Journal of minimally invasive gynecology最新文献

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Comparative Analysis of Electrosurgical Energy and Hemostatic Sealant for Hemostasis in Laparoscopic Ovarian Cystectomy: A Randomized Controlled Phase III Study 电外科能量与止血密封剂在腹腔镜卵巢囊肿切除术中止血效果的比较分析：随机对照 III 期研究。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.10.001

Ok-Ju Kang MD, Joo-Hyun Nam MD, PhD, Jeong-Yeol Park MD, PhD

Study Objective

To evaluate the efficacy of hemostatic sealant versus electrosurgical energy in achieving hemostasis and preserving postoperative ovarian reserve during laparoscopic ovarian cystectomy.

Design

Randomized controlled trial.

Setting

Single-center study.

Patients

A total of 121 patients undergoing laparoscopic ovarian cystectomy.

Interventions

Patients were randomized to receive either hemostatic sealant or electrosurgical energy for hemostasis during surgery.

Measurements and Main Results

The primary outcome measured was the time required to achieve hemostasis. Secondary outcomes included operating time, estimated blood loss, and assessment of postoperative ovarian reserve through hormone levels (anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], E2, inhibin) at three follow-up intervals. The results showed comparable hemostasis times between the two groups. Postoperative hormone levels indicated no significant differences in the impact on ovarian reserve between the groups, except in cases of bilateral ovarian cystectomy, where the hemostatic sealant group exhibited a lesser decline in AMH levels.

Conclusion

Both hemostatic sealant and electrosurgical energy showed equivalent effectiveness in achieving hemostasis during laparoscopic ovarian cystectomy, with comparable results in hemostasis time, blood loss, postoperative complications, and ovarian reserve preservation. However, in cases of bilateral ovarian cystectomy, the hemostatic sealant group exhibited a lesser decline in AMH levels, suggesting a potential advantage in preserving ovarian reserve in these specific cases.

研究目的评估在腹腔镜卵巢囊肿切除术中，止血密封剂与弹道外科能量在实现止血和保留术后卵巢储备方面的疗效设计：随机对照试验设定：单中心研究单中心研究共121名接受腹腔镜卵巢囊肿切除术的患者：测量和主要结果：测量的主要结果是实现止血所需的时间。次要结果包括手术时间、估计失血量以及通过三次随访的激素水平（AMH、FSH、E2、抑制素）评估术后卵巢储备情况。结果显示，两组的止血时间相当。术后激素水平显示，除双侧卵巢囊肿切除术（BOC）外，两组对卵巢储备功能的影响无明显差异，止血密封剂组的 AMH 水平下降较少：结论：止血密封剂和电外科能量在腹腔镜卵巢囊肿切除术中的止血效果相当，在止血时间、失血量、术后并发症和卵巢储备保护方面的结果也相当。不过，在双侧卵巢囊肿切除术（BOC）病例中，止血密封剂组的AMH水平下降较少，这表明在这些特殊病例中，止血密封剂组在保留卵巢储备功能方面具有潜在优势。

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JMIG reviewer Spotlight – Megan Wasson

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.11.010

引用次数: 0

Board Of Directors-Ed Calendar

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/S1553-4650(25)00003-2

引用次数: 0

A Challenging Case of IUD Retrieval From the Colon 从结肠取出宫内节育器的挑战性案例

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.08.008

Adi Dayan-Schwartz MD, MHA , Saleh Agbaria MD , Suzan Abd Elgani MD , Liron Kogan MD

引用次数: 0

Malpositioned IUD in Uterine Didelphys 子宫内膜异位症的宫内节育器错位。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.07.024

Caroline Shadowen MD , Lauren van Reesema MD , Jeffrey J. Woo MD

引用次数: 0

Regarding “The Effect of Hormonal Treatment on Ovarian Endometriomas: A Systematic Review and Meta-Analysis” 关于 "激素治疗对卵巢子宫内膜异位症的影响：系统回顾与元分析"：激素治疗与卵巢子宫内膜异位症。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.08.024

