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1.
Taiwan J Obstet Gynecol ; 61(1): 24-33, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35181041

RESUMO

Inguinal endometriosis is a very rare entity with uncertain pathophysiology, that poses several diagnostic and therapeutic challenges. This study aimed to summarize published literature on the diagnosis and treatment of this condition. Thus, a systematic literature search was conducted in PubMed/MEDLINE, Scopus and the Cochrane Library. An effort was made to numerically analyze all parameters included in case reports and retrospective analyses, as well. The typical and atypical features of this condition, investigations used, type of treatment and histopathology were recorded. More specifications about the surgical treatment, such as operations previously performed, type of surgery and treatment after surgery have been acknowledged. Other sites of endometriosis, the presence of pelvic endometriosis and the follow-up and recurrence have been also documented. Overall, the search yielded 61 eligible studies including 133 cases of inguinal endometriosis. The typical clinical presentation includes a unilateral inguinal mass, with or without catamenial pain. Transabdominal or transvaginal ultrasound was typically used as the first line method of diagnosis. Groin incision and exploratory surgery was the treatment indicated by the majority of the authors, while excision of part of the round ligament was reported in about half of the cases. Chemotherapy and radiotherapy were initiated in cases of coexisting endometriosis-related neoplasia. Inguinal recurrence or malignant transformation was rarely reported. The treatment of inguinal endometriosis is surgical and a long-term follow-up is needed. More research is needed on the effectiveness of suppressive hormonal therapy, recurrence rate and its relationship with endometriosis-associated malignancies.


Assuntos
Endometriose/cirurgia , Virilha/diagnóstico por imagem , Canal Inguinal/diagnóstico por imagem , Ligamento Redondo do Útero/patologia , Ultrassonografia , Endometriose/diagnóstico , Endometriose/terapia , Feminino , Virilha/patologia , Humanos , Canal Inguinal/patologia , Canal Inguinal/cirurgia , Ligamento Redondo do Útero/cirurgia , Resultado do Tratamento
2.
Acta Biomed ; 92(S1): e2021375, 2022 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-35045065

RESUMO

We report two cases of endometriosis of the round ligament in a 37 and 26 - years old women, with a lump in their right groin and catamenial pain referred to plastic surgery department. MRI showed in both cases nodular lesion in the right inguinal region. The patological examination of the surgical specimen revealed endometriosis of the round ligament. The presence of a groin mass with pain increasing during the menstrual period must raise the suspicion of inguinal endometriosis and a gynecological evaluation is essential to provide a correct management of this rare condition.


Assuntos
Endometriose , Ligamento Redondo do Útero , Dismenorreia , Endometriose/diagnóstico por imagem , Endometriose/cirurgia , Feminino , Virilha , Humanos , Imageamento por Ressonância Magnética , Ligamento Redondo do Útero/diagnóstico por imagem , Ligamento Redondo do Útero/cirurgia
5.
Am J Case Rep ; 22: e934564, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34916480

RESUMO

BACKGROUND Endometriosis is a common gynecological disorder occurring in around 10% of women of reproductive age. Inguinal endometriosis is a rare condition; however, it should be considered in the differential for inguinal masses in women of reproductive age. Usually, it occurs after implantation of endometrial tissue during previous surgical procedures. Patients with inguinal endometriosis are often multiparous women with a history of previous gynecological or obstetric surgery. It represents a diagnostic dilemma, as it is often misdiagnosed as other inguinal pathologies. CASE REPORT Herein, we report a case of a 33-year-old nulliparous woman with left groin pain for 2 years increasing in the severity during menstruation. A physical examination revealed a 1.5-cm left inguinal mass. Ultrasound showed an ill-defined speculated solid hypoechoic left inguinal mass measuring 1.6×1.4 cm. Computed tomography (CT) of the pelvis revealed a left inguinal mass measuring 1.7×1.2 cm, demonstrating central hypo-attenuation with thickening of the round ligament. Exploration of the inguinal region revealed an adherent mass to the round ligament and floor of the canal, which was excised completely with a safety margin. The inguinal canal floor was strengthened using proline mesh. Histopathological examination of the mass confirmed the diagnosis of left inguinal endometriosis. CONCLUSIONS Inguinal endometriosis is a rare clinical entity mimicking other common inguinal conditions. A high index of suspicion is crucial for its preoperative diagnosis, especially in the presence of an inguinal mass associated with cyclic changes in size and pain severity. Its standard management is surgical excision.


