Abstract:
STUDY OBJECTIVES:To evaluate the rate of intrauterine adhesions after hysteroscopic resection of hyperplastic and/or cancer areas and the efficacy of combined treatment. DESIGN:Observational retrospective study. SETTING:Patients affected by endometrial atypical hyperplasia of the endometrium or early stage endometrial carcinoma. PATIENTS:Twenty-three patients, up to 45 years of age. INTERVENTION:Conservative treatment based on hysteroscopic resection of hyperplastic and/or cancer areas and subsequent therapy with megestrol acetate 160 mg/day. METHODS AND MAIN RESULTS:Approximately 5% of endometrial cancers (ECs) are diagnosed in women younger than 40 years old, usually with a good prognosis. From 2010 to 2014, 23 patients, up to age 45 years, who were affected by endometrial cancer (EC) grade 1 or atypical complex hyperplasia (ACH) and who wished to preserve fertility, underwent conservative treatment based on hysteroscopic resection of the hyperplastic and/or cancer areas and subsequent therapy with megestrol acetate 160 mg/day. Data with regard to age, body mass index, symptoms, history of infertility, and previous assisted reproductive technologies attempts, obstetrics history, previous diagnosis of intrauterine sinechiae, hysteroscopic findings, duration of therapy, follow-up reports, and reproductive outcomes were collected and analyzed. Of the 23 patients enrolled in the study, 3 patients (13%) presented with an endometrioid EC grade 1, and 20 patients (87%) had ACH. Twelve patients (52.2%) had complete remission after 3 months of progestin therapy, 9 patients (39.1%) had a complete remission after 6 months, and 2 (8.7%) patients had remission after 9 months. Six patients underwent a second hysteroscopic resection. The 3 patients with an initial diagnosis of EC had complete remission after a mean of 4 months of high-dose progestin therapy; in patients with ACH, remission occurred after a mean of 3 months. In all patients, intrauterine adhesions were not detected at any follow-up diagnostic hysteroscopy. After a median follow-up time of 25 months (range 8-37), we registered 1 (4.3%) relapse of disease. A total of 7 pregnancies in 6 patients were counted, after an average time of 7.4 months (range 3-13 months) after the end of progestin therapy. CONCLUSIONS:Hysteroscopic resection of hyperplastic and/or cancer areas before high dosage progestin therapy seems to be a safe and effective approach in the management of ACH and in patients with early EC who wish to preserve fertility.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
De Marzi P,Bergamini A,Luchini S,Petrone M,Taccagni GL,Mangili G,Colombo G,Candiani Mdoi
10.1016/j.jmig.2015.06.004subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1178-82issue
7eissn
1553-4650issn
1553-4669pii
S1553-4650(15)00490-2journal_volume
22pub_type
杂志文章abstract:STUDY OBJECTIVE:To determine whether pain, as part of an indication for global endometrial ablation, is an independent risk factor for failure. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:Academic-affiliated community hospital. PATIENTS:Women undergoing global endometrial abl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.020
更新日期:2018-01-01 00:00:00
abstract::Laparoscopic myomectomy is a common surgical treatment for symptomatic uterine leiomyomas. Proponents of the laparoscopic approach to myomectomy propose that the advantages include shorter length of hospital stay and recovery time. Others suggest longer operative time, greater blood loss, increased risk of recurrence,...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2014.08.007
更新日期:2015-01-01 00:00:00
abstract::Virginity in adult women, although a personal decision, is a limiting factor for gynecologists in diagnosis and treatment. This report presents 26 cases of virgin patients with various gynecologic problems: 11 with vaginal bleeding, 7 with heavy discharge and foul odor, 6 with protruding vaginal mass, and 2 with a sen...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.05.002
更新日期:2007-09-01 00:00:00
abstract:STUDY OBJECTIVES:To estimate whether variability in the size and ratios of the lower and upper abdomen exist in women undergoing robotic gynecologic surgery and whether demographic variables are significantly associated, and to determine the association between abdominal wall dimensions and supraumbilical robotic port ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.04.008
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Laparoscopic extravesical ureteroneocystostomy is an infrequently described technique. Our aim is to describe five cases where we used the intracorporeal freehand suturing technique successfully for performing laparoscopic extravesical transperitoneal ureteral reimplantation with psoas hitch. We ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.03.016
更新日期:2006-07-01 00:00:00
abstract:STUDY OBJECTIVE:To identify risk factors associated with postoperative urinary retention in patients undergoing outpatient minimally invasive hysterectomy. DESIGN:A retrospective cohort study. SETTING:An academic medical center. PATIENTS:All patients undergoing outpatient minimally invasive hysterectomy between Janu...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.06.003
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:We aim to describe the clinical characteristics and the principles of combined laparoscopic and thoracoscopic management of women with diaphragmatic endometriosis at our institution. DESIGN:Case series (Canadian Task Force Classification II2). SETTING:Tertiary care referral center. PATIENTS:Four wome...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.06.012
更新日期:2009-09-01 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 evaluate risk of leakage and tissue dissemination associated with various contained tissue extraction (CTE) techniques. DESIGN:In vitro study (Canadian Task Force classification: II-1). SETTING:Academic hospital simulation laboratory. INTERVENTION:Beef tongue specimens weighing 400 to 500 g were s...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.06.004
更新日期:2014-09-01 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:OBJECTIVE:To demonstrate our technique for robot-assisted laparoscopic ectopic pregnancy excision and concomitant scar revision. DESIGN:We present a stepwise narrated demonstration of our primary laparoscopic technique. SETTING:Although cesarean scar pregnancy is rare, it leads to life-threatening complications and o...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.06.017
更新日期:2020-06-27 00:00:00
abstract:STUDY OBJECTIVE:The objective of our study is to provide a contemporary description of hysterectomy practice and temporal trends in Canada. DESIGN:A national whole population retrospective analysis of data from the Canadian Institute for Health Information SETTING: Canada PATIENTS: All women who underwent hysterectomy...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2021.01.010
