We describe an exceptionally rare case of epithelioid trophoblastic tumor (ETT) in a patient with recurrent implantation failure (RIF). A 38-year-old Japanese woman, gravida 1, para 1, was diagnosed with RIF following three unsuccessful cryopreserved morphologically good embryo transfers with hormone replacement cycles after thawing. She underwent hysteroscopy and endometrial biopsy to exclude chronic endometritis but was referred because ETT was strongly suspected. Following a preoperative diagnosis of stage I ETT, she underwent laparoscopic total hysterectomy and bilateral salpingo-oophorectomy. A yellowish elevated lesion was observed in the lower uterine body. Immunohistochemical staining was negative for human chorionic gonadotropin and human placental lactogen and positive for p63, with a Ki-67 proliferation index of >10%. She was diagnosed with stage I ETT, but postoperative chemotherapy was not administered because of the lesion location and occurrence within 48 months of the prior term delivery. She had no recurrence at 24 months postoperatively.
{"title":"Epithelioid trophoblastic tumor diagnosed during a thorough examination of recurrent implantation failure: A case report","authors":"Yasuhiko Kamada, Junko Haraga, Naoyuki Ida, Shoji Nagao, Hiroyuki Yanai, Hisashi Masuyama","doi":"10.1111/jog.16259","DOIUrl":"https://doi.org/10.1111/jog.16259","url":null,"abstract":"<p>We describe an exceptionally rare case of epithelioid trophoblastic tumor (ETT) in a patient with recurrent implantation failure (RIF). A 38-year-old Japanese woman, gravida 1, para 1, was diagnosed with RIF following three unsuccessful cryopreserved morphologically good embryo transfers with hormone replacement cycles after thawing. She underwent hysteroscopy and endometrial biopsy to exclude chronic endometritis but was referred because ETT was strongly suspected. Following a preoperative diagnosis of stage I ETT, she underwent laparoscopic total hysterectomy and bilateral salpingo-oophorectomy. A yellowish elevated lesion was observed in the lower uterine body. Immunohistochemical staining was negative for human chorionic gonadotropin and human placental lactogen and positive for p63, with a Ki-67 proliferation index of >10%. She was diagnosed with stage I ETT, but postoperative chemotherapy was not administered because of the lesion location and occurrence within 48 months of the prior term delivery. She had no recurrence at 24 months postoperatively.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nanayo Sasagasako, Chizuko Aoki-Kamiya, Yuma Tada, Tatsuya Miyake, Tadashi Maezawa, Hidetaka Kawabata, Kaoru Kawasaki, Masashi Takamura, Asuka Okunomiya, Jun Yoshimatsu
Aim
The number of childhood or adolescent and young adult cancer survivors is increasing. Often, they encounter new problems, such as late complications after cancer treatment and pregnancy. Female cancer survivors were reported to have increased risks of obstetrical complications and pregnancy-associated cardiovascular disease (CVD), such as cardiomyopathy. Therefore, preconception counseling (PC) is important. This study aimed to assess the current status of PC for cancer survivors through a questionnaire survey.
Methods
An online questionnaire survey was conducted on doctors specializing in oncology and female cancer survivors aged 18–39 years.
Results
In total, 34 doctors and 18 cancer survivors responded. Specifically, 32 (94.1%) explained the effect of cancer treatment on reproductivity, 8 (23.5%) explained the risks of CVD and other-organ complications during pregnancy, and 14 (41.2%) recommended PC and screening health checks to their patients before pregnancy. Although many doctors feel the importance and need for PC, only half responded that their facilities have a department in charge of PC. Sixteen cancer survivors (88.9%) were informed about their reproductivity before or during cancer treatment. Only two women (11.1%) were informed of the increased risks of CVD and other-organ complications during pregnancy. Four women (22.2%) received PC preoperatively.
Conclusions
Female cancer survivors are mostly informed about their reproductive health, but poorly informed about the CVD risks after conception. Currently, the implementation rate of PC is low; thus, spreading awareness of the importance of PC among doctors and patients is necessary.
