Peritoneal vaginoplasty by Luohu I and Luohu II technique: a comparative study of the outcomes.

BACKGROUND: Surgical vaginoplasty is the standard treatment for women suffering from Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. This study compares the advantages and disadvantages of Luohu I technique or its modification, Luohu II technique. METHODS: Women with MRKH syndrome undergoing laparoscopic peritoneal vaginoplasty using either the Luohu I (N = 145) or Luohu II (N = 155) technique were recruited. We compare the effectiveness of the Luohu II and one of Luohu I. Sexual satisfaction was checked by Female Sexual Function Index. RESULTS: There was no significant difference in the mean operation time, volume of intraoperative blood loss, time for the first passage of gas, sexual satisfaction (and hospital stay for patients in either group (P > 0.05). But patients in the Luohu II group had a significantly lower incidence of complications than patients in the Luohu I group. All patients had vaginal depths more than 9 cm over 3 months post-surgery. CONCLUSIONS: Compared with the traditional Luohu I laparoscopic peritoneal vaginoplasty, the Luohu II operation is easier to perform and causes less damage to the bladder and rectum. The physiological and anatomical features of the artificial vagina resemble the normal vagina in both techniques.

Laparoscopic treatment for retroperitoneal hyaline-vascular type localized Castleman's disease (LCD) in the iliac vessel region.

To improve the understanding, diagnostic levels, and therapeutic levels of retroperitoneal hyaline vascular type LCD in the iliac vessel region. Diagnostic and therapeutic processes of 4 patients with retroperitoneal LCD in the iliac vessel region were retrospectively analyzed. The median ages of the research patients was 31.3 years old, Pelvic vascular dual-source computed tomography (CT) indicated an abnormal pelvic irregular cloddy intensity shadow with heterogeneous densities and punctate calcified lesions. The enhanced scanning showed significantly enhanced lesions and multiple tortuous vascular images inside and around the lesions. Patients' preoperative diagnoses were all "pelvic mass with unknown characteristics", and retroperitoneal masses were successfully stripped off after the laparoscopic surgery. Intra operative findings indicated 1 mass located at the left obturator nerve, 1 at the left internal iliac artery, and 2 at the right external iliac artery. The postoperative pathological reports suggest a diagnosis of Castleman's disease. Retroperitoneal LCD in the iliac vessel region is generally asymptomatic. Preoperative imaging data may help with the diagnosis, but a confirmed diagnosis depends on the results of the pathological examination. Iliac artery embolization is performed prior to laparoscopic mass stripping if the masses have abundant blood supply, while lymphadenectomy is also applied to those with enlarged lymph nodes.

Endostar combined with cisplatin inhibits tumor growth and lymphatic metastasis of lewis lung carcinoma xenografts in mice.

OBJECTIVE: To investigate the effects of endostar, a recombined humanized endostatin, plus cisplatin on the growth, lymphangiogenesis and lymphatic metastasis of the Lewis lung carcinoma (LLC) in mice. METHODS: A tumor model were established in C57BL/6 mice by intravenious transplantation of LLC cells. Then the mice were randomized to receive administration with NS, endostar, cisplatin, or endostar plus cisplatin. After the mice were sacrificed, tumor multiplicity, tumor size and lymph node metastasis were assessed. Then the expression of vascular endothelial growth factor-c (VEGF-C) and podoplanin were determined by immunohistochemical staining. RESULTS: Endostar plus cisplatin significantly suppressed tumor growth. lymphatic metastasis and prolonged survival time of the mice without obvious toxicity. The inhibition of lymphatic metastasis was associated with decreased microlymphatic vessel density (MLVD) and expression of VEGF-C. CONCLUSIONS: Endostar combined with cisplatin was more effective to suppress tumor growth and lymphatic metastasis than either agent alone. Thus this may provide a rational alternative for lung carcinoma treatment.

Transvaginal surgical treatment of cesarean scar ectopic pregnancy.

