Journal of minimally invasive gynecology最新文献

英文中文

Risk Factors and Prediction Nomogram of Local Regeneration after Ultrasound-guided Microwave Ablation of Uterine Fibroids. 超声引导下子宫肌瘤微波消融术后局部再生的风险因素和预测提名图。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-02 DOI: 10.1016/j.jmig.2024.07.020

Yongyan He, Sainan Guan, Shanshan Wu, Jinxiu Wan, Haijing Peng, Shuang Liang, Huahui Liu, Jiangyu Guo, Ronghua Yan, Erjiao Xu

Study objective: To explore the risk factors associated with local regeneration of the treated uterine fibroids (UFs) after microwave ablation (MWA) and to develop a nomogram model for predicting the risk of local regeneration.

Design: Retrospective study.

Setting: The Eighth Affiliated Hospital of Sun Yat-Sen University.

Patients: Patients with UFs who underwent MWA at our hospital between October 2020 and April 2023 were included.

Intervention: MWA was used for the treatment of UFs.

Measurements and main results: A total of 47 patients with 68 fibroids were included into this study. Over a median follow-up of 13 months (interquartile range, 8-22 months), local regeneration occurred in 11 UFs. The clinical and imaging characteristics of these patients were recorded and compared. Risk factors for local regeneration were determined through univariate and multivariate Cox regression analysis. Multivariate analysis revealed that the fertility desires, larger size of UFs (≥95.3 cm³), and hyperenhancement of UFs on contrast-enhanced ultrasound were independent risk factors for local regeneration after MWA. A predictive nomogram was constructed to predict the local regeneration after MWA of UFs. The concordance index (C-index) (C-index, 0.924; internal validation C-index, 0.895) and the 1- and 2-year area under the curve values (0.962, 0.927) all indicated that the nomogram had good predictive performance. Calibration and decision curve analysis curves further confirmed the model's accuracy and clinical utility.

Conclusion: Fertility desires, larger size of UFs, and hyperenhancement on contrast-enhanced ultrasound were independent predictors of UFs local regeneration after MWA in our study. The nomogram constructed based on the abovementioned independent risk factors may help predict which UFs will develop local regeneration after MWA.

研究目的探讨微波消融术（MWA）后子宫肌瘤（UFs）局部再生的相关风险因素，并建立预测局部再生风险的提名图模型：设计：回顾性研究：背景：中山大学附属第八医院：纳入2020年10月至2023年4月期间在我院接受MWA治疗的UFs患者：测量和主要结果：本研究共纳入47例68个子宫肌瘤患者。在中位 13 个月的随访期间（四分位间范围：8 至 22 个月），11 例 UFs 发生了局部再生。研究人员记录并比较了这些患者的临床和影像学特征。通过单变量和多变量 Cox 回归分析确定了局部再生的风险因素。多变量分析显示，生育愿望、UFs较大（≥95.3cm3）和对比增强超声（CEUS）显示的UFs高增强是MWA后局部再生的独立危险因素。为预测 UFs 在 MWA 后的局部再生情况，构建了一个预测提名图。一致性指数（C-index = 0.924，内部验证 C-index=0.895）以及 1 年和 2 年的曲线下面积（AUC）值（0.962，0.927）均表明提名图具有良好的预测性能。校准和决策曲线分析（DCA）曲线进一步证实了该模型的准确性和临床实用性：结论：在我们的研究中，生育愿望、UFs较大和CEUS高增强是MWA后UFs局部再生的独立预测因素。根据上述独立风险因素构建的提名图可能有助于预测哪些 UF 在 MWA 后会发生局部再生。

