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1.
Artigo em Inglês | MEDLINE | ID: mdl-36323291

RESUMO

Due to the increasing popularity of minipigs as pets, the frequency of presentation to the veterinarian is increasing as well. In addition to routine measures such as claw trimming, vaccination and antiparasitic treatment, diagnostics, and therapy of diseased minipigs are also common activities in the veterinary practice. In recent years, we have noticed more and more pathological changes of the female genital tract of uncastrated minipigs. There are also some case reports available in the international literature in this regard. The following case report describes the diagnostic procedures and ovariohysterectomies of 2 13-year-old female minipigs in detail. In these cases, uterine adenocarcinoma, and uterine carcinoma, respectively, combined with cystic endometrial hyperplasia (CEH) of the endometrium were diagnosed.


Assuntos
Adenocarcinoma , Hiperplasia Endometrial , Doenças dos Suínos , Neoplasias Uterinas , Suínos , Animais , Feminino , Hiperplasia Endometrial/diagnóstico , Hiperplasia Endometrial/cirurgia , Hiperplasia Endometrial/veterinária , Porco Miniatura , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/veterinária , Endométrio/patologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Adenocarcinoma/veterinária , Doenças dos Suínos/diagnóstico , Doenças dos Suínos/cirurgia , Doenças dos Suínos/patologia
3.
Front Public Health ; 10: 920578, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36276379

RESUMO

Background: Robotic surgery for malignant uterine cancer raises issue of economic sustainability for providers. The objective of this study was to assess the value of surgical admissions for malignant uterine cancer in a University Hospital through an analysis of their costs and outcomes by comparing three different surgical approaches (laparotomy, laparoscopic, and robotic surgery). Methods: Hospitalizations between 1 January 2019 and 31 October 2021 for malignant uterine cancer surgery were selected and stratified. For each surgical approach, mean values (with 95% confidence intervals, CI) were calculated for cost items. Moreover, 30-day readmission frequency was calculated for the three approaches compared to each other. ANOVA and Student's t-test and relative risk (RR) were used for statistical analysis. A break-even analysis was carried out by evaluating the volume of robotic and non-robotic surgical admissions. Results: A total of 1,336 hospitalizations were included in the study, 366 with robotic, 591 with laparoscopic, and 379 with laparotomy surgery. Robotic surgery, compared to laparoscopic and laparotomy ones, showed a statistically significant difference (p < 0.001) in the economic margin, which was largely negative (-1069.18 €; 95%CI:-1240.44--897.92 €) mainly due to devices cost, and a lower percentage of 30-day readmissions (1.4%; 95%CI: 0.2-2.6%), with a statistically significant difference only vs. laparotomy (p = 0.029). Laparoscopic compared to laparotomy surgery showed a significantly (p < 0,001) more profitable economic margin (1692.21 €; 95%CI: 1531.75 €-1852.66 €) without a significant difference for 30-day readmissions. Break-even analysis showed that, on average, for each malignant uterine cancer elective surgery performed laparoscopically, 1.58 elective robotic surgeries are sustainable for the hospital (95% CI: 1.23-2.06). Conclusion: Break-even analysis could be a useful tool to support hospital management in planning and governance of malignant uterine cancer surgery. Systematic application of this tool will allow defining over time right distribution of robotic, laparoscopic, and laparotomy surgeries' volumes to perform to ensure both quality and economic-financial balance and therefore value of uterine oncological surgery. Concerning research, this study paves the way for a multicentric study, the extension of outcomes of malignant uterine surgery to be considered and assessed, and the future inclusion of other therapeutic interventions in the analysis.


Assuntos
Laparoscopia , Neoplasias Uterinas , Feminino , Humanos , Laparotomia , Neoplasias Uterinas/cirurgia , Hospitalização , Hospitais
4.
Int J Gynecol Pathol ; 41(6): 573-577, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36302188

RESUMO

Leiomyo-adenomatoid tumour (LMAT) is a rare benign neoplasm and very few cases of LMAT of the uterus are documented in the literature. Uterine LMATs are usually detected incidentally during the histopathologic evaluation of routine myomectomy or hysterectomy specimens for leiomyomata. Thorough evaluation of the morphological features and a concise immunohistochemical panel allows for accurate classification of this benign neoplasm.