{"title":"The current status of preconception counseling for female cancer survivors on cardiovascular complications in pregnancy: A questionnaire survey to doctors and survivors","authors":"Nanayo Sasagasako, Chizuko Aoki-Kamiya, Yuma Tada, Tatsuya Miyake, Tadashi Maezawa, Hidetaka Kawabata, Kaoru Kawasaki, Masashi Takamura, Asuka Okunomiya, Jun Yoshimatsu","doi":"10.1111/jog.16252","DOIUrl":"https://doi.org/10.1111/jog.16252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The number of childhood or adolescent and young adult cancer survivors is increasing. Often, they encounter new problems, such as late complications after cancer treatment and pregnancy. Female cancer survivors were reported to have increased risks of obstetrical complications and pregnancy-associated cardiovascular disease (CVD), such as cardiomyopathy. Therefore, preconception counseling (PC) is important. This study aimed to assess the current status of PC for cancer survivors through a questionnaire survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online questionnaire survey was conducted on doctors specializing in oncology and female cancer survivors aged 18–39 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 34 doctors and 18 cancer survivors responded. Specifically, 32 (94.1%) explained the effect of cancer treatment on reproductivity, 8 (23.5%) explained the risks of CVD and other-organ complications during pregnancy, and 14 (41.2%) recommended PC and screening health checks to their patients before pregnancy. Although many doctors feel the importance and need for PC, only half responded that their facilities have a department in charge of PC. Sixteen cancer survivors (88.9%) were informed about their reproductivity before or during cancer treatment. Only two women (11.1%) were informed of the increased risks of CVD and other-organ complications during pregnancy. Four women (22.2%) received PC preoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Female cancer survivors are mostly informed about their reproductive health, but poorly informed about the CVD risks after conception. Currently, the implementation rate of PC is low; thus, spreading awareness of the importance of PC among doctors and patients is necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nur Fatin Nabilah Mohd Sahardi, Manishaa Priya, Suzana Makpol, Mohamad Nasir Shafiee
Objective
This comprehensive review highlights the current research on metabolomics and the metabolic pathways involved in endometrial cancer (EC), offering potential non-invasive biomarkers for EC.
Methods
The data was extracted from published manuscripts between 2015 and 2024 using the reputed search engine “Pubmed.” All gathered data were organized into a single table, facilitating a comparison with earlier findings.
Results
The results of this study revealed most metabolites identified in previous metabolomic research on EC are associated with lipid, glucose, and amino acid metabolism.
Conclusion
Therefore, understanding these metabolic pathway alterations in EC is crucial for improving diagnosis, prognosis, and treatments by specially targeting these metabolic pathways.
{"title":"Clinical translation of metabolomics markers in endometrial carcinoma","authors":"Nur Fatin Nabilah Mohd Sahardi, Manishaa Priya, Suzana Makpol, Mohamad Nasir Shafiee","doi":"10.1111/jog.16246","DOIUrl":"https://doi.org/10.1111/jog.16246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This comprehensive review highlights the current research on metabolomics and the metabolic pathways involved in endometrial cancer (EC), offering potential non-invasive biomarkers for EC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data was extracted from published manuscripts between 2015 and 2024 using the reputed search engine “Pubmed.” All gathered data were organized into a single table, facilitating a comparison with earlier findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results of this study revealed most metabolites identified in previous metabolomic research on EC are associated with lipid, glucose, and amino acid metabolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Therefore, understanding these metabolic pathway alterations in EC is crucial for improving diagnosis, prognosis, and treatments by specially targeting these metabolic pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian heterologous sarcoma is a rare malignancy. Only three cases of ovarian chondrosarcoma have been reported in the literature, and almost all of these were components of ovarian teratomas. Herein, we report the clinicopathological characteristics of an ovarian chondrosarcoma in a 68-year-old woman who had previously undergone total hysterectomy. She had no subjective symptoms, and the tumor was unexpectedly found by further examination of osteoarthritis of the hip joint. Preoperative magnetic resonance imaging revealed curious findings of a lobulated high-intensity component with a leaf-vein-like low-intensity component. Computed tomography revealed irregularly distributed ossification extending to the entire tumor. Preoperative levels of CA125, CA19-9, carcinoembryonic antigen, α-fetoprotein, and lactic dehydrogenase were all within normal limits. Macroscopic findings of the surgically resected tumor and pathologic findings revealed no teratoma component in the tumor. Finally, we diagnosed the tumor as a primary chondrosarcoma of the ovary.
