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Sample records for abandoned radical hysterectomy

  1. Classical radical hysterectomy and nerve-sparing radical hysterectomy in the treatment of cervical cancer

    Marcin Makowski; Marek Nowak; Marian Szpakowski; Jacek Władziński; Anna Serwach-Nowińska; Łukasz Janas; Jacek R. Wilczyński

    2014-01-01

    Aim of the study: To compare Piver III radical hysterectomy (RH) with nerve-sparing radical hysterectomy (NSRH) for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerves and perioperative complications. Material and methods : Seventy-three consecutive patients with invasive cervical cancer underwent RH (53 cases) or NSRH (20 cases) from 2001 to 2012 at the Department of Gynecology and Gynecologic Oncology of Polish Mother’s Memorial Hospital – Research...

  2. Classical radical hysterectomy and nerve-sparing radical hysterectomy in the treatment of cervical cancer

    Marcin Makowski

    2014-06-01

    Full Text Available Aim of the study: To compare Piver III radical hysterectomy (RH with nerve-sparing radical hysterectomy (NSRH for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerves and perioperative complications. Material and methods : Seventy-three consecutive patients with invasive cervical cancer underwent RH (53 cases or NSRH (20 cases from 2001 to 2012 at the Department of Gynecology and Gynecologic Oncology of Polish Mother’s Memorial Hospital – Research Institute in Łódź. Results : Compared with patients treated with RH, patients who underwent NSRH presented no significant difference in terms of operative time (146 vs. 143 minutes, p > 0.05, blood loss and hospital stay (9.2 vs. 7.5 days, p > 0.05. A positive surgical margin was found in 6 cases of RH. No serious surgical complications were found in the NSRH group, while there were 4 cases in the RH group. Conclusions : Nerve-sparing radical hysterectomy is safe and feasible surgical management for cervical cancer patients, which should improve the physiology of the pelvic autonomic nerve system postoperatively. The technique is relatively new and its oncologic efficiency has not been fully established yet, moreover it requires sophisticated anatomical knowledge and high operative skills.

  3. Radical Hysterectomy and Total Abdominal Vaginectomy for Primary Vaginal Cancer.

    Ozgul, Nejat; Basaran, Derman; Boyraz, Gokhan; Salman, Coskun; Yuce, Kunter

    2016-03-01

    The aim of this surgical video is to demonstrate en bloc radical removal of uterus and vagina in a patient with clinical early-stage vaginal cancer. Surgical treatment was offered to our patient for clinical early-stage primary vaginal cancer. An en bloc radical hysterectomy, systematic pelvic lymphadenectomy, and total abdominal vaginectomy were performed. Postoperative adjuvant radiation or chemotherapy was not recommended for completely resected pathologic stage I disease with no lymph node involvement and negative surgical margins. Radical surgery can be a treatment option for selected patients with primary vaginal cancer. PMID:26825828

  4. Laparoscopic pelvic anatomy of nerve-sparing radical hysterectomy.

    Park, Nae Yoon; Cho, Young Lae; Park, Il Soo; Lee, Yoon Soon

    2010-03-01

    Many reports regarding nerve-sparing radical hysterectomy have been published. However, most reports have been based on systematic descriptions via laparotomy or cadaver dissection. The aim of this work was to describe the pelvic anatomy of nerve-sparing radical hysterectomy via laparoscopy, with specific focus on the inferior hypogastric plexus. This study is based on 125 patients with FIGO stage IB cervical cancer who had undergone laparoscopic nerve-sparing radical hysterectomies since 1999. The inferior hypogastric plexus was demonstrated via laparoscopy and was comprised of afferent fibers from the sacral root (S2, S3, and S4), sacral sympathetic ganglion, and hypogastric nerve, and efferent fibers forming its vesical, uterovaginal, and rectal branches. During the dissection of the posterior leaf of the vesicouterine ligament, various vesical veins were identified. If the cut edge of an inferior vesical vein was pulled medially with upward traction, the vesical branches of the inferior hypogastric plexus were exposed and these were divided into medial and lateral branches. The magnified view of laparoscopy made it possible to dissect nerves and vessels meticulously and to secure a clear resection margin during the dissection of the deep part of the cardinal ligament, uterosacral ligament, and posterior leaf of the vesicouterine ligament. PMID:20108355

  5. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  6. Hysterectomy

    ... such as wound infection, bleeding, blood clots, and nerve and tissue damage, than vaginal or laparoscopic hysterectomy. ... hysterectomy, you still may need pelvic exams and cervical cancer screening. Glossary Adhesions: Scarring that binds together ...

