Abstract:
STUDY OBJECTIVES:To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery to treat endometrial cancer. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:National Surgical Quality Improvement Program. PATIENTS:Patients with endometrial cancer who underwent surgery from 2005 to 2011. INTERVENTIONS:Women were grouped according to weight, as follows: normal weight (BMI 18 to <30), obese (BMI 30 to <40), and morbidly obese (BMI ≥ 40). Univariate and multivariable logistic regression models were analyzed. MEASUREMENTS AND MAIN RESULTS:Of 3947 patients, 38% were of normal weight, 38% were obese, and 24% were morbidly obese. Of these, 48% underwent laparoscopy and 52% underwent laparotomy. Overall 30-day morbidity and mortality were 13% and 0.7%, respectively. Obesity and morbid obesity were associated with a higher American Society of Anesthesiologists class, diabetes, and hypertension. Preoperatively, elevated serum creatinine concentration, hypoalbuminemia, and leukocytosis were more common in morbidly obese women than those of normal weight. Laparoscopic surgery was performed less frequently in morbidly obese women than in those of normal weight (42.5% vs 50%; p = .001). Morbidly obese patients were more likely to develop postoperative complications (morbidly obese 16% vs normal weight 13% vs obese 11%; p = .001), in particular surgical (morbidly obese 14% vs normal weight 11% vs obese 9%; p < .001) and infectious complications (morbidly obese 10% vs normal weight 5% vs obese 5%; p = .01). After laparotomy, morbidly obese women demonstrated a higher rate of any complication (normal weight 21%, obese 18%, morbidly obese 25%; p = .002), surgical complications (normal weight 18%, obese 14%, morbidly obese 22%; p = .002) and infectious complications (normal weight 6%, obese 10%, morbidly obese 16%; p < .001). After laparoscopy there was no difference in complication rates according to BMI group. The 30-day mortality was not significantly different according to BMI. After adjusting for confounders, obesity and morbid obesity did not independently predict 30-day morbidity or mortality. CONCLUSIONS:Morbidly obese patients with endometrial cancer have more preoperative morbidities and postoperative complications, in particular surgical and infectious complications, and are less likely to undergo minimally invasive surgery. However, obesity was not an independent predictor of perioperative outcomes after controlling for other confounders.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Mahdi H,Jernigan AM,Aljebori Q,Lockhart D,Moslemi-Kebria Mdoi
10.1016/j.jmig.2014.07.014subject
Has Abstractpub_date
2015-01-01 00:00:00pages
94-102issue
1eissn
1553-4650issn
1553-4669pii
S1553-4650(14)00404-Xjournal_volume
22pub_type
杂志文章abstract::Female reproductive tract anomalies are difficult to number in the general population but are often discovered in evaluations of menstrual complications or fertility disorders. Traditionally, assessment of the reproductive tract entailed hysterosalpingography to image the uterine cavity with the final diagnosis provid...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.10.014
更新日期:2014-05-01 00:00:00
abstract::Adhesions represent a frequent thought-provoking surgical ramification that greatly affects clinical practice, thereby making adhesion deterrence an important area of public health intervention, research, and the fiscal budget. Postoperative adhesions have been observed in up to 94% of patients after laparotomy. Adhes...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2014.12.009
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the actual cost difference in performing Essure hysteroscopic sterilization in the office compared with ambulatory surgery using laparoscopic sterilization in the operating room. DESIGN:Cost-comparison analysis (Canadian Task Force classification III). SETTING:University hospital and affil...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.05.016
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to estimate the impact of sentinel nodes in gynecologic oncology on fellowship training and discuss potential solutions. DESIGN:Retrospective multi-institution cohort (Canadian Task Force classification II-2). SETTING:Three tertiary cancer referral cancer centers. PATIENTS:Patients with end...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.006
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate the surgical repair of a rectovaginal fistula (RVF) using the modified Martius procedure. DESIGN:A step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING:RVF is abnormal epithelialized connections between the vagina and rectum. Causes of...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.08.657
更新日期:2018-01-01 00:00:00
abstract::The incidence of adnexal masses in pregnancy is estimated to be 1% to 4%. In select cases, surgical intervention is required. Recent studies have demonstrated that laparoscopy during pregnancy is safe and confers many advantages over laparotomy. Herein we present a series of nine cases collected prospectively that dem...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.02.024
更新日期:2013-09-01 00:00:00
abstract::A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and vari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.021
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the feasibility and surgical outcome of a novel technique of endoscopic inguinal lymphadenectomy to treat vulvar cancer. DESIGN:Retrospective analysis performed by a single center over 2 years (Canadian Task Force classification II-2). SETTING:Major university teaching hospital. PATIENTS:...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.06.011
更新日期:2011-09-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of our study was to quantify the rate, type, and cost of interventions for uterine myomas to payers in Germany, France, and England. DESIGN:Computations using data from national hospital activity databases. DESIGN CLASSIFICATION:II-3. SETTING:Hospital admissions in Germany, France, and ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.09.581
更新日期:2009-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the impact of ultrasound-guided transvaginal ovarian needle drilling (TND) versus laparoscopic ovarian drilling (LOD) on ovarian reserve and pregnancy rate in patients with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). DESIGN:A randomized clinical trial (Canadian Task F...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2018.01.036
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To study the effect of robotic surgery on the surgical approach to endometrial cancer in a gynecologic oncology center over a short time. DESIGN:Prospective analysis of patients with early-stage endometrial cancer who underwent robotic surgery. SETTING:Teaching hospital. PATIENTS:Eighty patients who ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.03.013
更新日期:2009-07-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the incidence of uterine vascular malformations (UVMs) including uterine arteriovenous malformations (AVMs) in patients after abortion or delivery and in outpatients. DESIGN:Prospective study (Canadian Task Force classification II-3). SETTING:Fukushima Red Cross Hospital. PATIENTS:Six pat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.12.008