{"title":"Primary chondrosarcoma of the ovary","authors":"Yukiko Matsuzawa, Hiroki Kurosawa, Kazuhiro Murakami, Mitsumasa Osakabe, Yoh Watanabe","doi":"10.1111/jog.16250","DOIUrl":"https://doi.org/10.1111/jog.16250","url":null,"abstract":"<p>Ovarian heterologous sarcoma is a rare malignancy. Only three cases of ovarian chondrosarcoma have been reported in the literature, and almost all of these were components of ovarian teratomas. Herein, we report the clinicopathological characteristics of an ovarian chondrosarcoma in a 68-year-old woman who had previously undergone total hysterectomy. She had no subjective symptoms, and the tumor was unexpectedly found by further examination of osteoarthritis of the hip joint. Preoperative magnetic resonance imaging revealed curious findings of a lobulated high-intensity component with a leaf-vein-like low-intensity component. Computed tomography revealed irregularly distributed ossification extending to the entire tumor. Preoperative levels of CA125, CA19-9, carcinoembryonic antigen, α-fetoprotein, and lactic dehydrogenase were all within normal limits. Macroscopic findings of the surgically resected tumor and pathologic findings revealed no teratoma component in the tumor. Finally, we diagnosed the tumor as a primary chondrosarcoma of the ovary.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cesarean scar defect (CSD) is a long-term complication of cesarean section (CS). However, its risks for perimenopausal women remain unclear. We present a rare case of CSD involving hematometra in a perimenopausal woman, which led to emergency hysterectomy. A 51-year-old woman with a history of CS presented with acute abdominal pain. Transvaginal ultrasonography and magnetic resonance imaging identified a hematometra within a large CSD extending into the cervical myometrium. Emergent hysterectomy was performed due to persistent pain. Histopathology revealed a fresh hematoma within the CSD, with ectopic endometrial glands and hemorrhage on its walls. This case highlights the pathogenesis of hematometra within a CSD and underscores its potential to cause acute abdomen in perimenopausal women.
{"title":"Hematometra within a cesarean scar defect in a perimenopausal woman: A case report","authors":"Atsushi Murakami, Shunichiro Tsuji, Yu Koikawa, Mari Nakata, Suzuko Moritani, Takashi Murakami","doi":"10.1111/jog.16253","DOIUrl":"https://doi.org/10.1111/jog.16253","url":null,"abstract":"<p>Cesarean scar defect (CSD) is a long-term complication of cesarean section (CS). However, its risks for perimenopausal women remain unclear. We present a rare case of CSD involving hematometra in a perimenopausal woman, which led to emergency hysterectomy. A 51-year-old woman with a history of CS presented with acute abdominal pain. Transvaginal ultrasonography and magnetic resonance imaging identified a hematometra within a large CSD extending into the cervical myometrium. Emergent hysterectomy was performed due to persistent pain. Histopathology revealed a fresh hematoma within the CSD, with ectopic endometrial glands and hemorrhage on its walls. This case highlights the pathogenesis of hematometra within a CSD and underscores its potential to cause acute abdomen in perimenopausal women.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jog.16253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Li, Dian Wang, Qing Duan, Ning Su, Xiufang Li, Haifeng Qiu
Objectives
Gastric-type endocervical adenocarcinoma (GEA) is a rare malignant tumor that is not associated with high-risk HPV infection, known for its high invasiveness and resistance to current treatments. This study assessed the effectiveness of anti-angiogenic regimens in real-world GEA patients.
Methods
Patients with GEA were enrolled between February 2012 and March 2023, and their clinicopathological characteristics were collected from their medical records. The patients were categorized into groups based on whether they received anti-angiogenic treatments or not. Survival analysis was conducted using the Kaplan–Meier method.
Results
A total of 43 GEA patients were enrolled in this study, with 23 cases who received anti-angiogenic drugs (nine received them as the primary treatment, 12 as first-line therapy after recurrence/metastasis, and two as second-line therapy) as the observation group. The other 20 patients who received similar treatments without the anti-angiogenic regimens serve as the control group. Compared to the control group, the addition of anti-angiogenic drugs as the primary treatment mildly extended progression-free survival (PFS) while not being statistically significant (16 months vs 11 months, p = 0.744). The negative results were also observed in 12 patients who started anti-angiogenic therapy as first-line therapy after recurrence/metastasis (8.5 months vs 9 months, p = 0.518). As for the overall survival (OS), no benefits were detected in either patients who started the anti-angiogenic therapy as primary or subsequent treatments (p = 0.499 and 0.450, respectively).