Assuntos
Endometriose , Hérnia Inguinal , Ligamento Redondo do Útero , Adulto , Endometriose/diagnóstico , Feminino , Virilha , Hérnia Inguinal/diagnóstico , Humanos , Dor
6.
Am J Case Rep ; 22: e934313, 2021 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-34911925

RESUMO

BACKGROUND Round ligament varices (RLVs) are a rare entity that occurs almost only in pregnancy. Given its rarity and perhaps the lack of its awareness, it is not surprising that RLVs are often an overlooked differential diagnosis for inguinal swelling. Furthermore, this is aggravated by the fact that the clinical findings of RLVs on physical examination are usually non-specific and indistinguishable from the other more common causes of groin swelling. CASE REPORT A 35-year-old Asian woman, gravidity 1 parity 0 presented at 26 weeks of gestation with a painless right inguinal lump. She was given a provisional diagnosis of "inguinal hernia." Ultrasonography and color Doppler of the right inguinal lump showed echo-free tubular structures within the right inguinal canal, which became more prominent with Valsalva maneuver and demonstrated vascularity on color Doppler with a venous flow pattern, compatible with RLV. The patient was therefore reassured and treated conservatively. The symptoms spontaneously resolved after a few weeks postpartum. CONCLUSIONS With this case, we hope to increase the awareness of round ligament varices as an important differential diagnosis for an inguinal lump in pregnancy, and highlight the potential difficulty in making the diagnosis clinically. Ultrasonography can serve as a crucial investigation for the prompt and precise diagnosis of RLV, but more importantly, can be a safer alternative to invasive surgical exploration.


Assuntos
Hérnia Inguinal , Ligamento Redondo do Útero , Varizes , Adulto , Diagnóstico Diferencial , Feminino , Virilha , Humanos , Gravidez , Ligamento Redondo do Útero/diagnóstico por imagem , Ultrassonografia , Varizes/diagnóstico por imagem
7.
Ultrasound Obstet Gynecol ; 58(6): 926-932, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34090310

RESUMO

OBJECTIVE: To evaluate the accuracy of transvaginal ultrasound (TVS) in diagnosing deep endometriosis (DE) involving the uterosacral ligaments (USLs), torus uterinus (TU) or posterior vaginal fornix (PVF) in women with suspected endometriosis scheduled for laparoscopic surgery. METHODS: In this prospective study, consecutive women with clinically suspected pelvic endometriosis who were scheduled for laparoscopic surgery were invited to participate. TVS was performed before surgery. TVS findings were compared with those obtained at laparoscopy and confirmed histologically. The accuracy of TVS for diagnosing DE involving the USLs, TU or PVF was assessed. Additionally, the association of DE involving the USLs, TU or PVF on TVS with symptoms and with DE affecting other pelvic locations was assessed. RESULTS: In total, 172 patients were included. The global sensitivity and specificity of TVS in diagnosing DE affecting the USLs, TU and/or PVF were 92% and 87%, respectively. For DE involving the USLs, the accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio and negative likelihood ratio of TVS were 89.5%, 96.6%, 82.1%, 85.0%, 95.8%, 5.41 and 0.04, respectively; the respective values for DE involving the TU were 86.6%, 83.9%, 89.4%, 89.0%, 84.4%, 7.92 and 0.18, and the respective values for DE involving the PVF were 93.6%, 87.0%, 94.6%, 71.4%, 97.9%, 16.20 and 0.14. Logistic regression analysis showed a significant association between DE affecting the USLs, TU and/or PVF and DE affecting the rectosigmoid (odds ratio, 5.43; P < 0.001). Dyschezia was associated strongly with DE involving the USLs, TU and PVF, while dysmenorrhea was associated significantly with DE involving the TU. CONCLUSION: TVS has high accuracy, sensitivity, specificity, PPV and NPV for the detection of DE involving the USLs, TU and PVF in women with suspected endometriosis scheduled for laparoscopic surgery. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Endometriose/diagnóstico por imagem , Ligamentos/diagnóstico por imagem , Sacro/diagnóstico por imagem , Ultrassonografia/estatística & dados numéricos , Útero/diagnóstico por imagem , Vagina/diagnóstico por imagem , Adulto , Feminino , Humanos , Valor Preditivo dos Testes , Estudos Prospectivos , Ligamento Redondo do Útero/diagnóstico por imagem , Sensibilidade e Especificidade
8.
BMC Womens Health ; 21(1): 90, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653321