Assuntos
Tumor Adenomatoide , Leiomioma , Miomectomia Uterina , Neoplasias Uterinas , Feminino , Humanos , Tumor Adenomatoide/diagnóstico , Tumor Adenomatoide/cirurgia , Tumor Adenomatoide/patologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Leiomioma/diagnóstico , Leiomioma/patologia , Útero/patologia
5.
Pan Afr Med J ; 42: 156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36187039

RESUMO

Uterine inversion is a rare postpartum complication. It is a rare condition in which the internal surface of the uterus protrudes through the vagina. Non-puerperal uterine inversion (NPUI) is extremely rare. In most instances, it is linked to uterine tumors. Among these tumors, leiomyoma is the most frequent cause reported in data. This condition may not be noticed until time of surgery. Malignancy is suspected in most cases. Nevertheless, uterine inversion can be diagnosed preoperatively using radiology. Difficulties in diagnosing NPUI makes this clinical case a challenge in gynaecology and not commonly reported in literature. We report our experience in the diagnosis and treatment of a complete non-puerperal uterine inversion associated with uterine angioleiomyoma. The patient's age was 44, gravida 2 para 1 presented with intermittent vaginal bleeding for four months and an acute abdominal cramping pain. On examination, a large mass lesion was observed which occupies the vaginal cavity and the contour of the uterine cervix could not be reached. Biopsies and Immunohistochemistry matched with an angioleiomyoma. She underwent a transvaginal surgical reposition technique: Spinelli's. It is important to diagnose accurate non-puerperal uterine inversion. Surgery provides good prognosis and it is necessary. We report a case of NPUI caused by angioleiomyoma. Nevertheless, malignancy must be eliminated in first place.


Assuntos
Abdome Agudo , Angiomioma , Hemangioma , Complicações do Trabalho de Parto , Inversão Uterina , Neoplasias Uterinas , Pré-Escolar , Feminino , Humanos , Gravidez , Inversão Uterina/diagnóstico , Inversão Uterina/etiologia , Inversão Uterina/cirurgia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia , Útero/cirurgia , Vagina
6.
Zhonghua Fu Chan Ke Za Zhi ; 57(10): 746-752, 2022 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-36299177

RESUMO

Objective: To analyze the clinical application and to evaluate the efficiency of hysteroscopical electroresection of International Federation of Gynecology and Obstetrics (FIGO) type 3 myoma. Methods: The clinical data of patients who underwent hysteroscopical electroresection single FIGO type 3 myoma in Obstetrics and Gynecology Hospital of Fudan University from January 2019 to October 2021 were collected retrospectively. The clinical symptoms, myoma size, location, operation time, intraoperative bleeding, surgical complications and postoperative follow-up were recorded, and the subsequent pregnancy outcomes were followed-up. Results: Totally 35 patients with FIGO type 3 myoma were included in this study. The average age was (36.6±4.7) years old, the diameter of myoma was (4.0±1.2) cm (range: 2.0-5.8 cm). The rate of complete resection of myoma in one operation was 86% (30/35), the average operation time was (41±15) minutes (range: 20-65 minutes), and the average intraoperative bleeding was (24±18) ml (range: 5-150 ml). No complications such as uterine perforation, massive hemorrhage, hyperhyderation syndrome and infection occurred in all patients perioperation. There were 20 cases with significant increase of menstruation before operation, the cure rate and effective rate of hysteroscopical electroresection of FIGO type 3 myoma were 75% (15/20) and 95% (19/20). There were 24 patients with fertility requirements, their average follow-up time was (14.5±6.8) months, the pregnancy rate within 1 year after operation was 79% (19/24), and the average postoperative pregnancy time was (5.8±3.4) months. There were 15 cases who had completed delivery after operation, including 10 cases of vaginal delivery and 5 cases of cesarean section, and none of them had uterine rupture. Conclusions: Hysteroscopy could effectively resect FIGO type 3 myoma. Hysteroscopical electroresection of FIGO type 3 myoma is minimally invasive with rapid postoperative recovery and could achieve pregnancy in a short time, which is not only helpful to reduce the amount of menstruation, but also beneficial for the prognosis of fertility. It should be carried out by the experienced hysteroscopists.