Conclusion
We firstly evaluated the efficacy of anti-angiogenic drugs in treating patients with GEA. Although with a small sample size, our preliminary results clearly proposed that the anti-angiogenic therapy failed in suppressing tumors and should not be a preferred choice for GEA. As a much rarer tumor without standard treatments, we herein warned of a pitfall for gynecologic oncologists when facing this malignancy.
{"title":"The efficacy of anti-angiogenic drugs in gastric-type endocervical adenocarcinoma: A retrospective study","authors":"Jing Li, Dian Wang, Qing Duan, Ning Su, Xiufang Li, Haifeng Qiu","doi":"10.1111/jog.16247","DOIUrl":"https://doi.org/10.1111/jog.16247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gastric-type endocervical adenocarcinoma (GEA) is a rare malignant tumor that is not associated with high-risk HPV infection, known for its high invasiveness and resistance to current treatments. This study assessed the effectiveness of anti-angiogenic regimens in real-world GEA patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with GEA were enrolled between February 2012 and March 2023, and their clinicopathological characteristics were collected from their medical records. The patients were categorized into groups based on whether they received anti-angiogenic treatments or not. Survival analysis was conducted using the Kaplan–Meier method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 43 GEA patients were enrolled in this study, with 23 cases who received anti-angiogenic drugs (nine received them as the primary treatment, 12 as first-line therapy after recurrence/metastasis, and two as second-line therapy) as the observation group. The other 20 patients who received similar treatments without the anti-angiogenic regimens serve as the control group. Compared to the control group, the addition of anti-angiogenic drugs as the primary treatment mildly extended progression-free survival (PFS) while not being statistically significant (16 months vs 11 months, <i>p</i> = 0.744). The negative results were also observed in 12 patients who started anti-angiogenic therapy as first-line therapy after recurrence/metastasis (8.5 months vs 9 months, <i>p</i> = 0.518). As for the overall survival (OS), no benefits were detected in either patients who started the anti-angiogenic therapy as primary or subsequent treatments (<i>p</i> = 0.499 and 0.450, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We firstly evaluated the efficacy of anti-angiogenic drugs in treating patients with GEA. Although with a small sample size, our preliminary results clearly proposed that the anti-angiogenic therapy failed in suppressing tumors and should not be a preferred choice for GEA. As a much rarer tumor without standard treatments, we herein warned of a pitfall for gynecologic oncologists when facing this malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to “Sexuality and pregnancy: Beliefs and dysfunctions in pregnant women”","authors":"Andrea Murphy","doi":"10.1111/jog.16249","DOIUrl":"https://doi.org/10.1111/jog.16249","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sentinel lymph node (SLN) mapping using indocyanine green (ICG) is an alternative for reducing comprehensive lymph node dissection and its associated morbidity. This trial aimed to assess the efficacy and safety of ICG for SLN detection in patients with cervical and endometrial cancers at a single academic teaching hospital.
Methods
This single-arm, open-label trial conducted at Chiba University Hospital included patients with endometrial or cervical cancer, aged 20–70 years, with an Eastern Cooperative Oncology Group performance status of 0 or 1. ICG was injected into the uterine cervix after anesthesia induction. For patients with endometrial cancer, ICG was additionally injected into the uterine myometrium after laparotomy. Imaging-assisted surgery was then performed to locate and remove the SLNs. Systematic pelvic lymph node dissection was performed as the standard procedure, with additional para-aortic lymph node dissection in selected cases.
Results
The overall and bilateral SLN detection rates were 80.4% (37/46) and 50.0% (23/46), respectively. SLN identification was successful in 37 patients. Of these, 34 had pathologically negative SLNs, and all of them showed no lymph node metastasis in the backup dissection (negative predictive value: 100%). The remaining three cases had pathologically positive SLNs. No adverse events were observed in a total of 49 enrolled patients.
Conclusions
ICG injection was found to be safe. SLN mapping using ICG has demonstrated significant potential in reducing surgical interventions and associated complications in the treatment of early-stage gynecological cancers.