{"title":"Risk Factors and Prediction Nomogram of Local Regeneration after Ultrasound-guided Microwave Ablation of Uterine Fibroids.","authors":"Yongyan He, Sainan Guan, Shanshan Wu, Jinxiu Wan, Haijing Peng, Shuang Liang, Huahui Liu, Jiangyu Guo, Ronghua Yan, Erjiao Xu","doi":"10.1016/j.jmig.2024.07.020","DOIUrl":"10.1016/j.jmig.2024.07.020","url":null,"abstract":"<p><strong>Study objective: </strong>To explore the risk factors associated with local regeneration of the treated uterine fibroids (UFs) after microwave ablation (MWA) and to develop a nomogram model for predicting the risk of local regeneration.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>The Eighth Affiliated Hospital of Sun Yat-Sen University.</p><p><strong>Patients: </strong>Patients with UFs who underwent MWA at our hospital between October 2020 and April 2023 were included.</p><p><strong>Intervention: </strong>MWA was used for the treatment of UFs.</p><p><strong>Measurements and main results: </strong>A total of 47 patients with 68 fibroids were included into this study. Over a median follow-up of 13 months (interquartile range, 8-22 months), local regeneration occurred in 11 UFs. The clinical and imaging characteristics of these patients were recorded and compared. Risk factors for local regeneration were determined through univariate and multivariate Cox regression analysis. Multivariate analysis revealed that the fertility desires, larger size of UFs (≥95.3 cm<sup>3</sup>), and hyperenhancement of UFs on contrast-enhanced ultrasound were independent risk factors for local regeneration after MWA. A predictive nomogram was constructed to predict the local regeneration after MWA of UFs. The concordance index (C-index) (C-index, 0.924; internal validation C-index, 0.895) and the 1- and 2-year area under the curve values (0.962, 0.927) all indicated that the nomogram had good predictive performance. Calibration and decision curve analysis curves further confirmed the model's accuracy and clinical utility.</p><p><strong>Conclusion: </strong>Fertility desires, larger size of UFs, and hyperenhancement on contrast-enhanced ultrasound were independent predictors of UFs local regeneration after MWA in our study. The nomogram constructed based on the abovementioned independent risk factors may help predict which UFs will develop local regeneration after MWA.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Abdominal Wall Endometriosis: Minimally Invasive Surgery for Excision and Repair 自发性腹壁子宫内膜异位症：微创手术切除和修复。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.04.023

引用次数: 0

COVID Recovery Laparoscopic Simulation Program for Gynecological Registrars—Trainee Perceptions of Regional Model 针对妇科注册医师的 Covid 恢复腹腔镜模拟程序--受训者对区域模型的看法。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.05.007

Study Objective

The acquisition of gynecological operating skills can be challenging for trainees given the conflicting demands of clinical work. Alternative models of surgical skill training such as laparoscopic simulation is, therefore, required. This study demonstrates the development of a regional gynecological surgery laparoscopic simulation program and trainee perceptions of such an approach.

Design

An intervention-based cohort study.

Setting

A regional model based in West Midlands training region.

Patients/Participants

Responses from 64 trainees in the training region who participated in this regional program were included.

Interventions

A 3-stream curriculum was developed to deliver key training outcomes as required by the Royal College of Obstetricians and Gynaecologists (RCOG) core curriculum as a component of a COVID Recovery Program. Courses were held in 7 teaching hospitals. Courses consisted of both theory and practical teaching.

Measurements

A structured feedback tool was used to collect trainee perceptions of the program. Trainee satisfaction was measured on the Likert scale of 1 to 3. A qualitative thematic analysis was conducted with rank-order analysis of coded free-text responses.

Main Results

Overall, the majority of trainees 92% (n = 58/64) were very satisfied with the course. Rank-order analysis demonstrated hands-on-practice to be the key perceived benefit of laparoscopic simulation among basic and intermediate trainees, while feedback on procedural skills was felt most useful among advanced trainees.

Conclusion

A regional approach to laparoscopic simulation training is both achievable and acceptable. Trainee perceptions of usefulness are altered by seniority and experience. This should be accounted for in the development of laparoscopic simulation programs.

研究目的：由于临床工作的需求相互冲突，妇科手术技能的掌握对受训人员来说具有挑战性。因此，需要采用腹腔镜模拟等其他手术技能培训模式。本研究展示了地区性妇科手术腹腔镜模拟项目的发展情况以及学员对这种方法的看法：设计：基于干预的队列研究：患者/参与者：患者/参与者：包括来自该培训地区参加该地区项目的 64 名学员的反馈：干预措施：根据皇家妇产科学院（RCOG）核心课程的要求，制定了三流课程，作为Covid恢复计划的组成部分，提供关键培训成果。培训课程在七家教学医院举行。课程包括理论和实践教学：采用结构化反馈工具收集学员对课程的看法。学员满意度采用 1-3 级李克特量表进行测量。对自由文本回答进行了定性主题分析，并对编码的自由文本回答进行了排序分析：总体而言，92%（n=58/64）的学员对课程非常满意。排序分析表明，在基础和中级学员中，动手实践是他们认为腹腔镜模拟课程的主要益处，而在高级学员中，程序技能方面的反馈被认为是最有用的：结论：腹腔镜模拟培训的区域性方法是可以实现和接受的。学员对有用性的看法会因资历和经验而改变。在制定腹腔镜模拟计划时应考虑到这一点。