Assuntos
Leiomioma , Mioma , Neoplasias Uterinas , Humanos , Gravidez , Feminino , Adulto , Leiomioma/cirurgia , Neoplasias Uterinas/cirurgia , Estudos Retrospectivos , Cesárea
8.
Am J Case Rep ; 23: e937266, 2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36262031

RESUMO

BACKGROUND Intracardiac leiomyomatosis (ICLM) is an extremely rare tumor which is benign but presents with aggressive behavior. To date, there is still no standard of care for ICLM therapy, and treatment for complicated ICLM has obtained even less attention. Radical surgery was usually recommended to remove the patients' tumors completely. Since initial complete surgical resection cannot be performed in all cases, bilateral salpingo-oophorectomy (BSO), via its effects of estrogen deprivation, may be a feasible primary step in the treatment of premenopausal women with unresectable ICLM. CASE REPORT We describe a case of a residual mass in the inferior vena cava and right atrium that shrank dramatically after BSO. The patient was a 41-year-old woman with initially unresectable ICLM. Total hysterectomy with BSO and excision of the retroperitoneal mass was performed, but the intracaval tumor above L5 was not removed. Pathology revealed a benign leiomyoma which was strongly positive for both estrogen receptor and progesterone receptor. Two weeks after the BSO, the patient's serum estradiol level had decreased to a postmenopausal level. At the same time, the proximal end of the intracaval tumor shrank dramatically from the level of the right atrium to the level of L3 only 2 weeks after the surgery. Therefore, this may provide a therapeutic window for a second reduction surgery. CONCLUSIONS BSO, via its estrogen deprivation effect, may provide a simple but effective initial treatment choice for premenopausal women who suffer from primary unresectable ICLM.


Assuntos
Neoplasias Cardíacas , Leiomiomatose , Neoplasias Uterinas , Humanos , Feminino , Adulto , Leiomiomatose/cirurgia , Leiomiomatose/patologia , Receptores de Progesterona , Salpingo-Ooforectomia , Receptores de Estrogênio , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/patologia , Veia Cava Inferior/cirurgia , Veia Cava Inferior/patologia , Histerectomia , Estradiol , Estrogênios
9.
Comput Math Methods Med ; 2022: 4018803, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36238468

RESUMO

Background: Uterine fibroids are most common in women aged 30-50 and are the most common benign gynecological tumors. Relevant data suggest that about 25% of patients with uterine fibroids are at childbearing age. Uterine fibroids not only cause the discomfort symptoms, and affect the pregnancy, but also have certain malignant transformation risk, thus needed to be treated positively and promptly. Aim: This study is aimed at exploring the effect of laparoscopic myomectomy and comprehensive rehabilitation nursing on patients with uterine fibroids. Methods: The clinical data of 110 cases of uterine fibroids admitted to our hospital from August 2019 to December 2021 were analyzed retrospectively, and they were divided into two groups according to postoperative rehabilitation strategies. Both groups were treated with laparoscopic myomectomy. The A group was treated with routine rehabilitation strategy, while the B group was treated with comprehensive rehabilitation nursing strategy. The differences in operation-related indicators, stress factors, inflammatory factors, nutritional indicators, knowledge mastery, occurrence of adverse symptoms and pain scores, negative emotion scores, nursing satisfaction, and simplified comfort status scale (GCQ) scores between the two groups under nursing strategies were compared. Results: The postoperative exhaust time (13.14 ± 2.03) h, bed time (9.86 ± 1.94) h, postoperative hospital stay (4.37 ± 1.31) d, and total hospital stay (6.78 ± 1.69) d in the B group were shorter than those in the A group, and the hospitalization expenses (0.74 ± 0.25) million were less than those in the A group (P < 0.05). Before operation, stress factors, inflammatory factors, and nutritional indexes were compared between the two groups (P > 0.05). On the 3rd day after operation, tumor necrosis factor-α (TNF-α), cortisol (Cor), norepinephrine (NE), and interleukin-1ß (IL-1ß) in the two groups showed a significantly upward trend compared with those before operation, and albumin and transferrin were significantly fell compared with those before operation. However, the values of stress factor and inflammatory factor in the B group were significantly lower than those in the A group, and the values after the decrease of nutritional index were significantly higher than those in the A group (P < 0.05). The pain scores at 24 h, 48 h, and 72 h after operation in the B group were significantly lower than those in the A group (P < 0.05). Negative emotions, nursing satisfaction, and GCQ scores were compared between the two groups before intervention (P > 0.05). After the intervention, the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the two groups were significantly lower than those before the intervention, and the scores of nursing satisfaction and GCQ were higher than those before the intervention. The values of negative emotions in the B group after the decline were significantly lower than those in the A group, while the values of nursing satisfaction and GCQ after the increase were higher than those in the A group (P < 0.05). The excellent and good rate of knowledge acquisition in the B group was 94.55% (52/55), which was significantly higher than 78.18% (43/55) in the A group (P < 0.05). The incidence of adverse symptoms in the B group was 9.09% (5/55), which was lower than 21.82% (12/55) in the A group, while the difference was not statistically significant (P > 0.05). Conclusion: Laparoscopic myomectomy combined with comprehensive rehabilitation nursing can reduce the postoperative stress state of patients with uterine fibroids, improve patient satisfaction, reduce adverse emotions, and promote rehabilitation.


