[Diagnostic micro-laparoscopy in gynecology]. / Mikrolaparoskopia diagnostyczna w ginekologii.

Diagnostic microlaparoscopy was performed on 30 patients aged 17-41. Indications++ for these procedures were: sterility (17), tumor of the ovary (5), endometriosis (3), uterine myoma (2), pelvic pain syndrome++ (1), carcinoma of the ovary--second look procedures (1), operative hysteroscopy (1). During these procedures we examined small pelvis and 17 patients were additionally undergone chromotubation. These procedures lasted 8-24 minutes. No complications were noticed during and after operations. Microlaparoscopy were verified by laparoscopy with positive correlation of data. Advantages and limitations of microlaparoscopy were taken into consideration. We presented possibilities of the new diagnostic technique in gynaecology.

[Laparoscopic Galvin-TeLinde hysterectomy for treatment of a microinvasive cervical carcinoma]. / Laparoskopische Galvin-TeLinde-Hysterektomie zur Behandlung eines mikroinvasiven Zervixkarzinoms.

The original technique of laparoscopical Galvin-TeLinde-hysterectomy in patients with FIGO IA1 cervical cancer is presented. Differences between this technique and classical abdominal procedure are discussed. Based on the presented case the authors discuss the significance of laparoscopy in cervical cancer treatment.

[Individualization of surgical treatment for female pelvic floor disorders]. / Indywidualizacja leczenia chirurgicznego zaburzen statyki narzadów plciowych kobiety.

The side effects of female pelvic floor disorders surgical treatment (as the disease per se) may worsen the quality of life. The aim of this paper is to indicate how these side effects may be reduced. The author concludes that this goal may be achieved by: 1. thorough anamnesis and physical examination, 2. precise diagnosis of affected compartments, 3. individualized surgery (original list of surgical methods and their possible side effects on reproduction, sexual and physical activity is presented), 4. adequate patient's information including possible side effects and limitation of the treatment.

[The management of cervical cancer cases in pregnancy and puerperium]. / Postepowanie w przypadkach raka szyjki macicy w czasie ciazy i pologu.

UNLABELLED: Cervical cancer in women during pregnancy and puerperium is a serious diagnostic and therapeutic problem. Twelve multiparas with confirmed cervical cancer during pregnancy, delivery and puerperium were examined. The mean age of the group was 35. In two of them cervical cancer was diagnosed in the second trimester, in 5 in the third trimester and in 5 in puerperium. Clinical stage according to FIGO was as follow: Ib--9 patients, IIa--2 patients, III--1 patient. In two patients operated in the second trimester--extended hysterectomy was performed. In four women cesarean section with extended hysterectomy and lymphadenectomy was performed. Only one patient in third trimester had cesarean section and in the same time unradical hysterectomy because of bleeding. In two patients in puerperium extended hysterectomy was performed (Meigs operation). Three patients underwent only radiotherapy. All patients who were operated on underwent subsequent radiotherapy. CONCLUSIONS: Cervical cancer during pregnancy and puerperium is diagnosed very late, usually in advanced stage. It is connected with lack of clinical and cytological examination of women before pregnancy. Principles of treatment of cervical cancer in pregnancy and puerperium do not differ from those applicable in other patients.

[Wound healing after vulvar surgery]. / Gojenie sie ran po operacjach sromu.

Vulvular wounds healing is an important problem in vulvar surgery. Prolonged healing worsens patients quality of live, and is related to prolonged hospitalization and use of antibiotics. The aim of this report is to analyse factors, which may influence vulvular wounds healing. It was found that extended vulvar surgery and advanced age of patients are the negative factors in vulvar wound healing. Antibioticotherapy, drainage and diseases like diabetes mellitus, hypertension and obesity don't affect the vulvular wounds healing.

[The place of second-look laparoscopy in monitoring treatment of advanced malignant ovarian neoplasms]. / Miejsce second-look laparoskopii w monitorowaniu leczenia zaawansowanych postaci nowotworów zlosliwych jajnika.