{"title":"COVID Recovery Laparoscopic Simulation Program for Gynecological Registrars—Trainee Perceptions of Regional Model","authors":"","doi":"10.1016/j.jmig.2024.05.007","DOIUrl":"10.1016/j.jmig.2024.05.007","url":null,"abstract":"<div><h3>Study Objective</h3><p>The acquisition of gynecological operating skills can be challenging for trainees given the conflicting demands of clinical work. Alternative models of surgical skill training such as laparoscopic simulation is, therefore, required. This study demonstrates the development of a regional gynecological surgery laparoscopic simulation program and trainee perceptions of such an approach.</p></div><div><h3>Design</h3><p>An intervention-based cohort study.</p></div><div><h3>Setting</h3><p>A regional model based in West Midlands training region.</p></div><div><h3>Patients/Participants</h3><p>Responses from 64 trainees in the training region who participated in this regional program were included.</p></div><div><h3>Interventions</h3><p>A 3-stream curriculum was developed to deliver key training outcomes as required by the Royal College of Obstetricians and Gynaecologists (RCOG) core curriculum as a component of a COVID Recovery Program. Courses were held in 7 teaching hospitals. Courses consisted of both theory and practical teaching.</p></div><div><h3>Measurements</h3><p>A structured feedback tool was used to collect trainee perceptions of the program. Trainee satisfaction was measured on the Likert scale of 1 to 3. A qualitative thematic analysis was conducted with rank-order analysis of coded free-text responses.</p></div><div><h3>Main Results</h3><p>Overall, the majority of trainees 92% (n = 58/64) were very satisfied with the course. Rank-order analysis demonstrated hands-on-practice to be the key perceived benefit of laparoscopic simulation among basic and intermediate trainees, while feedback on procedural skills was felt most useful among advanced trainees.</p></div><div><h3>Conclusion</h3><p>A regional approach to laparoscopic simulation training is both achievable and acceptable. Trainee perceptions of usefulness are altered by seniority and experience. This should be accounted for in the development of laparoscopic simulation programs.</p></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

International Societies 国际社团

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/S1553-4650(24)00284-X

引用次数: 0

Long-Term Costs of Minimally Invasive Sacral Colpopexy Compared to Native Tissue Vaginal Repair With Concomitant Hysterectomy 微创骶骨阴道成形术与同时进行子宫切除术的原生组织阴道修复术的长期成本比较。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.04.025

Study Objective

To determine the long-term costs of hysterectomy with minimally invasive sacrocolpopexy (MISCP) versus uterosacral ligament suspension (USLS) for primary uterovaginal prolapse repair.

Design

A hospital-based decision analysis model was built using TreeAge Pro (TreeAge Software Inc, Williamstown, MA). Those with prolapse were modeled to undergo either vaginal hysterectomy with USLS or minimally invasive total hysterectomy with sacrocolpopexy (MISCP). We modeled the chance of complications of the index procedure, prolapse recurrence with the option for surgical retreatment, complications of the salvage procedure, and possible second prolapse recurrence. The primary outcome was cost of the surgical strategy. The proportion of patients living with prolapse after treatment was the secondary outcome.

Setting

Tertiary center for urogynecology.

Patients

Female patients undergoing surgical repair by the same team for primary uterovaginal prolapse.

Interventions

Comparison analysis of estimated long-term costs was performed.

Measurements and Main Results

Our primary outcome showed that a strategy of undergoing MISCP as the primary index procedure cost $19 935 and that undergoing USLS as the primary index procedure cost $15 457, a difference of $4478. Furthermore, 21.1% of women in the USLS group will be living with recurrent prolapse compared to 6.2% of MISCP patients. Switching from USLS to MISCP to minimize recurrence risk would cost $30 054 per case of prolapse prevented. Additionally, a surgeon would have to perform 6.7 cases by MISCP instead of USLS in order to prevent 1 patient from having recurrent prolapse.

Conclusion

The higher initial costs of MISCP compared to USLS persist in the long term after factoring in recurrence and complication rates, though more patients who undergo USLS live with prolapse recurrence.

