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 performed deviated from the preoperative surgical plan. DESIGN:Retrospective study comparing 3 surgical interventions in an intention-to-treat analysis. SETTING:Tertiary care hospital. PATIENTS:Women with significant pain (visual analog scale [VAS] >7) who were diagnosed with bowel endometriosis from preoperative imaging and underwent laparoscopic surgery for bowel endometriosis at a large referral center between 2014 and 2017. INTERVENTION:Laparoscopic shaving, disc resection, or full-segment resection and reanastomosis of bowel endometriosis. MEASUREMENTS AND MAIN RESULTS:A total of 172 patients (mean age, 36.6 ± 5.2 years) underwent bowel surgery for endometriosis (n = 30 shaving, 71 disc, and 71 segmental resection). Total operative time was similar in the 3 group, but the mean length of hospital stay was longer in the segmental group (5.3 ± 1.0 days) compared with the disc group (4.6 ± 0.9 days) and the shaving group (3.8 ± 1.5 days) (p = .001). The surgical procedure was performed as planned according to the clinical algorithm in 86.5% of patients. Adherence to the proposed clinical algorithm resulted in a low incidence of overall complications (8.7% of total complications, 4.6% of minor complications, and 3.5% of major complications). The incidence of minor complications was higher in the segmental group (9.9%) compared with the discoid group (1.4%) and the shaving group (0%) (p = .0236), whereas the incidence of major complications were similar across the 3 groups (3.3%, 2.8%, and 4.2%, respectively; p = .899). There was a significantly higher frequency of pseudomembranous colitis in the segmental resection group (7 patients; 9.9%) compared with the discoid group (n = 1; 1.4%) and shaving group (0%) (p = .04). Owing to discrepancies between preoperative imaging and intraoperative findings after dissection and mobilization, deviation from the planned procedure occurred in a total of 25 of 172 cases (14.5%), with a less extensive procedure actually performed in 21 of 25 (84%) of the deviated cases. One of the 4 cases (25%) that involved a more extensive procedure resulted in a major complication of rectovaginal fistula. CONCLUSION:Selective bowel resection algorithm provides a systematic approach to the surgical management of patients with bowel endometriosis. Adherence to the surgical plan according to the preoperative imaging and criteria outlined in the algorithm can be accomplished in the majority of patients; however, the surgical team should be aware that upstaging or downstaging may be required, depending on the intraoperative findings. When feasible, the team should opt for a less extensive procedure to avoid complications associated with more radical surgery.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Abrão MS,Andres MP,Barbosa RN,Bassi MA,Kho RMdoi
10.1016/j.jmig.2019.06.010subject
Has Abstractpub_date
2020-01-01 00:00:00pages
883-891issue
4eissn
1553-4650issn
1553-4669pii
S1553-4650(19)30288-2journal_volume
27pub_type
杂志文章abstract::We present the case of a 17-year-old nulliparous woman with a history of obesity (body mass index 36.2 kg/m(2)), type 2 diabetes, and polycystic ovary syndrome, who was diagnosed with grade 1 endometrioid adenocarcinoma without radiological evidence of myometrial invasion or metastatic disease. After failure of a fert...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.03.017
更新日期:2015-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy and safety of repeated endometrial resection. DESIGN:Retrospective study (Canadian Task Force classification II-3). SETTING:University teaching hospital. PATIENTS:Women with a failed primary endometrial resection. INTERVENTION:Repeated endometrial resection, roller-ball coag...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.003
更新日期:2008-11-01 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 compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions. DESIGN:Prospective non-randomized study (Canadian Task Force classification II-2). SETTING:Tertiary center f...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmig.2014.01.023
更新日期:2014-07-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the pregnancy and neonatal outcomes of surgical treatment for adnexal torsion (AT) during pregnancy. DESIGN:A retrospective case-control study (Canadian Task Force classification II-2). SETTING:A tertiary care academic medical center. MEASUREMENTS AND MAIN RESULTS:The study group inclu...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.04.015
更新日期:2019-01-01 00:00:00
abstract::Surgeons performing sophisticated endoscopic operations must be well versed in alternate laparoscopic access methods to address evolving patient expectations and safety requirements. The safety of left upper quadrant laparoscopic entry in patients with prior surgeries and abdominal adhesions was evaluated. Laparoscopi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2004.12.026
更新日期:2005-01-01 00:00:00
abstract::This review article summarizes the salient literature on the diagnosis and management of endometrial polyps. Electronic resources including Medline, PubMed, CINAHL, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Current Contents, and EMBASE were searched with the MeSH terms including all...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2011.05.018
更新日期:2011-09-01 00:00:00
abstract::Endometriosis is a common condition that affects as many as 10% to 20% of women of reproductive age. Because of the subtle clinical signs and symptoms and limitations of imaging methods, the diagnosis is frequently delayed or missed, with serious consequences including hypertension, hydronephrosis, and loss of kidney ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.09.006
