Gynecological Surgery最新文献

{"title":"Laparoscopic-assisted myomectomy with uterine artery occlusion at a freestanding ambulatory surgery center: a case series.","authors":"Paul MacKoul,&nbsp;Natalya Danilyants,&nbsp;Faraj Touchan,&nbsp;Louise Q van der Does,&nbsp;Leah R Haworth,&nbsp;Nilofar Kazi","doi":"10.1186/s10397-020-01075-2","DOIUrl":"https://doi.org/10.1186/s10397-020-01075-2","url":null,"abstract":"<p><strong>Background: </strong>Non-hysteroscopic myomectomy is infrequently performed in a freestanding ambulatory setting, in part due to risks of intraoperative hemorrhage. There are also concerns about increased surgical risks for morbidly obese patients in this setting. The purpose of this study is to report the surgical outcomes of a series of laparoscopic-assisted myomectomy (LAM) cases at a freestanding ambulatory surgery center (ASC), including a comparative analysis of outcomes in morbidly obese patients (BMI > 40 kg/m²).</p><p><strong>Methods: </strong>A retrospective comparative analysis was performed of 969 women, age 18 years or older, non-pregnant, who underwent LAM by one of two high volume, laparoscopic gynecologic surgical specialists at a freestanding ambulatory surgery center serving the Washington, DC area, between October 2013 and February 2019. Reversible occlusion was performed laparoscopically by placing a latex-based rubber catheter as a tourniquet around the isthmus of the uterus, causing a temporary occlusion of the bilateral uterine arteries. Permanent occlusion was performed laparoscopically via retroperitoneal dissection and uterine artery ligation at the origin of the anterior branch of the internal iliac artery. Minilaparotomy was performed for specimen removal in all cases. No power morcellation was used. Postoperative complications were graded using the Clavien-Dindo Classification system. Outcomes were compared across BMI categories using Pearson Chi-Square.</p><p><strong>Results: </strong>Average myoma weight and size were 422.7 g and 8.3 cm, respectively. Average estimated blood loss (EBL) was 192.1 mL; intraoperative and grade 3 postoperative complication rates were 1.4% and 1.6%, respectively. While EBL was significantly higher in obese and morbidly obese patients, this difference was not clinically meaningful, with no significant difference in blood transfusion rates. There were no statistically significant intraoperative or postoperative complication rates across BMI categories. There was a low rate of hospital transfers (0.7%) for all patients.</p><p><strong>Conclusion: </strong>Laparoscopic-assisted myomectomy can be performed safely in a freestanding ambulatory surgery setting, including morbidly obese patients. This is especially important in the age of COVID-19, as elective surgeries have been postponed due to the 2020 pandemic, which may lead to a dramatic and permanent shift of outpatient surgery from the hospital to the ASC setting.</p>","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"17 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-020-01075-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38072488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopy in the coronavirus disease 2019 (COVID-19) era.","authors":"Stefano Angioni","doi":"10.1186/s10397-020-01070-7","DOIUrl":"10.1186/s10397-020-01070-7","url":null,"abstract":"<p><p>The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in China at the end of 2019 has become a pandemic infection that has now involved 200 countries with 465,915 confirmed cases and 21,031 confirmed deaths. Unfortunately, many data have shown that the high number of undocumented infections could have a major role in the rapid diffusion of the disease. In most of the nations involved, non-urgent, non-cancer procedures have been stopped to reallocate medical and paramedical staff to face the emergency. Moreover, concerns have been raised that minimally invasive surgery could be a procedure that carries the risk of virus diffusion in the operating theater during surgery. This paper reports clinical recommendations and scientific studies to assist clinicians in this field.</p>","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"17 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37958170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to reviewers","authors":"D. Sellman","doi":"10.1007/s10397-008-0448-0","DOIUrl":"https://doi.org/10.1007/s10397-008-0448-0","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"6 1","pages":"97"},"PeriodicalIF":0.0,"publicationDate":"2019-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10397-008-0448-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46754505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic lateral suspension: a single-site and single-surgeon experience","authors":"C. Mang, H. Huemer, A. Birkenmaier, J. Humburg","doi":"10.1186/s10397-019-1067-7","DOIUrl":"https://doi.org/10.1186/s10397-019-1067-7","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1067-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43640050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of diagnostic hysteroscopy in diagnosis of incomplete uterine septum in patients with recurrent pregnancy loss in the era of transvaginal 3D ultrasound scan","authors":"O. Abuzeid, J. LaChance, J. Hebert, M. Abuzeid, R. Welch","doi":"10.1186/s10397-019-1066-8","DOIUrl":"https://doi.org/10.1186/s10397-019-1066-8","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"16 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1066-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41969608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of laparoscopy-assisted vaginal hysterectomy as endoscopic single-station surgery and conventional laparoscopic hysterectomy—surgical effects on safety and quality of life","authors":"A. Mustea, B. Holthaus, H. Elmeligy, S. Krüger-Rehberg, D. Trojnarska, Z. Alwafai, Juliane Sternberg, M. Stope, T. Kohlmann, I. Meinhold-Heerlein, D. Koensgen","doi":"10.1186/s10397-019-1062-z","DOIUrl":"https://doi.org/10.1186/s10397-019-1062-z","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"16 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1062-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41870175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical management of deeply infiltrating endometriosis - 7 year experience in a tertiary endometriosis centre in London","authors":"M. Wild, T. Miskry, Asmaa Al-Kufaishi, G. Rose, M. Crofton","doi":"10.1186/s10397-019-1065-9","DOIUrl":"https://doi.org/10.1186/s10397-019-1065-9","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1065-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47171071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of ovarian suspension in preventing postoperative ovarian adhesions in patients with severe pelvic endometriosis—a case-control study","authors":"Z. Dehbashi, S. Khazali, F. Tanha, Farnaz Mottahedian, M. Ghajarzadeh, Saghar Samimi Sadeh, K. Kamali","doi":"10.1186/s10397-019-1063-y","DOIUrl":"https://doi.org/10.1186/s10397-019-1063-y","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"16 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1063-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41775363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study","authors":"A. Macciò, G. Chiappe, P. Kotsonis, Fabrizio Lavra, R. Nieddu, P. Onnis, E. Sanna, V. Mais, C. Madeddu","doi":"10.1186/s10397-019-1064-x","DOIUrl":"https://doi.org/10.1186/s10397-019-1064-x","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1064-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46072057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of unsuccessful endometrial ablation: a retrospective study","authors":"K. R. Stevens, D. Meulenbroeks, S. Houterman, T. Gijsen, S. Weyers, B. Schoot","doi":"10.1186/s10397-019-1060-1","DOIUrl":"https://doi.org/10.1186/s10397-019-1060-1","url":null,"abstract":"","PeriodicalId":46311,"journal":{"name":"Gynecological Surgery","volume":"16 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s10397-019-1060-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45469239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}