Abstract:
STUDY OBJECTIVE:Our primary goal was to uncover preoperative and intraoperative risk factors that prevented same-day discharge (SDD) after myomectomy in a setting where SDD was the standard of care. Uncovered predictors would serve to enhance patient counseling and medical optimization before surgery. DESIGN:Single-center retrospective cohort study. SETTING:Urban university hospital center, by fellowship-trained minimally invasive gynecologic surgeons. PATIENTS:A total of 315 consecutive patients undergoing minimally invasive myomectomy between March 2012 and May 2018. INTERVENTION:Minimally invasive myomectomy. MEASUREMENTS AND MAIN RESULTS:Preoperative and intraoperative characteristics were collected for analysis as predictors of SDD vs overnight admission. Comparisons of demographic, clinical, imaging, and operative characteristics were made using appropriate statistical methods for normally distributed, skewed, and categorical variables. Length of stay was analyzed as a categorical variable, SDD vs overnight admission. A logistic regression model was used to evaluate SDD vs any overnight stay. Out of the 315 patients undergoing laparoscopic myomectomy, 208 (66.03%) were discharged on the same day, and 107 (33.96%) were admitted for at least 1 day after surgery. The patients were more likely to be admitted overnight if they were of Asian ethnicity (p = .01), or if they had a lower preoperative Hct (36.15 vs 37.57; p < .003). An increase in any myoma characteristic metric was associated with overnight stay after surgery; these included mean myoma weight (512.0 g vs 310.1 g; p < .001), estimated size of the largest myoma on imaging (9.01 cm vs 7.77 cm; p < .001), and number of myomas removed (6.59 vs 5.57; p = .021). Other statistically significant differences between the overnight admission and SDD groups were mean estimated blood loss (599.4 mL vs 221.9 mL; p < .001), operative time (224.4 minutes vs 140.9 minutes; p < .001), and surgery end time (15:02 hours vs 12:43 hours; p < .001). Intraoperative complications associated with overnight admission were estimated blood loss >1 L (p < .001) and any intraoperative transfusion (p < .001). The adjusted logistic regression model identified an increase in operative time (by 60 minutes) and later surgery end time (by 60 minutes) as predictors of an overnight stay, whereas an 5% increase in preoperative hematocrit was associated with a 34% decrease in odds for an overnight stay. CONCLUSION:Perioperative factors, such as preoperative hematocrit, and myoma characteristics, as well as intraoperative factors, such as prolonged operative time and surgery end-time, are independent predictors of overnight hospital admission after minimally invasive myomectomy. Our present data can be used to provide better patient counseling before surgery.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Moawad G,Park D,Maasen M,Frost A,Tyan Pdoi
10.1016/j.jmig.2019.03.022subject
Has Abstractpub_date
2020-01-01 00:00:00pages
195-199issue
1eissn
1553-4650issn
1553-4669pii
S1553-4650(19)30147-5journal_volume
27pub_type
杂志文章abstract:STUDY OBJECTIVE:To demonstrate the feasibility of sentinel lymph node (SLN) biopsy using a laparoendoscopic single-site (LESS) approach in endometrial cancer (EC). DESIGN:A step-by-step video demonstration of the surgical procedure (Canadian Task Force Classification III). SETTING:The satisfaction of patients who und...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.10.035
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:STUDY OBJECTIVE:To assess the efficacy of prostaglandin F2α (PGF2α) in hysteroscopic myomectomy of submucous myomas. DESIGN:Single-blind, randomized clinical trial study. SETTING:Teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran. PATIENTS:Forty-four patients with symptomatic submucous...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.05.026
更新日期:2020-01-01 00:00:00
abstract::This systematic review aimed to investigate complications related to initial trocar insertion among 3 different laparoscopic techniques: Veress needle (VN) entry, direct trocar entry (DTE), and open entry (OE). A literature search was completed, and complications were assessed. Major vessel injury, gastrointestinal in...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jmig.2018.06.023
更新日期:2019-01-01 00:00:00
abstract::The reproductive outcome in 41 consecutive patients with cesarean-induced isthmocele and secondary infertility was evaluated prospectively. Patients included menopausal women (mean [SD; 95% CI] age, 35 [4.1; 29-42] years), with fertility duration of 3 to 8 (4.6 [28]) years with isthmocele, postmenstrual abnormal uteri...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.10.011
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the thermal ablative effects of magnetic resonance-(MR) guided focused ultrasound surgery (MRgFUS) on adenomyosis and to assess improvement in clinical parameters. DESIGN:Twenty patients with adenomyosis were treated with MRgFUS. Extensive adenomyosis (6 cases) was treated with 2 applicatio...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.06.010
更新日期:2008-09-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:Multi-institutional study performed in 6 referral gynecologic...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2016.01.029
更新日期:2016-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of laparoscopic ultrasound (LUS) as compared with contrast-enhanced magnetic resonance imaging (CE-MRI) and transvaginal ultrasound (TVUS) in detection of uterine myomas. DESIGN:Retrospective study of imaging methods used in a trial of LUS-guided radiofrequency volumetric ther...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.015
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy of total surgical treatment of ectopic cervical pregnancy [1] with a minimally invasive approach performed by hysteroscopy [2]. DESIGN:Step-by-step video demonstration of the surgical technique using 5 mm hysteroscopy followed by 10 mm resectoscopy. SETTING:A research and univ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.01.009
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effectiveness of and patient satisfaction with different routes of misoprostol administration for short-term cervical priming before operative hysteroscopy. DESIGN:Randomized blinded trial (Canadian Task Force classification I). SETTING:University hospital. PATIENTS:One hundred and twe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2016.12.024