  7. Can radical parametrectomy be omitted inoccult cervical cancer afterextrafascial hysterectomy?

    Huai-WuLu,; JingLi,; Yun-YunLiu,; Chang-HaoLiu,; Guo-CaiXu,; Ling-LingXie,; Miao-FangWu; Zhong-QiuLin

    2015-01-01

    Background:Occult invasive cervical cancer discovered after simple hysterectomy is not common, radical parame‑trectomy (RP) is a preferred option for young women. However, the morbidity of RP was high. The aim of our study is to assess the incidence of parametrial involvement in patients who underwent radical parametrectomy for occult cervical cancer or radical hysterectomy for early‑stage cervical cancer and to suggest an algorithm for the triage of patients with occult cervical cancer to avoid RP. Methods:A total of 13 patients with occult cervical cancer who had undergone RP with an upper vaginectomy and pelvic lymphadenectomy were included in this retrospective study. Data on the clinicopathologic characteristics of the cases were collected. The published literature was also reviewed, and low risk factors for parametrial involvement in early‑stage cervical cancer were analyzed. Results:Of the 13 patients, 9 had a stage IB1 lesion, and 4 had a stage IA2 lesion. There were four patients with grade 1 disease, seven with grade 2 disease, and two with grade 3 disease. The median age of the entire patients was 41years. The most common indication for extrafascial hysterectomy was cervical intraepithelial neoplasia 3. Three patients had visible lesions measuring 10–30mm, in diameter and ten patients had cervical stromal invasions with depths ranging from 4 to 9mm; only one patient had more than 50% stromal invasion, and four patients had lymph‑vascular space invasion (LVSI). Perioperative complications included intraoperative bowel injury, blood transfusion, vesico‑vaginal ifstula, and ileus (1 case for each). Postoperative pathologic examination results did not show residual disease or parametrial involvement. One patient with positive lymph nodes received concurrent radiation therapy. Only one patient experienced recurrence. Conclusions:Perioperative complications following RP were common, whereas the incidence of parametrial involve‑ment was very low

  8. Learning curve analysis of laparoscopic radical hysterectomy for gynecologic oncologists without open counterpart experience

    Kong, Tae-Wook; Chang, Suk-Joon; Paek, Jiheum; Park, Hyogyeong; Kang, Seong Woo; Ryu, Hee-Sug

    2015-01-01

    Objective To evaluate the learning curve of laparoscopic radical hysterectomy (LRH) for gynecologic oncologists who underwent residency- and fellowship-training on laparoscopic surgery without previous experience in performing abdominal radical hysterectomy (ARH). Methods We retrospectively reviewed 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer who underwent LRH (Piver type III) between April 2006 and March 2014. The patients were divid...

  9. Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

    The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy. Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups. Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS. Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy

  10. Application of da Vinci® Robot in simple or radical hysterectomy: Tips and tricks

    Iavazzo, Christos; Gkegkes, Ioannis D.

    2016-01-01

    The first robotic simple hysterectomy was performed more than 10 years ago. These days, robotic-assisted hysterectomy is accepted as an alternative surgical approach and is applied both in benign and malignant surgical entities. The two important points that should be taken into account to optimize postoperative outcomes in the early period of a surgeon’s training are how to achieve optimal oncological and functional results. Overcoming any technical challenge, as with any innovative surgical method, leads to an improved surgical operation timewise as well as for patients’ safety. The standardization of the technique and recognition of critical anatomical landmarks are essential for optimal oncological and clinical outcomes on both simple and radical robotic-assisted hysterectomy. Based on our experience, our intention is to present user-friendly tips and tricks to optimize the application of a da Vinci® robot in simple or radical hysterectomies. PMID:27403078

  11. Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy

    KATO, TATSUYA; Watari, Hidemichi; Takeda, Mahito; Hosaka, Masayoshi; Mitamura, Takashi; Kobayashi, Noriko; Sudo, Satoko; Kaneuchi, Masanori; Kudo, Masataka; Sakuragi, Noriaki

    2013-01-01

    Objective The aim of this study was to investigate the prognostic factors and treatment outcome of patients with adenocarcinoma of the uterine cervix who underwent radical hysterectomy with systematic lymphadenectomy. Methods A total of 130 patients with stage IB to IIB cervical adenocarcinoma treated with hysterectomy and systematic lymphadenectomy from 1982 to 2005 were retrospectively analyzed. Clinicopathological data including age, stage, tumor size, the number of positive node sites, ly...

  12. Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study

    Jensen, Pernille T; Groenvold, Mogens; Klee, Marianne C;

    2004-01-01

    BACKGROUND: Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early-stage cervical carcinoma. The authors investigated the longitudinal course of self-reported sexual function after RH. METHODS: The current study was comprise...

  13. Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

    Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

  14. Self-assessment of morbidity following radical hysterectomy for cervical cancer.

    Butler-Manuel, S A; Summerville, K; Ford, A; Blake, P; Riley, A J; Sultan, A H; Monga, A K; Stanton, S L; Shepherd, J H; Barton, D P

    1999-03-01

    The aim of this study was to assess the magnitude of the morbidity following radical surgery for early stage cervical cancer. We performed a retrospective survey of all women who had undergone a radical hysterectomy and lymphadenectomy between the months of July 1995 and December 1996 inclusive at either the Royal Marsden or St George's Hospital (n =38), using a detailed questionnaire on bladder, ano-rectal and sexual function, both before and after treatment. Sixteen women (44.4%) received adjuvant radiotherapy. The mean interval between surgery and inquiry was 16.4% months (range 8-25 months). The mean age at the time of surgery was 40.5 years. Thirty-six out of 38 women contacted responded (94.7%). Overall 33 women (91.7%) reported new bladder, ano-rectal or sexual symptoms. Complaints of urinary incontinence, particularly of urge incontinence, and of voiding difficulties increased significantly after surgery (P sex lives, 54.8% thought that their sex life was worse after treatment, and 12.9% of women had ceased sexual activity altogether. Of women of childbearing age 53.8% felt adversely affected by their loss of fertility. Bladder, ano-rectal and sexual symptoms are very common following radical hysterectomy for cervical cancer, with adverse effect on quality of life, and persist into the second year after treatment. PMID:15512265

  15. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  16. The anatomical basis and prevention of neurogenic voiding dysfunction following radical hysterectomy.