The role of second-look laparotomy in management of advanced ovarian cancer is still controversial. One of the arguments against this method is the risk of this wide operation. Replacement of second-look laparotomy by laparoscopy maybe the way to minimize that risk. The aim of this report is the comparison of second-look laparotomy and laparoscopy. The prospectively gathered material consists of 56 women with ovarian cancer, 17 of them were qualified for second-look procedures. Laparoscopy was the first step in this procedure. In 5 patient the residual malignancy in abdominal cavity was found. In 11 there were no evidence of the disease, and in 1 case laparoscopic inspection was impossible. When the laparoscopy was negative or impossible the second-look laparotomy was performed. Only in one case after negative laparoscopy the evidence of malignancy during laparotomy was found. In our opinion: 1) Positive second-look laparoscopy is equivalent to laparotomy and permits to avoid it. 2) The negative second-look laparoscopy with its contemporary technique still requires the subsequent laparotomy.

[Long term observation of patients after bilateral ligation of internal iliac arteries]. / Odlegle obserwacje pacjentek po obustronnym podwiazaniu tetnic biodrowych wewnetrznych.

Internal iliac arteries ligation is procedure useful intraoperative haemorrhage control. It was reported as simple and without severe early side effects. The aim of this study is to assess the distant side effects of this procedure. Study group consists of 66 hysterectomized patients. Among them 23 had internal iliac arteries ligation (group I) and 43 hysterectomy without this procedure (group II). The ten month to 2.5 years follow-up does not revealed any differences in complaints of patients from both groups. Thus, internal iliac arteries ligation appeared to have no side effects also in distant observation.

[Laparoscopic ligation of the internal iliac artery in bleeding cervix carcinoma]. / Laparoskopische Ligatur der A. iliaca interna bei einem blutenden Zervixkarzinom.

Laparoscopic ligation of internal iliac artery was performed in two patients with bleeding from stage II cervical cancer. The hemostatic effect, shortening of convalescence and early initiation of radiotherapy was obtained. Additionally, during procedure the lymph node sampling was performed. Laparoscopy appeared to be an alternative procedure to abdominal or extraperitoneal ligation of internal iliac artery.

[Laparoscopic ligature of the iliac arteries in treatment of hemorrhage related to uterine cervical cancer]. / Laparoskopowe podwiazanie tetnic biodrowych wewnetrznych w leczeniu krwotoku ze zmienionej nowotworowo szyjki macicy.

Laparoscopic ligation of internal iliac artery was performed in two patients with bleeding from stage II cervical cancer. The hemostatic effect, shortening of convalescence and early initiation of radiotherapy was obtained. Additionally, during procedure the laparoscopic lymph node sampling was performed. Laparoscopy appeared to be an alternative procedure to abdominal or extraperitoneal ligation of internal iliac artery.

Hemodynamic effects of intravenous hydralazine in pregnant women with severe hypertension.

The hemodynamic changes after intravenous administration of hydralazine were assessed using M-mode echocardiography in 13 pregnant patients with severe hypertension. The patients were divided into two groups: eight who had preeclampsia (group 1) and five who had essential hypertension and/or superimposed preeclampsia (group 2). Patients in group 1 had significantly lower pretreatment cardiac indexes and higher systemic vascular resistances (P less than .01) than did patients of group 2, despite similar mean blood pressure values. Thirty minutes after intravenous administration of 12.5 mg hydralazine, a significant decrease in mean arterial pressure (21%) and systemic vascular resistance (41%) and also a significant increase in heart rate (22%) and cardiac index (33%) were observed in group 1. The hemodynamic response in group 2 was attenuated; the mean arterial pressure and systemic vascular resistance fell by an average of 11 and 13%, respectively. The post-hydralazine percent changes in mean blood pressure for the total patient population did not correlate with the initial values of blood pressure (r = .091). In contrast, the percent reduction in systemic vascular resistance after administration of hydralazine inversely correlated with the control values of vascular resistance (r = -.742). These findings indicate that cardiovascular response to acute hydralazine administration is related to the baseline hemodynamic setting. M-mode echocardiography seems to be a reliable method for comprehensive analysis of cardiovascular effects of pharmacologic intervention in pregnant women with hypertension.