{"title":"Evaluation of the usefulness of sentinel lymph node mapping using indocyanine green in patients with cervical and endometrial cancers: A single-center prospective exploratory study","authors":"Yuji Habu, Hirokazu Usui, Shinsuke Hanawa, Satoyo Otsuka, Rie Okuya, Eri Katayama, Ayumu Matsuoka, Natsuko Nakamura, Nozomi Sakai, Kyoko Nishikimi, Shinichi Tate, Yoshito Ozawa, Hideki Hanaoka, Makio Shozu, Kaori Koga, Akira Mitsuhashi","doi":"10.1111/jog.16254","DOIUrl":"https://doi.org/10.1111/jog.16254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Sentinel lymph node (SLN) mapping using indocyanine green (ICG) is an alternative for reducing comprehensive lymph node dissection and its associated morbidity. This trial aimed to assess the efficacy and safety of ICG for SLN detection in patients with cervical and endometrial cancers at a single academic teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-arm, open-label trial conducted at Chiba University Hospital included patients with endometrial or cervical cancer, aged 20–70 years, with an Eastern Cooperative Oncology Group performance status of 0 or 1. ICG was injected into the uterine cervix after anesthesia induction. For patients with endometrial cancer, ICG was additionally injected into the uterine myometrium after laparotomy. Imaging-assisted surgery was then performed to locate and remove the SLNs. Systematic pelvic lymph node dissection was performed as the standard procedure, with additional para-aortic lymph node dissection in selected cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall and bilateral SLN detection rates were 80.4% (37/46) and 50.0% (23/46), respectively. SLN identification was successful in 37 patients. Of these, 34 had pathologically negative SLNs, and all of them showed no lymph node metastasis in the backup dissection (negative predictive value: 100%). The remaining three cases had pathologically positive SLNs. No adverse events were observed in a total of 49 enrolled patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ICG injection was found to be safe. SLN mapping using ICG has demonstrated significant potential in reducing surgical interventions and associated complications in the treatment of early-stage gynecological cancers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Can Tercan, Emrah Dagdeviren, Ali Selcuk Yeniocak, Sultan Can, Fatih Aktoz
Aim
This study aims to evaluate the impact of two-dimensional (2D) versus three-dimensional (3D) imaging systems and barbed versus standard absorbable multifilament sutures on surgical times and complications in total laparoscopic hysterectomy.
Methods
A retrospective cohort study was conducted at a tertiary hospital between May 2020 and September 2024. Patients who underwent total laparoscopic hysterectomy were categorized into four groups based on imaging system (UltraHD-2D vs. FullHD-3D) and suture type (VICRYL™ multifilament suture interrupted figure-of-8 technique vs. V-LOC™ barbed suture running technique). Primary outcomes included vaginal cuff closure time and total operation duration. Secondary outcomes were mean suturing time, perceived difficulty, and postoperative complications.
Results
A total of 159 patients were analyzed. Vaginal cuff closure time was significantly shorter with 3D imaging systems compared to 2D systems when VICRYL™ sutures were used (13.85 ± 4.30 vs. 21.17 ± 5.13 min, p < 0.001). No significant difference was observed between imaging systems when V-LOC™ barbed sutures were used. Across both systems, V-LOC™ sutures consistently reduced suturing time compared to VICRYL™ sutures (p < 0.001). Surgeon-perceived difficulty was lower with V-LOC™ sutures, particularly in 2D systems. No significant difference in complication rates was observed between groups (p = 0.188).
Conclusion
The use of 3D imaging systems in total laparoscopic hysterectomy significantly reduces vaginal cuff closure duration and overall operative time with VICRYL™ sutures, while V-LOC™ sutures consistently enable faster procedures across both imaging modalities. These findings suggest that 3D imaging systems and barbed sutures may enhance surgical efficiency without increasing complication rates.
{"title":"Comparing the impact of three-dimensional display systems and barbed V-LOC™ sutures in laparoscopic hysterectomy: A retrospective cohort study","authors":"Can Tercan, Emrah Dagdeviren, Ali Selcuk Yeniocak, Sultan Can, Fatih Aktoz","doi":"10.1111/jog.16251","DOIUrl":"https://doi.org/10.1111/jog.16251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to evaluate the impact of two-dimensional (2D) versus three-dimensional (3D) imaging systems and barbed versus standard absorbable multifilament sutures on surgical times and complications in total laparoscopic hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted at a tertiary hospital between May 2020 and September 2024. Patients who underwent total laparoscopic hysterectomy were categorized into four groups based on imaging system (UltraHD-2D vs. FullHD-3D) and suture type (VICRYL™ multifilament suture interrupted figure-of-8 technique vs. V-LOC™ barbed suture running technique). Primary outcomes included vaginal cuff closure time and total operation duration. Secondary outcomes were mean suturing time, perceived difficulty, and postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 159 patients were analyzed. Vaginal cuff closure time was significantly shorter with 3D imaging systems compared to 2D systems when VICRYL™ sutures were used (13.85 ± 4.30 vs. 21.17 ± 5.13 min, <i>p</i> < 0.001). No significant difference was observed between imaging systems when V-LOC™ barbed sutures were used. Across both systems, V-LOC™ sutures consistently reduced suturing time compared to VICRYL™ sutures (<i>p</i> < 0.001). Surgeon-perceived difficulty was lower with V-LOC™ sutures, particularly in 2D systems. No significant difference in complication rates was observed between groups (<i>p</i> = 0.188).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of 3D imaging systems in total laparoscopic hysterectomy significantly reduces vaginal cuff closure duration and overall operative time with VICRYL™ sutures, while V-LOC™ sutures consistently enable faster procedures across both imaging modalities. These findings suggest that 3D imaging systems and barbed sutures may enhance surgical efficiency without increasing complication rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We reviewed case reports of acute fatty liver of pregnancy (AFLP) in Japan and summarized its characteristics, including coagulation factors, fibrinolytic factors, and platelet counts.