RESUMO

BACKGROUND: Inguinal endometriosis (IEM) is a rare extra pelvic endometriosis. Here, we study the clinical characteristics, management strategies, and long-term gynecological outcomes of IEM patients at Beijing Chaoyang Hospital. CASE PRESENTATION: Three patients presented with a total of four lesions (one on the left side, one on the right side, and one bilaterally). The diameters of the four lesions were 2 cm, 2 cm, 3.5 cm and 1.5 cm, respectively. Two patients were admitted with inguinal hernias. Two patients were admitted with endometrioses-one with ovarian endometriosis and one with pelvic endometriosis. The hernia sac was repaired concomitantly via excision of the round ligament in two patients. One patient underwent a concomitant laparoscopy for gynecologic evaluations, including an ablation to the peritoneal endometriosis, and resection of the left uterosacral ligament endometriosis and pelvic adhesiolysis. All lesions were located on the extraperitoneal portion of the round ligament and were diagnosed histologically. No recurrence was observed in the inguinal region. All patients diagnosed with adenomyosis were treated with medication alone without any complaints. CONCLUSIONS: Inguinal endometriosis can occur simultaneously with pelvic endometriosis. In most cases, a concomitant hernia sac appears together with groin endometriosis. Clinical management should be individualized and performed in tandem with general practitioners and obstetrics & gynecology experts. Pelvic disease, in particular, should be followed-up by a gynecologist.


Assuntos
Endometriose , Laparoscopia , Ligamento Redondo do Útero , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Seguimentos , Virilha , Humanos , Recidiva Local de Neoplasia , Ligamento Redondo do Útero/cirurgia
10.
J Minim Invasive Gynecol ; 28(1): 100-106, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32387566

RESUMO

STUDY OBJECTIVE: Recently, there has been a paradigm shift toward uterine conservation during the surgical management of pelvic organ prolapse (POP), specifically uterine prolapse. There are few reports on transvaginal uterosacral ligament hysteropexy (TULH). This study aimed to describe our surgical technique and outcomes. DESIGN: Retrospective review and description of surgical technique. Anatomic outcome has been reported using the POP quantification system. Complications were segregated. A comparison of parametric continuous variables was performed using paired t test. Categoric variables were evaluated using the Pearson χ2 test and the Fisher exact test. A p-value <.05 was considered significant. SETTING: Teaching hospital. PATIENTS: Forty patients who underwent TULH from 2009 to 2017. INTERVENTIONS: TULH. MEASUREMENTS AND MAIN RESULTS: A total of 40 patients met the inclusion criteria. Of these, 56.1% had preoperative stage 3 prolapse. The median operative time was 116 minutes. The mean estimated blood loss was 158.5 mL. Transient ureteral obstruction occurred in 2 patients. The mean follow-up time was 17.2 months, and all patients had significant improvement of prolapse (p <.001). There was also an improvement in urinary incontinence and bladder storage symptoms (p <.001). None of the patients were reoperated on for recurrent POP. CONCLUSION: TULH is an effective uterus-preserving surgical alternative for the treatment of uterovaginal prolapse and provides good apical support. It is also associated with a low short-term recurrence and incidence of reoperation. TULH is a viable option for suitable patients with uterovaginal prolapse who desire uterine conservation.