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the efficacy and reproductive outcome of hysteroscopic removal of retained products of conception. DESIGN:Retrospective analysis (Canadian Task Force classification II-3). SETTING:Tertiary care university hospital. PATIENTS:One hundred fifty-nine patients were consecutively admitted to our ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.09.001
更新日期:2011-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate the proper use of vessel-sealing devices during vaginal hysterectomy. DESIGN:Educational video (Canadian Task Force classification level III). SETTING:University hospital. INTERVENTION:The video reviews the principles on the use of energy in minimally invasive surgery. We focus on how ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.04.018
更新日期:2019-02-01 00:00:00
abstract::Hysteroscopic sterilization is rapidly replacing interval laparoscopic sterilization. Six years after the Food and Drug Administration's approval of Essure hysteroscopic sterilization, U.S. and worldwide literature and clinical experience have confirmed the safety, effectiveness, and low rate of adverse events reporte...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2009.02.009
更新日期:2009-05-01 00:00:00
abstract::Survivors of pelvic cancer treatment live with the ramifications of pelvic radiation for many years after their cure. Several options are available to preserve ovarian function and fertility in reproductive age women undergoing pelvic radiation. Laparoscopic ovarian transposition is an under-utilized, yet fairly simpl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2016.08.831
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:The primary objective was to compare carbon dioxide (CO2) absorption rates in patients undergoing gynecologic laparoscopy with a standard versus valveless insufflation system (AirSeal; ConMed, Utica, NY) at intra-abdominal pressures (IAPs) of 10 and 15 mm Hg. Secondary objectives were assessment of surg...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2019.05.005
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To discuss our clinical and surgical experience with 30 cases of ureteral endometriosis. DESIGN:Retrospective analysis (Canadian Task Force classification II-3). SETTING:Tertiary care university hospital. PATIENTS:Records were assessed for all patients who underwent laparoscopic surgery for deep infi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.03.005
更新日期:2008-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether the systematic use of an intrauterine manipulator influences the accuracy of frozen section analysis in early-stage endometrial cancer. DESIGN:Case-control study (Canadian Task Force classification II-1). PATIENTS:Three hundred fourteen consecutive women with early-stage endometria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.11.007
更新日期:2011-03-01 00:00:00
abstract::Essure is a popular method of permanent sterilization that offers a minimally invasive approach that avoids the risks of traditional sterilization procedures in the operating room. Despite the rarity of complications, there has been concern in the popular media over the safety of Essure. We describe the third reported...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.020
更新日期:2016-01-01 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::Intrapartum rupture of an unscarred uterus is rare in current times. However, it is still associated with significant maternal and fetal mortality and morbidity. Unlike rupture or dehiscence of a previous cesarean scar, which is occasionally bloodless, complete rupture of a gravid unscarred uterus frequently results i...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.07.005
更新日期:2005-11-01 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 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::Postmenopausal women with adnexal masses suspicious for malignancy must undergo surgery for histopathologic confirmation. The low positive predictive value for malignancy of the currently available preoperative examinations results in 5 to 220 surgeries performed for each case of pelvic malignancy detected, depending ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.05.007
更新日期:2012-09-01 00:00:00
abstract::Lymphatic complications are a common occurrence after staging surgery for early-stage ovarian cancer (eEOC). We investigated whether the introduction of minimally invasive surgery influences the risk of developing lymphoceles and lymphorrhea in patients undergoing staging for eEOC. For this purpose, data of consecutiv...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jmig.2017.03.014
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to estimate effectiveness of transdermal scopolamine to prevent postoperative nausea and vomiting after gynecologic laparoscopy. DESIGN:Patients were randomized to receive preoperative transdermal scopolamine or placebo. Main outcome measure was incidence of nausea during the first 24 hours p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2007.08.616
更新日期:2008-01-01 00:00:00
abstract:STUDY OBJECTIVE:To validate the algorithm for selective bowel surgery based on preoperative imaging by comparing the perioperative outcomes of patients who undergo each type of bowel surgery for deep bowel disease, and secondarily to evaluate the incidence, factors, and subsequent outcomes when the actual procedure per...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.06.010
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVES:To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. DESIGN:A randomized controlled trial (Canadian Task Force Classification I). SETTING:An academic hospital. PATIENTS:Forty-six women who underwent laparoscopic hyste...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2015.08.881
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the efficacy of performing the Essure hysteroscopic sterilization in an office-based setting. DESIGN:Prospective, longitudinal analysis (Canadian Task Force classification II-3). SETTING:University out-patient office. PATIENTS:All patients undergoing permanent sterilization in our outpat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.11.010
更新日期:2006-03-01 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::Since Noecker first reported a colouterine fistula secondary to diverticulitis in 1929, about 20 cases have been reported in the literature. Methods for diagnosis have yet to be established. Herein we report the first case of a colouterine fistula at the level of the isthmus diagnosed at hysteroscopy. Diagnostic hyste...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.08.725
更新日期:2012-01-01 00:00:00