie.

Operative or postoperative deep vein thrombosis (DVT) occurs in about 10-30% of the patients undergoing gynecologic surgery, depending on the kind of operation and the presence of predisposing risk factors. Fatal pulmonary embolism is the direct and most severe complication of DVT in 8% of all patients in the postoperative period. DVT commonly results in circulatory insufficiency and ulcers of the lower extremities. The goal of effective prevention of DVT is achieved only by the use of drugs like coumarin, dextran, low dose heparin or low dose heparin-DHE. The therapeutic value of these medicaments and their side effects will be presented and new developments shortly discussed.

[Diagnostic methods for the exploration of the female breast]. / Diagnostische Möglichkeiten zur Beurteilung der weiblichen Brust

The diagnostic methods for exploration of the female breast (self-examination, clinical examination, mammography, xero-radiography, thermography, open biopsy, and aspiration biopsy smears) are briefly discussed. Their advantages and disadvantages emerge in their application for the detection of breast disease.

[Clinical experiences with prostaglandin E 2 and F 2 alpha in the termination of pregnancy and labor induction in intrauterine fetal death]. / Klinische Erfahrungen mit Prostaglandin E2 und F2alpha zum Schwangerschaftsabbruch und zur Weheneinleitung bei intrauterinem Fruchttod.

In 34 cases of therapeutic termination of pregnancy in the second trimester and in 26 cases of fetal death in utero up to the 43rd week of pregnancy, expulsion of the uterine contents was achieved by means of transabdominal-intraamniotic and intravenous administration of prostaglandin (PG) E2 and PGF2lalpha. The average expulsion time was 14 1/2-16h. The following respective doses were needed: for intraamniotic use, 5-25 mg PGE2 and 40-120 mg PGF2alpha, and for intravenous use 5.8-7.3 mg PGE2 and 43.3-52.3 mg PGF2alpha. Two patients required treatment for side effects. These results are compared with existing data from the literature and the clinical application of various prostaglandins is discussed.

[Results of treatment of 177 stage Ib and IIa cervix cancers at the Zurich University Gynecologic Clinic]. / Behandlungsresultate von 177 Carcinoma colli uteri Stadium Ib und IIa an der Universitäts-Frauenklinik Zürich.

Between 1971 and 1980, 177 patients were treated for a carcinoma of the uterine cervix (145 stage Ib, 32 stage IIa) in the Department of Gynecology and Obstetrics at the University Hospital Zürich, Switzerland. There were 115 patients who underwent radical hysterectomy combined with pelvic lymphadenectomy. Of these, 91 also received radiotherapy. Surgery could not be performed on 62 patients due to internal medical problems and risks presented by anaesthesia. They were treated solely by combined radiotherapy. Of the 177 patients, 79.5% had a squamous-cell carcinoma, 14.8% an adenocarcinoma and the other 5.7% rare types of carcinomas. Of the 115 patients who were operated, metastases of pelvic lymph nodes were found in 13% and an infiltrative carcinoma of the parametrium in 8.7%. The most severe complications we had were uretero- or vesicovaginal fistulas (5.2% of all operated patients). No significant statistical difference was found in the results of the three methods of treatment. The 5-year survival rate in stage Ib was between 61 and 81% (non corrected) and between 75 and 85% (corrected). In stage IIa, there were not enough patients for valid statistical conclusions to be drawn.