Assuntos
Ligamento Largo/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Tratamentos com Preservação do Órgão/métodos , Prolapso de Órgão Pélvico/cirurgia , Ligamento Redondo do Útero/cirurgia , Prolapso Uterino/cirurgia , Adulto , Idoso , Ligamento Largo/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Prolapso de Órgão Pélvico/epidemiologia , Prolapso de Órgão Pélvico/patologia , Peritônio/patologia , Peritônio/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Recidiva , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Incontinência Urinária/cirurgia , Prolapso Uterino/epidemiologia , Prolapso Uterino/patologia , Vagina/patologia , Vagina/cirurgia
11.
J Laparoendosc Adv Surg Tech A ; 31(1): 6-10, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32609074

RESUMO

Background: Laparoscopic repair has been recommended as the method-of-choice of groin hernia repair among women. Whether the round ligament of uterus should be divided to facilitate mesh placement remains controversial. This study aims to review the outcomes of laparoscopic total extraperitoneal (TEP) groin hernia repair in women and to evaluate the impact of division of round ligament. Methods: Consecutive female patients with inguinal or femoral hernias who underwent elective laparoscopic TEP repair at a single institution from 2006 to 2017 were included for retrospective analysis. Primary outcomes were postoperative pain, genital prolapse, and recurrence. Outcomes of patients who had the round ligament divided were further compared with those with round ligament preserved and multivariable adjusted analysis was performed. Results: Sixty-eight patients with a total of 77 TEP repairs were included in the 12-year study period. The mean age was 45 ± 16 years old. Incidental femoral hernia was identified in 4 patients (5.9%). There was 1 (1.3%) recurrence upon mean follow-up of 42.9 ± 37.3 months. The round ligament was divided in 67.5% of patients, and upon multivariable adjusted analysis, there were no statistically significant differences in outcomes in terms of chronic pain (odds ratio [OR] = 2.210, P = .357), paresthesia (OR = 0.241, P = .149), and genital prolapse (OR = 0.327, P = .415) when compared with patients with preserved round ligament. Conclusion: Laparoscopic groin hernia repair in women is associated with low recurrence. Division of round ligament intraoperatively facilitates mesh placement and has minimal impact on clinical outcomes.


Assuntos
Hérnia Femoral/cirurgia , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Ligamento Redondo do Útero/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Herniorrafia/instrumentação , Humanos , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Recidiva , Estudos Retrospectivos , Telas Cirúrgicas , Resultado do Tratamento
12.
Ultrasound Obstet Gynecol ; 57(5): 821-828, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32770812

RESUMO

OBJECTIVE: To describe the clinical and ultrasound characteristics of accessory cavitated uterine malformations (ACUMs). METHODS: This was a single-center observational study of consecutive patients diagnosed with an ACUM, who had undergone an ultrasound examination by an experienced ultrasound examiner between January 2013 and May 2019, identified retrospectively from medical records. ACUM was diagnosed when a cavitated lesion with a myometrial mantle and echogenic contents was seen within the anterolateral wall of the myometrium beneath the insertion of the round ligament. In all women, presenting symptoms and clinical history were recorded along with detailed descriptions of the lesions and any concomitant pelvic abnormalities. RESULTS: Twenty patients diagnosed with an ACUM were identified. Median age was 29.2 (interquartile range, 25.0-35.8) years. None of the women was premenarchal or postmenopausal. All of the women reported painful periods or pelvic pain and none of them reported subfertility. Twelve of the ACUMs were in the right anterolateral myometrium and eight were in the left anterolateral myometrium. Both a myometrial mantle and a fluid-filled cavity were considered to be defining features on ultrasound. The fluid contained within the cavity was either echogenic with a ground-glass appearance or hyperechoic. All of the lesions were spherical in shape. The Doppler flow seen in the outer rim was not markedly different from that of the surrounding myometrium, and the content of the cavity was avascular on Doppler examination. The mean outer cavity diameter of the ACUMs was 22.8 (95% CI, 20.9-24.8) mm and the mean internal cavity diameter was 14.1 (95% CI, 12.2-16.1) mm. Four women opted for transvaginal ultrasound-guided alcohol sclerotherapy. Surgical excision was carried out in eight cases, and the diagnosis was confirmed on histopathological examination in all of them. CONCLUSIONS: ACUMs are a uterine abnormality with a distinct ultrasound appearance, which are associated with dysmenorrhea and chronic pelvic pain. Knowledge of their typical appearance on ultrasound could facilitate early detection and treatment. There are several treatment options for ACUM, ranging from simple analgesia to complete excision. Further prospective and longitudinal studies are required to study the prevalence and natural history of this condition. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Ecocardiografia Doppler , Miométrio/anormalidades , Anormalidades Urogenitais/diagnóstico por imagem , Útero/anormalidades , Adulto , Dor Crônica/congênito , Dor Crônica/diagnóstico por imagem , Dismenorreia/congênito , Dismenorreia/diagnóstico por imagem , Feminino , Humanos , Miométrio/diagnóstico por imagem , Dor Pélvica/congênito , Dor Pélvica/diagnóstico por imagem , Estudos Retrospectivos , Ligamento Redondo do Útero/diagnóstico por imagem , Anormalidades Urogenitais/complicações , Útero/diagnóstico por imagem
13.
Ann Ital Chir ; 92020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33764330