更新日期:2021-01-18 00:00:00
abstract::Prolapse of a sigmoid neovagina, created in patients with congenital vaginal aplasia, is rare. In correcting this condition, preservation of coital function and restoration of the vaginal axis should be of primary interest. A 34-year-old woman with vaginal agenesis underwent vaginoplasty using sigmoid colon. Almost 6 ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2011.12.012
更新日期:2012-03-01 00:00:00
abstract:STUDY OBJECTIVE:To identify bowel nodule features of deep infiltrating endometriosis (DIE) measured through preoperative ultrasound scanning that influence laparoscopic surgical strategy. DESIGN:A retrospective study. SETTING:Malzoni Clinic-Endoscopica Malzoni Department, Center for Advanced Endoscopic Gynecological ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.034
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:There are many instruments with different energy modalities or with different properties that are available for use in total laparoscopic hysterectomy. The aim of the study was to compare the use of LigaSure (Valleylab, Boulder, CO), HALO PKS cutting forceps (Gyrus-ACMI, Maple Grove, MA), and ENSEAL tis...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2014.01.010
更新日期:2014-07-01 00:00:00
abstract::Cornual pregnancy is an infrequent pathological condition with severe prognosis if not adequately recognized. Ipsilateral salpingectomy represents a unique risk factor for this clinical entity. This article reports a laparoscopically treated spontaneous cornual pregnancy after homolateral salpingectomy for an earlier ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2008.11.008
更新日期:2009-03-01 00:00:00
abstract:STUDY OBJECTIVE:Sacrocolpopexy (SCP) has become the standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. DESIGN:The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.10.020
更新日期:2020-11-01 00:00:00
abstract:STUDY OBJECTIVE:To provide surgeons with techniques for preemptive analgesia during minimally invasive gynecologic surgery. Postoperative pain management is an important component of patient care after gynecologic surgery. There have been numerous advances in pain management, including studies that show that preoperati...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.09.768
更新日期:2019-02-01 00:00:00
abstract::Bilateral tubal ligation (BTL) for sterilization has been known to decrease the risk of ovarian cancer. Recent studies have suggested that bilateral salpingectomy (BS) may be an alternative to BTL or tubal occlusion for women desiring permanent sterilization, owing to a possibly greater protective effect against ovari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2017.01.001
更新日期:2017-01-01 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::Venous thromboembolism (VTE) is the leading cause of preventable healthcare-related death after surgery. Although there is a large body of research on VTE in the general population as well as risk-assessment tools, evidence specific to the current practices in gynecologic surgery is more sparse. This review article se...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.025
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the clinical significance of pouch of Douglas (POD) obliteration in women undergoing laparoscopic excision of endometriosis. DESIGN:Prospective study (Canadian Task Force Classification II-2). SETTING:University-affiliated tertiary referral center for endometriosis. PATIENTS:A total of 45...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.01.011
更新日期:2011-05-01 00:00:00
abstract:STUDY OBJECTIVE:Laparoscopic port site metastases (PSMs) have an incidence of .5% to 2%. The management of an isolated PSM (iPSM), without evidence of recurrence elsewhere, remains unclear. The aim of this study was to elucidate practices regarding iPSMs. DESIGN:A 23-item survey was created using commercially availabl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.01.011
更新日期:2017-01-01 00:00:00
abstract::Uterine inversion is a rare obstetric emergency usually occurring in the immediate postpartum period after the third stage of labor. The incidence is reported to be between 1 in 550 to 1 in several thousand deliveries. Delayed postpartum uterine inversion is even less common, and may present a management challenge. We...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.12.003
更新日期:2010-03-01 00:00:00
abstract:STUDY OBJECTIVE:Privileging and credentialing requirements are determined by medical staff leadership at the hospital level to ensure clinicians provide safe healthcare services. No standardized guidelines exist for gynecologic surgery. The objective of this study is to examine the variability of the criteria used to g...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2016.08.001
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the surgical technique and short-term outcomes for 26 cases of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) sacrocolpopexy for the treatment of pelvic organ prolapse (POP). DESIGN:Retrospective case series 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.2018.08.009
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:Feasibility of laparoscopic extraperitoneal surgical staging for locally advanced cervical carcinoma in a gynecologic oncology fellowship training program. DESIGN:Retrospective analysis (II-2) of all patients who underwent laparoscopic extraperitoneal surgical staging at Women and Children's Hospital f...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.04.007
更新日期:2006-09-01 00:00:00
abstract::A MEDLINE search was conducted using the keywords "laparoscopy ovarian cancer," "laparoscopy and borderline ovarian tumors," "advanced stage ovarian cancer," "laparoscopic cytoreduction ovarian cancer," "laparoscopy intraperitoneal catheter," "port-site metastases," and "carbon dioxide pneumoperitoneum." The publicati...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2009.01.007
更新日期:2009-05-01 00:00:00
abstract::The primary goal of the clinical evaluation of abnormal uterine bleeding is to establish a specific diagnosis in the most efficient and least invasive manner possible. Hysteroscopy (HS) allows physicians to obtain directed biopsy in addition to direct visualization of the uterine cavity and lesions, but often requires...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.08.003
更新日期:2006-11-01 00:00:00
abstract:STUDY OBJECTIVE:The identification of less invasive methods with acceptable diagnostic value for evaluating intrauterine abnormalities can improve the satisfaction of patients and physicians. Although hysteroscopy plus biopsy has favorable predictive and diagnostic values, limited studies have evaluated its value, and ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.02.016
更新日期:2020-01-01 00:00:00