PURPOSE: To explore the feasibility of surgical management of cesarean scar ectopic pregnancy (CSEP) using a transvaginal approach. METHODS: Thirty-eight patients with CSEP presenting at the Shenzhen Nanshan People's hospital between January 2008 and May 2012 were reviewed in the study. Ten patients underwent uterine artery embolization, 13 patients underwent endoscopic CSEP removal in combination with chemotherapy and 15 received transvaginal surgical therapy (transvaginal group). Patients were followed up for between 3 and 48 months. RESULTS: Postoperative fever and irregular menstrual bleeding after healing were each observed in one of ten patients undergoing embolization. No pregnancies were reported in this group during follow-up. Endoscopy procedures included two patients undergoing laparoscopy and 11 undergoing hysteroscopy resection. There were six pregnancies during follow-up in this group. Transvaginal surgery was performed uneventfully in all cases. All patients recovered without complications. There were no reports of irregular menstrual bleeding or changes in menstrual blood volume. Serum HCG levels declined rapidly to within the normal range. The time to menstrual cycle recovery (29.2 ± 5.7 days) was significantly shorter than with endoscopic surgery (37.6 ± 8.2 days) or embolization (64.4 ± 9.2 days; P < 0.05). Three patients became pregnant after transvaginal surgery. CONCLUSION: Transvaginal removal of ectopic pregnancy tissue is a new surgical approach for the treatment of CSEP. The efficacy and safety of the approach needs further confirmation.

Assessment of transvaginal hysterotomy combined with medication for cesarean scar ectopic pregnancy.

The objective of this retrospective study was to explore a novel surgical technique, transvaginal hysterotomy combined with methotrexate injection, for treatment of cesarean scar ectopic pregnancy in 12 patients. All patients underwent the operation. Mean (SD; 95% CI) operative time was 21.6 (7.3; 17.0-26.2) minutes, and intraoperative blood loss was 90.8 (59.6; 52.9-128.7) mL. Postoperative ultrasonography confirmed removal of the pregnancy sac. The length of hospital stay was 7.4 (3.7; 5.0-9.8) days. The first normal postoperative menstrual period was at 28.3 (5.6; 24.7-31.9) days after surgery. The serum ß-human chorionic gonadotropin concentration returned to normal at 15.8 (6.3; 11.8-19.8) days. We conclude that surgical removal of the ectopic sac via transvaginal hysterotomy combined with methotrexate injection during the operation is a potentially good new approach to treatment of cesarean scar ectopic pregnancy. The efficacy and safety of the technique need further confirmation in future studies.

[Effects of endostatin on the growth and lymphangiogenesis of Lewis lung carcinoma xenograft in mice].

OBJECTIVE: to investigate the effects of endostar, a recombined humanized endostatin, on the growth, lymphangiogenesis and lymphatic metastasis of Lewis lung carcinoma xenograft in mice. METHODS: lewis lung carcinoma (LLC) xenograft were established in C57 mice by intravenous transplantation of 1 × 10(6) cells. Then tumor-bearing mice were assigned into two groups: control group received caudal vein injections of 0.2 ml of 0.9% sodium chloride for 15 days, and treatment group received 500 µg endostar daily. Six weeks after LLC cell injection mice were sacrificed, and then tumor numbers and size were recorded. The expression of vascular endothelial growth factor-c (VEGF-C) and microlymphatic vessel density (MLVD) were observed by immunohistochemical staining. RESULTS: tumor number and size of control group were significantly higher than those of treatment group. The microlymphatic vessel density (MLVD) was 5.7 ± 1.6 in the treatment group, which was markedly lower than in the control mice (7.8 ± 1.6). Two lymph node metastases were observed in treatment group, and eight in control group. Lymphatic metastases were more frequent in control group than in treatment group. Expression of VEGF-C in control group was significantly higher than that in treatment group. CONCLUSION: endostar significantly inhibits the growth, lymphangiogenesis and lymphatic metastasis of Lewis lung carcinoma xenografts, and the inhibitory effect is due to its ability to regulate the expression of VEGF-C of tumors in part.