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy. DESIGN:Step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING:Cesarean section scar ectopic pregnancy is a rare form of ectopic pregnancy wi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.11.006
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To explore the feasibility and effectiveness of a modified posterior vaginal mesh suspension method in treating female rectocele with intractable constipation. DESIGN:Descriptive study (Canadian Task Force classification II-3). SETTING:The study was performed in the Study Center for Female Pelvic Dysf...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.06.004
更新日期:2012-11-01 00:00:00
abstract::Tubal diverticula is a rare disease, and the literature includes only a few reports of this condition. We tentatively summarized 13 cases to investigate the clinical characteristics, diagnosis, and treatment of tubal diverticula. The clinical manifestations, diagnosis at hysterosalpingography (HSG), surgical treatment...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.05.022
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of hypoxia-inducible factor (HIF) inhibitors, flotation agents, barriers, and a surfactant on pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model. DESIGN:Prospective randomized trial (Canadian Task Force classification I). SETTING:Department of Obstetrics and G...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.04.002
更新日期:2007-09-01 00:00:00
abstract::A 29-year-old woman with placenta increta with hemorrhage underwent uterine artery embolization using 12.5% NBCA (N-butyl 2-cyanoacrylate) diluted with iodized oil (Lipiodol). Complete resolution of placenta increta without performing curettage was obtained. The uterus returned to its normal shape, with restored endom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.03.020
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess potential differences in perioperative features and survival between laparoscopic-assisted vaginal hysterectomy and conventional transabdominal hysterectomy in stage I endometrial cancer. DESIGN:Retrospective, nonrandomized clinical study (Canadian Task Force classification II-2). SETTING:Ac...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.08.013
更新日期:2006-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the 10-year subjective outcome of use of retropubic tension-free vaginal tape (TVT). DESIGN:Structured telephone interview (Canadian Task Force classification II-3). SETTING:Universitiy-affiliated tertiary medical center. PATIENTS:Sixty consecutive women with urodynamically confirmed stress...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.07.006
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Laparoscopic uterine artery ligation may be performed during myomectomy or other uterine invasive procedures to reduce the amount of blood loss during surgery. In this video, the authors describe 3 different laparoscopic techniques to approach the uterine artery. DESIGN:Step-by-step video demonstration of 3 ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.026
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare hysteroscopic female sterilization procedures performed in-office versus a hospital operating room (OR) among newly trained physicians. DESIGN:Multisite hospital operating rooms and physician offices. PATIENTS:Women desiring permanent hysteroscopic sterilization. INTERVENTION:Hysteroscopic...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2006.05.014
更新日期:2006-09-01 00:00:00
abstract::Laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery are now being used in gynecologic oncologic procedures. We used our expertise with LESS to perform nerve-sparing laparoscopic radical hysterectomy. A 45-year-old woman with stage IA2 cervical cancer was referred to us. The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.019
更新日期:2013-11-01 00:00:00
abstract::The objective of our study was to evaluate the use of a procedure for vaginal ovarian cystectomy that is supported by the option to convert to laparoscopy. The ovarian cystectomy was initially approached transvaginally, and then if impossible, completed laparoscopically. We applied this operation system to 38 patients...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.01.010
更新日期:2008-05-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this study was to evaluate the surgical and oncologic outcomes of robotic hysterectomy with or without or less pelvic and aortic lymphadenectomy in severely obese patients (body mass index [BMI] ≥ 40 kg/m(2)) with endometrial cancer. MATERIAL AND METHODS:Between August 2010 and November 2014...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2015.08.887
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate a mesh-free laparoscopic uterosacral suture sacrohysteropexy (LUSSH). DESIGN:Technical video demonstrating LUSSH for uterine prolapse (Canadian Task Force classification III). SETTING:University hospital. PATIENT:A 37-year-old woman with grade 3 uterine descent requested uterine-sparin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.03.025
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:Although all ectopic pregnancies are associated with risk of hemorrhage, cornual pregnancies are feared for catastrophic hemorrhage and uncontrollable bleeding. The maternal mortality rate can be as high as 2.5%, which is 7 times higher than the mortality rate for ectopic pregnancies in general. Differe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.04.005
更新日期:2017-01-01 00:00:00
abstract::A 69-year-old woman had a 4-year history of recurrent giant condylomas (Buschke-Lowenstein tumor) in the anal and perianal regions, with extension to the vulva and vagina. After failure of 3 surgical excisions, one of which was radical, the condition was successfully treated using carbon dioxide laser vaporization and...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.05.007
更新日期:2010-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate continuous (CON) compared with cyclic (CYC) administration of combined oral estroprogestins for 6 months after laparoscopic excision of ovarian endometriomas associated with pain. DESIGN:Multicenter, prospective, randomized trial (Canadian Task Force classification I). SETTING:Tertiary car...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jmig.2010.11.004
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to evaluate the incidence of postoperative voiding dysfunction in patients undergoing vaginal hysterectomy (VH) or total laparoscopic hysterectomy (TLH) and to identify risk factors for the development of postoperative urinary retention after uncomplicated total hysterectomy. DESIGN:Prospecti...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.06.013
更新日期:2007-11-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the feasibility and safety of a McCall culdoplasty at the time of total laparoscopic hysterectomy and to evaluate the differences in the total vaginal length, vaginal apex during Valsalva, and sexual function 12 months after McCall culdoplasty compared with standard cuff closure. DESIGN:A pil...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2017.10.036
更新日期:2018-01-01 00:00:00