更新日期:2010-01-01 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: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:OBJECTIVE:To perform a systematic review of the literature to identify best practices for nonhysteroscopic myomectomy for women with myomas who desire future fertility. The focus areas included factors associated with conception and pregnancy outcomes after myomectomy, impact of surgical route (laparotomic, laparoscopi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2020.10.006
更新日期:2020-10-14 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:STUDY OBJECTIVE:Laparoscopic termino-terminal ureteral anastomosis has all the advantages of a minimally invasive approach in addition to the treatment of the pathologic condition [1]. Ureteral deep endometriosis can lead to severe consequences, such as hydroureteronephrosis and renal failure [2,3]. The main objective ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.11.017
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To describe the surgical approaches and excisional techniques used in an extreme case of deep infiltrating endometriosis (DIE) affecting the lateral pelvic side wall. DESIGN:A technical video showing the excision of advanced lateral DIE. SETTING:An academic tertiary care hospital. INTERVENTIONS:A 32-year-o...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.06.019
更新日期:2020-02-01 00:00:00
abstract::We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and th...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2015.06.016
更新日期:2015-11-01 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: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:To review pregnancy outcomes after laparoscopic myomectomy with the use of barbed suture. DESIGN:Retrospective cohort study and follow-up survey. SETTING:Single, large academic medical center. PATIENTS:Patients who underwent laparoscopic myomectomy with the use of barbed suture for myometrial closure...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.02.005
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN:Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING:University teaching hospital. PATIENTS:Sixty-five ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.03.018
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the feasibility of office hysteroscopy in patients with pregnancy-related problems such as retained trophoblastic tissue, persistent molar tissue, pregnancy with in situ intrauterine device (IUD), isthmocele, embryoscopy, and osseous metaplasia. DESIGN:Retrospective cohort chart review of u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.11.004
更新日期:2014-05-01 00:00:00
abstract::The radio-guided occult lesion localization (ROLL) technique has been in use since the mid-1990s, mainly in breast surgery. Today, ROLL is used for numerous oncologic pathologies, including parathyroid lesions, melanomas, and colorectal tumors. We report a patient with an 11-mm left mesorectal solitary recurrence of a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.09.012
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate stepwise techniques for the successful use of the laparoscopic single-site technique for safely performing transvaginal sacrocolpopexy for pelvic organ prolapse. DESIGN:Stepwise demonstration with narrated video footage (Canadian Task Force classification III). SETTING:Academic tertiary...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.11.018
更新日期:2020-11-26 00:00:00
abstract::Although endometrial cancer, the most common gynecologic malignancy, is most often diagnosed in postmenopausal women, it affects young women who wish to preserve fertility. The purpose of this article is to describe 2 cases of stage IA endometrial cancer managed conservatively by a combination of hysteroscopic surgery...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2014.08.782
更新日期:2015-01-01 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::The most common mode of injury to the ureter is iatrogenic; however, injury during laparoscopic sterilization is rare. Although thermal ureteric injury during laparoscopic sterilization has been reported, to our knowledge, this is the first published report of ureteric injury caused by placement of a Filschie clip dur...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.01.011
更新日期:2009-05-01 00:00:00
abstract::Conservative surgical management of uterine prolapse with uterine conservation has become an alternative treatment in women who wish to maintain their uterus. Vaginal and abdominal approaches for uterine suspension have been described and reported. Certain concomitant pathologic conditions of the uterus such as uterin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.04.025
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the accuracy of historic averages for estimating operating room (OR) time for hysterectomy among women with small and large uteri. DESIGN:A retrospective cohort study. SETTING:Data from women who underwent abdominal, vaginal, or laparoscopic hysterectomy between 2015 and 2017 at the Univer...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.01.003
更新日期:2019-01-01 00:00:00
abstract::Cervical pregnancy (CP) is an uncommon ectopic pregnancy that accounts for approximately less than 1% of extrauterine gestations. This case report describes a case of a viable ectopic CP successfully treated with systemic methotrexate therapy combined with hysteroscopic local endocervical resection of the heterotopic ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.03.009
更新日期:2006-07-01 00:00:00
abstract:STUDY OBJECTIVE:Τo investigate whether the use of vasopressin played an important role in the safe expansion of the indications of laparoscopic myomectomy in our practice. DESIGN:A retrospective comparison of prospectively collected data (Canadian Task Force classification II2). SETTING:A gynecologic endoscopy unit i...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.05.011
更新日期:2019-01-01 00:00:00
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 endometria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.06.004
更新日期:2015-11-01 00:00:00