Assuntos
Laparoscopia , Leiomioma , Enfermagem em Reabilitação , Miomectomia Uterina , Neoplasias Uterinas , Albuminas , Feminino , Humanos , Hidrocortisona , Interleucina-1beta , Leiomioma/cirurgia , Norepinefrina , Dor/cirurgia , Gravidez , Estudos Retrospectivos , Transferrinas , Fator de Necrose Tumoral alfa , Neoplasias Uterinas/cirurgia
10.
J Vet Med Sci ; 84(12): 1579-1584, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36261364

RESUMO

A 12-year-old female Himalayan cat underwent an ovariohysterectomy to remove an intra-abdominal mass. Histologic examination using immunohistochemical staining revealed that the mass was comprised of epithelial and mesenchymal components. Within the lesion, multinucleated giant cells (MGCs) were observed diffusely. MGCs were positive for vimentin and Iba-1 and negative for cytokeratin AE1/AE3 and CD204. In addition, MGCs were negative for Ki-67, indicating nonneoplastic cells. Osteoclast-like MGC (OLMGC) phenotype with tartrate-resistant acid phosphatase positivity was also seen. These findings suggested that the uterine tumor was carcinosarcoma with OLMGCs. Uterine tumors in humans, such as leiomyosarcoma and carcinosarcoma, with OLMGC infiltration, are well-known pathologic entities; however, they are rare in animals and to our knowledge, have not been previously reported in cats.


Assuntos
Carcinossarcoma , Doenças do Gato , Leiomiossarcoma , Neoplasias Uterinas , Animais , Gatos , Feminino , Carcinossarcoma/veterinária , Carcinossarcoma/patologia , Doenças do Gato/cirurgia , Doenças do Gato/patologia , Células Gigantes/patologia , Leiomiossarcoma/patologia , Leiomiossarcoma/veterinária , Osteoclastos , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/veterinária , Neoplasias Uterinas/patologia
11.
Eur J Obstet Gynecol Reprod Biol ; 279: 94-101, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36308940

RESUMO

The clinical value of lymph node dissection remains controversial. This study aimed to evaluate the impact of lymphadenectomy on the prognosis of patients with uterine leiomyosarcomas (uLMS) or endometrial stromal sarcomas (ESS). PubMed, EMBASE and the Cochrane Library were searched for studies describing the prognostic significance of lymphadenectomy in uLMS or ESS. Quality assessments were performed using the Newcastle-Ottawa Scale, relative hazard ratios and a random-effects model. Thirty-two retrospective cohort studies that included 26,693 patients in total were enrolled. Patients with uLMS or low-grade ESS (LG-ESS) had no survival benefits from lymphadenectomy. However, patients with high-grade ESS (HG-ESS), did show survival benefits of lymphadenectomy, with no heterogeneity. No significant evidence of publication bias was found. Lymphadenectomy had little prognostic effect on patients with early-stage uLMS or LG-ESS. The best treatment for HG-ESS is early, comprehensive hysterectomy with lymph node dissection.


Assuntos
Neoplasias do Endométrio , Leiomiossarcoma , Neoplasias Pélvicas , Sarcoma do Estroma Endometrial , Neoplasias Uterinas , Feminino , Humanos , Sarcoma do Estroma Endometrial/cirurgia , Sarcoma do Estroma Endometrial/patologia , Leiomiossarcoma/cirurgia , Leiomiossarcoma/patologia , Prognóstico , Estudos Retrospectivos , Neoplasias do Endométrio/patologia , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Excisão de Linfonodo , Neoplasias Pélvicas/cirurgia
13.
Fertil Steril ; 118(5): 990-991, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36154766