RESUMO

BACKGROUND: Differential diagnosis of inguinal mass must include, especially in female patients, a wide variety of lesions among which our analysis will focus on mesothelial cyst of the round ligament of the uterus. A rare developmental lesion often misdiagnosed as hernias and accidentally detected during surgical exploration of the groin region. CASE REPORT: Of a left inguinal mass causing local discomfort and progressive worsening of local pain. A pre-operative diagnosis of left symptomatic femoral hernia was made and the patient consented to surgical treatment. The surgical exploration of the inguinal and femoral canals revealed a femoral hernia associated to a clear fluid cystic lesion of around 2 cm arising from the round ligament. Histopathology demonstrated a mesothelial cyst of the round ligament CONCLUSIONS: Mesothelial cysts of the round ligament of the uterus must be taken into consideration in the differential diagnosis of groin swelling in female patients and a greater effort is needed in order to reach a preoperative diagnosis and prevent an over treatment. Key words: Mesothelial cyst, Preoperative diagnosis, Uterus.


Assuntos
Cistos , Hérnia Femoral , Hérnia Inguinal , Ligamento Redondo do Útero , Cistos/patologia , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Hérnia Femoral/diagnóstico , Hérnia Inguinal/diagnóstico , Humanos , Sobremedicalização/prevenção & controle , Ligamento Redondo do Útero/patologia , Ligamento Redondo do Útero/cirurgia , Útero
14.
Hernia ; 24(3): 633-637, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30900041

RESUMO

PURPOSE: Short-term effects of round ligament varicosity (RLV) in pregnancy have been investigated in small-scale studies. The long-term effects are unknown. This study aims to evaluate the risk of groin hernia manifestation after RLV in pregnancy, to delineate possible risk factors and to analyze the natural course of pregnancy and post-partum period with regard to RLV. METHODS: In a prospective analysis 28 pregnant women with RLV presented to the hernia clinic over 9 years. After clinical and ultrasound examination during pregnancy and publication of early results in 2013 a second structured follow-up was conducted. Demographic data, hernia-specific risk factors, comorbidities, pregnancy and birth-related data as well as post-partum period were documented without loss of follow-up. In these women, all pregnancies that occurred, including the ones without RLV, were analyzed. RESULTS: Median follow-up was 68 months (11.4-104.9). Only one groin hernia was found. No risk factors could be identified. After uncomplicated childbirth complaints subsided spontaneously in all but one patient within 4 weeks. Recurrence rates in subsequent pregnancies are up to 89%. CONCLUSION: Temporary RLV-induced dilation of the deep inguinal ring in pregnancy is not a common precursor for the development of inguinal hernias later in life. All findings support the theory that the hindrance of venous blood flow caused by the gravid uterus is an important contributing factor for RLV in pregnancy, which is self-limited but has a high risk of recurrence and is not an indication for surgery before or after delivery or for cesarean section.