研究目的确定子宫切除术联合微创骶尾部结扎术（MISCP）与子宫骶骨韧带悬吊术（USLS）用于子宫脱垂初次修复的长期成本：研究设计：使用 TreeAge Pro (TreeAge Software Inc, Williamstown, MA) 建立了一个基于医院的决策分析模型。研究设计：我们使用 TreeAge Pro（TreeAge Software Inc，马萨诸塞州威廉姆镇市）建立了一个基于医院的决策分析模型，对子宫脱垂患者进行阴道子宫切除术加子宫骶骨韧带悬吊术（USLS）或微创全子宫切除术加骶骨结节成形术（MISCP）。我们模拟了指数手术的并发症几率、可选择手术再治疗的脱垂复发几率、挽救手术的并发症几率以及可能的第二次脱垂复发几率。主要结果是手术策略的成本。治疗后脱垂患者的生存比例是次要结果：环境：三级泌尿妇科中心患者：由同一团队进行原发性子宫阴道脱垂手术修复的女性患者：测量和主要结果：我们的主要结果显示，将 MISCP 作为主要指标手术的策略成本为 19,935 美元，而将 USLS 作为主要指标手术的策略成本为 15,457 美元，两者相差 4,478 美元。此外，USLS 组中有 21.1% 的女性会出现复发性脱垂，而 MISCP 患者的这一比例仅为 6.2%。从 USLS 转为 MISCP 以最大程度降低复发风险，每预防一例脱垂将花费 30,054 美元。此外，为了防止一名患者复发脱垂，外科医生必须用 MISCP 代替 USLS 进行 6.7 例手术：结论：在考虑到复发率和并发症发生率后，MISCP的初始成本高于USLS，但从长期来看，MISCP的成本仍高于USLS，尽管接受USLS手术的患者中有更多的人复发脱垂。

{"title":"Long-Term Costs of Minimally Invasive Sacral Colpopexy Compared to Native Tissue Vaginal Repair With Concomitant Hysterectomy","authors":"","doi":"10.1016/j.jmig.2024.04.025","DOIUrl":"10.1016/j.jmig.2024.04.025","url":null,"abstract":"<div><h3>Study Objective</h3><p><span>To determine the long-term costs of hysterectomy with minimally invasive </span>sacrocolpopexy<span> (MISCP) versus uterosacral ligament suspension (USLS) for primary uterovaginal prolapse repair.</span></p></div><div><h3>Design</h3><p>A hospital-based decision analysis model was built using TreeAge Pro (TreeAge Software Inc, Williamstown, MA). Those with prolapse were modeled to undergo either vaginal hysterectomy<span> with USLS or minimally invasive total hysterectomy with sacrocolpopexy (MISCP). We modeled the chance of complications of the index procedure, prolapse recurrence with the option for surgical retreatment<span>, complications of the salvage procedure, and possible second prolapse recurrence. The primary outcome was cost of the surgical strategy. The proportion of patients living with prolapse after treatment was the secondary outcome.</span></span></p></div><div><h3>Setting</h3><p>Tertiary center for urogynecology.</p></div><div><h3>Patients</h3><p>Female patients undergoing surgical repair by the same team for primary uterovaginal prolapse.</p></div><div><h3>Interventions</h3><p>Comparison analysis of estimated long-term costs was performed.</p></div><div><h3>Measurements and Main Results</h3><p>Our primary outcome showed that a strategy of undergoing MISCP as the primary index procedure cost $19 935 and that undergoing USLS as the primary index procedure cost $15 457, a difference of $4478. Furthermore, 21.1% of women in the USLS group will be living with recurrent prolapse compared to 6.2% of MISCP patients. Switching from USLS to MISCP to minimize recurrence risk would cost $30 054 per case of prolapse prevented. Additionally, a surgeon would have to perform 6.7 cases by MISCP instead of USLS in order to prevent 1 patient from having recurrent prolapse.</p></div><div><h3>Conclusion</h3><p>The higher initial costs of MISCP compared to USLS persist in the long term after factoring in recurrence and complication rates, though more patients who undergo USLS live with prolapse recurrence.</p></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regarding “Cornual Pregnancy Reaching Eight-Weeks of Gestation Without Uterine Rupture” 关于 "妊娠满八周但未发生子宫破裂的角膜妊娠"。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.04.026

引用次数: 0

TOC 技术选择委员会

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/S1553-4650(24)00286-3

引用次数: 0

Authors’ Reply 作者回复。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.05.008

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》。

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/j.jmig.2024.05.017

引用次数: 0

Board Of Directors-Ed Calendar 董事会-教育日历

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology

Pub Date : 2024-08-01 DOI: 10.1016/S1553-4650(24)00283-8

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of minimally invasive gynecology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