RESUMO

OBJECTIVE: To provide a video tutorial on vaginal transisthmic myomectomy in women with large submucosal fibroids. DESIGN: Stepwise demonstration of the technique, with a narrated video footage. SETTING: Submucosal fibroids protrude into the uterine cavity and can cause numerous symptoms, including abnormal uterine bleeding, dysmenorrhea, subfertility, and obstetric complications. Over the last decades, hysteroscopic resection has become the preferred surgical approach for submucosal fibroids because it provides significant advantages regarding perioperative morbidity and postoperative recovery time when compared with laparotomy or laparoscopy with complete transection of the uterine wall. However, in large or multiple fibroids, longer surgery durations of hysteroscopic resection can lead to higher complication rates and incomplete resection. In some cases, hysteroscopic resection might even be impossible to perform. Furthermore, in many regions, special equipment for hysteroscopic myomectomy might not be available. Herein, we present a minimally invasive surgical alternative for approaching submucosal fibroids. PATIENT(S): A 26-year-old woman presenting with hypermenorrhea and dysmenorrhea (on a numeric rating scale from 0-10) caused by a recurrent International Federation of Gynaecology and Obstetrics (FIGO) type 0 fibroid measuring 5 cm in diameter. INTERVENTION(S): Vaginal transisthmic myomectomy performed with a longitudinal transection of the uterine cervix and isthmus, morcellation of the fibroid with a scalpel, and multilayer reconstruction. MAIN OUTCOME MEASURE(S): Vaginal transisthmic myomectomy is a fast and relatively simple, minimally invasive surgical technique suitable for large or multiple FIGO 0 and some FIGO 1 fibroids, necessitating the use of only basic surgical equipment. RESULT(S): Vaginal transisthmic myomectomy provides an additional minimally invasive surgical approach for submucosal fibroids. CONCLUSION(S): This surgical option for selected patients may help prevent complications resulting from prolonged hysteroscopic surgery, repeated hysteroscopic procedures owing to incomplete resection, and the morbidity of transabdominal approaches for myomectomy. With this video, we aim to expedite the clinical learning curve of this technique, which should be investigated on a broader scale in the future.


Assuntos
Leiomioma , Morcelação , Miomectomia Uterina , Neoplasias Uterinas , Gravidez , Humanos , Feminino , Adulto , Miomectomia Uterina/efeitos adversos , Miomectomia Uterina/métodos , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/complicações , Dismenorreia/complicações , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Leiomioma/complicações
15.
JSLS ; 26(3)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36071994

RESUMO

Background and Objectives: Since the 2014 Food and Drug Administration communication regarding the use of power morcellation, gynecologists have adopted alternative tissue extraction strategies. The objective of this study is to investigate the current techniques used by gynecologic surgeons for tissue extraction following minimally invasive hysterectomy or myomectomy for fibroids. Methods: An online survey was distributed to all AAGL members and responses were collected between March 26, 2019 and April 17, 2019. Results: Four hundred thirty-six respondents completed the survey. For hysterectomy, the most common methods of tissue extraction were manual morcellation through the colpotomy (72.4%) or minilaparotomy (66.9%). Nearly one-third (31.7%) endorsed using power morcellation. For myomectomy, manual morcellation via minilaparotomy (71.9%) was the most common approach, followed by power morcellation (35.7%). Use of containment bags was common. Minilaparotomy incisions were typically three cm and most often at the umbilicus.Geographic differences were detected, particularly with power morcellation. During hysterectomy, 18.4% of US-based surgeons reported its use, compared to 56.9% of nonUS-based surgeons. During myomectomy, 20.5% of US-based surgeons reported its use compared to 67.5% of their international counterparts. Age, years in practice, fellowship training, and practice location were all significantly associated with power morcellator use. Conclusion: A large majority of practitioners are performing manual morcellation through the colpotomy or minilaparotomy. Use of containment bags is common with all routes of tissue removal. Power morcellation use is less common in the United States than in other countries.


Assuntos
Laparoscopia , Leiomioma , Morcelação , Miomectomia Uterina , Neoplasias Uterinas , Feminino , Humanos , Laparoscopia/métodos , Leiomioma/cirurgia , Morcelação/métodos , Estados Unidos , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia
17.
Medicine (Baltimore) ; 101(35): e30414, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107540

RESUMO

RATIONALE: A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a clinically rare disease with an unclear origin and biological behavior. PATIENT CONCERNS: We present a case of UTROSCT in a 42-year-old woman who presented with abnormally increased menstrual volume for 2 years. DIAGNOSES: Initially, only ultrasound examination was performed to diagnose uterine fibroids, and then the tumor was surgically removed and sent for pathological examination. The patient was ultimately diagnosed with UTROSCT mainly based on pathological immunohistochemical examination and was further diagnosed with low malignant potential for recurrence based on genetic testing. INTERVENTIONS AND OUTCOMES: The patient underwent hysterectomy and bilateral adnexectomy, and no adjuvant radiotherapy or chemotherapy was performed after the surgery. Follow-up to date has indicated that she is in good condition. LESSONS: UTROSCT is a rare disease that requires pathological immunohistochemical examination to confirm the diagnosis and genetic testing when necessary so that a clear diagnosis can inform better decision-making regarding treatment measures.