Leilei Hu MD, Dan Liao MD

引用次数: 0

Introducing our Deputy Editor of Health Equity

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2025.01.001

Gary N. Frishman MD , Jason A. Abbott PhD, FRANZCOG, FRCOG B Med (Hons)

引用次数: 0

Extraction Laparotomy for Specimen Retrieval Does Not Alter Same-Day Discharge Plans 提取标本的腹腔手术不会改变当日出院计划。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.09.015

Marla E. Scott MD, Dani Ashak MD, Wilkin F. Muñoz Orozco BS, Allison E. Axtell MD, Scott E. Lentz MD

Study Objective

To evaluate whether extraction laparotomy (EL) for intact specimen removal adversely affected the feasibility or safety of same-day discharge (SDD) in patients undergoing minimally invasive surgery (MIS) for confirmed or suspected gynecologic malignancies.

Design

Retrospective study.

Setting

Single-institution study.

Patients

Patients undergoing MIS for gynecologic malignancy at a single institution, who underwent EL (N = 67) and age-matched controls (N = 134).

Interventions

Comparing SDD rates, complications, readmission, and outpatient follow-up after between patients requiring EL and those who did not after minimally invasive gynecologic surgery.

Measurements and Main Results

A total of 1224 patients were identified. Sixty-seven patients underwent EL for specimen extraction. From the remainder, 134 patients were selected as age-matched controls. SDD rate was 83% (EL) vs 87% (no EL) (p = .39). There was no difference in median pain scores (1.8 vs 1.9 p = .86), length of stay (0 days for both) (p = .41), 30-day readmission rate (6% vs 3%) (p = .45), emergency department visit (13% vs 10%) (p = .76), or any patient contact (34% vs 39%) (p = .53), between the groups. Specimen weight was higher for EL (524 g vs 142 g, p <.001), as was estimated blood loss (104 mL vs 46 mL, p <.001), and surgery time was increased by 22 minutes in the EL group (121 min vs 99 min, p <.001). Patients who underwent EL did require more narcotics in postanesthesia care unit (20.5 vs 12.2 oral morphine equivalent, p = .033); however, this did not translate to increased number of narcotics prescribed at discharge. On logistic regression, a higher specimen weight trended to increase the likelihood of admission (odds ratio, 1.04; confidence interval, 1.01–1.08); however, surgery time, time in postanesthesia care unit, race, body mass index, surgery type, or need for EL did not predict SDD or need for admission.

Conclusion

MIS patients who require EL can still achieve SDD. SDD is safe and feasible without increased risk of readmission, pain score, or unscheduled patient contact postoperatively.

研究目的评估因确诊或疑似妇科恶性肿瘤而接受微创手术（MIS）的患者，因完整标本取出而进行的开腹手术（EL）是否会对当日出院（SDD）的可行性或安全性产生不利影响：回顾性研究患者：接受微创手术的患者在单个机构接受微创手术治疗妇科恶性肿瘤的患者（67人）和年龄匹配的对照组（134人）：比较微创妇科手术后需要拔管开腹的患者与不需要拔管开腹的患者的当日出院率、并发症、再入院率和门诊随访率：共确定了 1224 名患者。67名患者接受了EL标本提取术。其余 134 名患者被选为年龄匹配的对照组。SDD率为83%（EL）对87%（无EL）（P=0.39）。两组患者的疼痛评分中位数（1.8 vs. 1.9，p=.86）、住院时间（LOS）（两组均为 0 天）（p=.41）、30 天再入院率（6% vs. 3%，p=.45）、急诊室就诊率（13% vs. 10%，p=.76）或任何患者接触率（34% vs. 39%，p=.53）均无差异。EL组的标本重量更高（524克对142克，p结论：需要开腹取材的微创手术患者仍可实现 SDD。当天出院是安全可行的，不会增加术后再入院风险、疼痛评分或计划外的患者接触。