Methods
PubMed/Medline and Ichushi databases from 2000 to 2022 were used to survey articles related to AFLP, and 93 articles (102 patients) were ultimately identified.
Results
The characteristics of the coagulation and fibrinolysis systems in AFLP were as follows: the prothrombin time-international normalized ratio and activated partial prothrombin time were prolonged (median value [quartiles]: 1.59 [1.31, 2.02] and 47.5 s [28.2, 97.5], respectively), and antithrombin and alpha 2-antiplasmin levels were low (23.0% [17.0, 33.0] and 44.6%, respectively), indicating non-productive coagulopathy due to severe liver damage. The concentrations of the thrombin-antithrombin complex and fibrinogen/fibrin degradation products were high (60.0 ng/mL [49.1, 82.8] and 49.2 μg/mL [20.8, 143.7], respectively), while the level of fibrinogen was low (82.0 mg/dL [52.5, 153.5]), suggesting disseminated intravascular coagulation with increased coagulation activity. A platelet count ≥12 × 104/μL was detected in approximately 70% of AFLP cases, and the median was within the normal range (16.1 × 104/μL [11.1, 19.2]).
Conclusions
Coagulopathy changes in AFLP may be based on non-productive coagulopathy of coagulation and fibrinolytic factors as well as disseminated intravascular coagulation with mild or no thrombocytopenia.
{"title":"Acute fatty liver of pregnancy may be associated with non-productive coagulopathy of coagulation and fibrinolytic factors as well as disseminated intravascular coagulation with mild or no thrombocytopenia: Review of case reports in Japan","authors":"Hirotada Suzuki, Akihide Ohkuchi, Kenji Horie, Manabu Ogoyama, Rie Usui, Hironori Takahashi, Hiroyuki Fujiwara","doi":"10.1111/jog.16230","DOIUrl":"https://doi.org/10.1111/jog.16230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We reviewed case reports of acute fatty liver of pregnancy (AFLP) in Japan and summarized its characteristics, including coagulation factors, fibrinolytic factors, and platelet counts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed/Medline and Ichushi databases from 2000 to 2022 were used to survey articles related to AFLP, and 93 articles (102 patients) were ultimately identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The characteristics of the coagulation and fibrinolysis systems in AFLP were as follows: the prothrombin time-international normalized ratio and activated partial prothrombin time were prolonged (median value [quartiles]: 1.59 [1.31, 2.02] and 47.5 s [28.2, 97.5], respectively), and antithrombin and alpha 2-antiplasmin levels were low (23.0% [17.0, 33.0] and 44.6%, respectively), indicating non-productive coagulopathy due to severe liver damage. The concentrations of the thrombin-antithrombin complex and fibrinogen/fibrin degradation products were high (60.0 ng/mL [49.1, 82.8] and 49.2 μg/mL [20.8, 143.7], respectively), while the level of fibrinogen was low (82.0 mg/dL [52.5, 153.5]), suggesting disseminated intravascular coagulation with increased coagulation activity. A platelet count ≥12 × 10<sup>4</sup>/μL was detected in approximately 70% of AFLP cases, and the median was within the normal range (16.1 × 10<sup>4</sup>/μL [11.1, 19.2]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Coagulopathy changes in AFLP may be based on non-productive coagulopathy of coagulation and fibrinolytic factors as well as disseminated intravascular coagulation with mild or no thrombocytopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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