Assuntos
Tumores do Estroma Gonadal e dos Cordões Sexuais , Neoplasias Uterinas , Adulto , Feminino , Humanos , Ovário/patologia , Doenças Raras , Tumores do Estroma Gonadal e dos Cordões Sexuais/diagnóstico , Tumores do Estroma Gonadal e dos Cordões Sexuais/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/cirurgia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia , Útero/patologia
18.
BMJ Case Rep ; 15(9)2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-36137642

RESUMO

Interstitial pregnancies present a diagnostic and management challenge and are associated with significant bleeding risk. We present a case of an interstitial ectopic pregnancy where there was a diagnostic delay due to the presence of uterine fibroids and where a laparoscopic myomectomy was required in order to perform laparoscopic resection of the ruptured interstitial pregnancy.This case demonstrates the possibilities at laparoscopy for ectopic pregnancy, highlights the benefit of a structured 'buddy' system between gynaecology surgeons and brings attention to the paucity of literature on the unique management challenges of ectopic pregnancy in the presence of leiomyoma.


Assuntos
Laparoscopia , Leiomioma , Complicações na Gravidez , Gravidez Intersticial , Miomectomia Uterina , Neoplasias Uterinas , Diagnóstico Tardio , Feminino , Hemorragia/complicações , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Gravidez , Complicações na Gravidez/cirurgia , Gravidez Intersticial/diagnóstico por imagem , Gravidez Intersticial/cirurgia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/cirurgia
19.
Ceska Gynekol ; 87(4): 289-294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36055791

RESUMO

OBJECTIVE: To summarize recent data and knowledge of laparoscopic power morcellation. METHODS: Review of articles. RESULTS: Laparoscopic morcellation has been introduced to gynecologic surgery in 90s. In 2014, Food and Drug Administration announced negative statement about the morcellation use due to the risk of potential spreading of malignant tumor cells. This statement reduced utilization of morcellation, especially in the United States. Since that, many health institutions and organizations started new researches focused on the safety of this surgical technique. After a couple of years, the morcellation is considered as a useful tool if certain rules are followed. CONCLUSION: Morcellation has a place in laparoscopic operative procedures even in 2022, in condition of correct selection of patients and possible utilization of contained in-bag morcellation.


Assuntos
Laparoscopia , Leiomioma , Morcelação , Miomectomia Uterina , Neoplasias Uterinas , Feminino , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Leiomioma/cirurgia , Morcelação/efeitos adversos , Morcelação/métodos , Estados Unidos , Miomectomia Uterina/métodos , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
20.
Taiwan J Obstet Gynecol ; 61(5): 889-895, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36088063

RESUMO

OBJECTIVE: To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon. CASE REPORT: A 66-year-old woman presented with lower abdominal pain. Pelvic examination showed tenderness over the lower abdominal region without cervical discharge. Per-rectal examination showed a hard tumor on the posterior uterine wall, while ultrasonography showed a tumor-like mass extending from the posterior uterine wall to the rectum. Magnetic resonance imaging showed signs of endometrial cancer invading the rectum. However, the tumor markers carbohydrate antigen (CA) 125, CA199, and carcinoembryonic antigen were in the normal range. Cystoscopy, panendoscopy, and colonoscopy showed no significant findings. On performing exploratory laparotomy, we observed pus and severe adhesion on the posterior uterine wall and rectum. Hysterectomy, bilateral adnexectomy, colectomy, and partial left ureter resection were performed. The final pathology showed XI. The pus culture revealed Klebsiella pneumonia and PCR revealed nocardiosis. The patient received 2 weeks of antibiotic treatment and was discharged thereafter. CONCLUSION: XI in elderly women is rare, and hence, differential diagnoses should be carefully considered.


Assuntos
Nocardiose , Pneumonia , Ureter , Neoplasias Uterinas , Idoso , Colo/patologia , Feminino , Humanos , Inflamação , Supuração , Ureter/patologia , Neoplasias Uterinas/cirurgia
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