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引用次数: 0

Does Platelet-Rich Plasma Improve Adhesion Recurrence and Pregnancy Outcomes in Women With Intrauterine Adhesions? A Systematic Review and Meta-Analysis 富血小板血浆能改善宫腔粘连妇女的粘连复发和妊娠结局吗？系统回顾和荟萃分析。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/j.jmig.2024.10.013

Gaofa Wang PhD, Yuanjun Zhu MD, Na Duan BSN, Chong Guo PhD, Nannan Liu BSN, Hanling Huang MD

Objective

To determine the role of Platelet-rich plasma (PRP) in improving pregnancy and adhesion recurrence outcomes in women who underwent hysteroscopic treatment of intrauterine adhesions.

Data Sources

A total of 3 databases: Google scholar, PubMed, and clinicaltrials.gov were searched extensively from inception until April 5, 2023, without any language restrictions.

Methods of Study selection

After the removal of duplicates, studies were first scrutinized on the basis of title/abstract followed by a full-text review to assess for eligibility. Data extraction was carried out in an online Excel sheet. Risk ratio (RR) and mean difference (MD) was used as the outcome measure for dichotomous and continuous outcomes, respectively. Comprehensive meta-analysis software (version 3) was used for statistical analysis. A p-value of .05 was deemed significant throughout the analysis.

This meta-analysis was registered on Prospero with the registration number “CRD42024524425.”

Tabulation, Integration, and Results

This meta-analysis comprised 12 studies: 8 randomized controlled trials (RCTs) and 4 non-RCTs with a total of population of 874 participants: 425 in the PRP group and 449 in the control group. Our meta-analysis showed that the PRP administration significantly improved the recurrence of moderate to severe adhesions (RR: 0.477, p-value: <.001), reduction in American Fertility Score (AFS) score (MD: 0.862, p-value: .043), clinical pregnancy rate (RR: 1.373, p-value = .036), menstruation flow (MD: 2.956, p-value: <.001), change in endometrial thickness (MD: 0.815, p-value <.001), and menstruation duration (MD: 1.132, p-value <.001). However, no significant difference was observed for chemical pregnancy, miscarriage, and live birth rate.

Conclusion

PRP shows promising results in reducing adhesion recurrence and has a potential to improve pregnancy outcomes. Further large-scale RCTs, particularly addressing dosage-response relationships, are needed to better understand the efficacy of PRP in preventing the recurrence of intrauterine adhesions.

目的确定富血小板血浆（PRP）在改善接受宫腔镜治疗宫腔粘连妇女的妊娠和粘连复发结果方面的作用：共有 3 个数据库：数据来源：共检索了 3 个数据库：Google scholar、PubMed 和 clinicaltrials.gov，检索时间从开始到 2023 年 4 月 5 日，没有任何语言限制：在去除重复内容后，首先根据标题/摘要对研究进行仔细审查，然后进行全文审阅，以评估是否符合条件。数据提取在在线 Excel 表中进行。风险比（RR）和平均差（MD）分别作为二分法和连续法的结果测量指标。统计分析采用综合荟萃分析软件（第 3 版）。在整个分析过程中，P 值达到 0.05 即为显著。本荟萃分析已在 Prospero 上注册，注册号为 "CRD42024524425" 表列、整合与结果：本荟萃分析包括 12 项研究：8 项随机对照试验 (RCT) 和 4 项非 RCT 试验，共有 874 人参与：其中 PRP 组 425 人，对照组 449 人。我们的荟萃分析表明，使用 PRP 能明显改善中度至重度粘连的复发率（RR：0.477，P 值：0.477）：结论：PRP 在减少粘连复发方面显示出良好的效果，并有可能改善妊娠结局。为了更好地了解 PRP 在预防宫腔粘连复发方面的功效，需要进一步开展大规模 RCT 研究，尤其是研究剂量-反应关系。

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引用次数: 0

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IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2025-02-01 DOI: 10.1016/S1553-4650(25)00006-8

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