Assuntos
Hérnia Inguinal/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Ligamento Redondo do Útero/irrigação sanguínea , Varizes/fisiopatologia , Adulto , Dilatação Patológica/diagnóstico , Dilatação Patológica/etiologia , Feminino , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/cirurgia , Humanos , Canal Inguinal/irrigação sanguínea , Período Pós-Parto , Gravidez/fisiologia , Complicações Cardiovasculares na Gravidez/diagnóstico , Estudos Prospectivos , Fatores de Risco , Ligamento Redondo do Útero/diagnóstico por imagem , Autoexame , Ultrassonografia , Manobra de Valsalva , Varizes/complicações , Varizes/diagnóstico por imagem , Adulto Jovem
15.
BMJ Case Rep ; 12(8)2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31473635

RESUMO

A gravida 4 para 1021, 41-year-old woman postcaesarean section at 39 weeks and 1 day with clinically significant haemorrhage required embolisation of unique uterine arterial collaterals. She had persistent haemorrhage after initial bilateral uterine artery embolisation, and on further investigation she was found to have a hypertrophied right round ligament artery. Once successful embolisation of this abnormal right round ligament artery was completed using a combination of Gelfoam and coils, haemostasis was achieved. She had rapid clinical improvement, no complications and no further admissions on postprocedural follow-up over a year and a half later.


Assuntos
Hemorragia Pós-Parto/cirurgia , Ligamento Redondo do Útero/irrigação sanguínea , Embolização da Artéria Uterina/métodos , Artéria Uterina/patologia , Adulto , Feminino , Humanos , Hipertrofia , Gravidez , Ligamento Redondo do Útero/cirurgia , Artéria Uterina/cirurgia
16.
J Obstet Gynaecol Res ; 45(11): 2220-2227, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31423703

RESUMO

AIM: Adequately powered, randomized controlled studies evaluating efficacy and safety of advanced bipolar energy devices in gynecologic laparoscopic surgery are very few. We aimed to compare the two most commonly used devices in total laparoscopic hysterectomy. METHODS: This randomized controlled trial was carried out in the department of obstetrics and gynecology in an education and research hospital. One hundred thirty-two women who underwent total laparoscopic hysterectomy for benign indications were included. Women with age younger than 18 years, suspected malignancy, stage 3-4 endometriosis and cervical/intraligamentary leiomyoma were excluded. Patients were randomized preoperatively to LigaSure or Articulating Enseal. One experienced surgeon performed all operations. RESULTS: LigaSure was used in 67 patients and Enseal was used in 65 patients. Primary outcomes of the study were operative time (time from start of sealing and transection of the round ligament until completion of colpotomy) and total operative time (time from skin incision to skin closure). Secondary outcomes were intraoperative blood loss (blood lost during operative time period) and perioperative complications. Operative time was significantly shorter in LigaSure group (P = 0.001). Total operative time, intraoperative blood loss and perioperative complications were similar. When two groups were further classified according to uterine weight taking 300 g as cut-off value, operative time was significantly shorter in LigaSure group in both subgroups (P = 0.003 and P = 0.007). CONCLUSION: LigaSure use in total laparoscopic hysterectomy shortens operative time when compared with Enseal; without an apparent increase in intraoperative blood loss and perioperative complications. On the other side, total operative time remains unaffected.


Assuntos
Histerectomia/métodos , Laparoscopia/métodos , Ligadura/métodos , Ligamento Redondo do Útero/cirurgia , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Resultado do Tratamento , Útero/irrigação sanguínea , Útero/cirurgia , Adulto Jovem
20.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451459

RESUMO

We reported a case of right inguinal endometriosis in a 41-year-old woman with unremarkable surgical and gynaecological history. She presented with right groin swelling for a month since her last menstrual period. Clinically the swelling was first diagnosed as inguinal hernia and later histologically proven to be endometriosis.


Assuntos
Doenças dos Anexos , Endometriose , Virilha/patologia , Hérnia Inguinal/diagnóstico , Doenças dos Anexos/diagnóstico , Doenças dos Anexos/patologia , Adulto , Diagnóstico Diferencial , Endometriose/diagnóstico , Endometriose/patologia , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Ligamento Redondo do Útero/patologia
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