    Tong, X K; Huo, R J

    1991-01-01

    The disorder of neurogenic dysfunction is one of the most important complications of radical hysterectomy. In order to prevent this potential complication, the authors have studied the composition and layers of the pelvic paravisceral structures. The nerve branching and distribution of the pelvic plexus of 12 adult female cadavers were analyzed. From lateral to medial the pelvic paravisceral structure is made up of three layers. The lateral layer is the pelvic visceral fascia, the middle, a vascular layer, and the medial one, a nervous one which consists of the pelvic plexus and subsidiary plexuses. The pelvic plexus and subsidiary plexuses are laid closely to the lateral walls of pelvic organs. The ischial spine was taken as the central point and two perpendicular lines penetrating through the ischial spine were used as the longitudinal axis and transverse axis. According to these landmarks, the pelvic plexus could be divided into three parts: behind the longitudinal axis are the roots of the pelvic plexus, near the longitudinal axis is the uterovaginal plexus, and in front of the longitudinal axis are the branches distributed to bladder and urethra. The pelvic plexus and the uterosacral and cardinal ligaments are closely related. The pelvic and subsidiary plexuses can be damaged in radical hysterectomy and voiding dysfunction may then develop. Some anatomic bases are provided to explain and hopefully prevent this from happening. PMID:1925917

  17. Radical Hysterectomy

    ... with grief and loss Rebuilding self-esteem Good communication: The key to building a successful sexual relationship Overcoming anxiety about sex Rekindling sexual interest Sexual activity with your partner ...

  18. Adjuvant radiotherapy after radical hysterectomy of the cervical cancer. Prognostic factors and complications

    Chatani, Masashi; Nose, Takayuki; Masaki, Norie [Osaka Univ. Medical School (Japan). Dept. of Radiation Therapy; Inoue, Toshihiko [Osaka Univ. Medical School (Japan). Dept. of Radiation Oncology

    1998-10-01

    Aim: To investigate prognostic factors and complications after radical hysterectomy followed by postoperative radiotherapy for carcinoma of the uterine cervix. Patients and Methods: One hundred twenty-eight patients with T1b-2b carcinoma of the uterine cervix following radical hysterectomy with bilateral pelvic lymphadenectomy and postoperative radiation therapy were reviewed. Pathologic and treatment variables were assessed by multivariate analysis for local recurrence, distant metastases and cause specific survival. Results: The number of positive nodes (PN) in the pelvis was the strongest predictor of pelvic recurrence and distant metastases. These 2 failure patterns independently affect the cause specific survival. The 5-year cumulative local and distant failure were PN(0): 2% and 12%, PN(1-2): 23% and 25%, PN(2<): 32% and 57%, respectively (p=0.0029 and p=0.0051). The 5-year cause specific survival rates were PN(0): 90%, PN(1-2): 59% and PN(2<): 42% (p=0.0001). The most common complication was lymphedema of the foot experienced by one-half of the patients (5-year: 42%, 10-year: 49%). Conclusion: These results suggest that patients with pathologic T1b-T2b cervix cancer with pelvic lymph node metastases are at high risk of recurrence or metastases after radical hysterectomy with pelvic lymphadenectomy and postoperative irradiation. (orig.) [Deutsch] Ziel: Untersuchung der prognostischen Faktoren und Komplikationen der adjuvanten Radiotherapie nach radikaler Hysterektomie bei Patienten mit Zervixkarzinom. Patienten und Methoden: In dieser Studie wurden 128 Patientinnen mit Zervixkarzinom untersucht, bei denen die pathologische Untersuchung nach radikaler Hysterektomie mit gleichzeitiger bilateraler pelvischer Lymphadenektomie und postoperativer Radiotherapie die Klassifikation als T1b-T2b-Karzinome ergab. Dabei wurden pathologische und therapeutische Parameter auf der behandelten Seite mit Hilfe der Multivarianzanalyse auf lokale Rezidive und Fernmetastasen

  19. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or on...

  20. Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy

    Fiorica, J.V.; Roberts, W.S.; Greenberg, H.; Hoffman, M.S.; LaPolla, J.P.; Cavanagh, D. (Univ.ersity of South Florida College of Medicine, Tampa (USA))

    1990-03-01

    Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphedema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.

  1. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

    Soisson, A.P.; Soper, J.T.; Clarke-Pearson, D.L.; Berchuck, A.; Montana, G.; Creasman, W.T. (Duke Univ. Medical Center, Durham, NC (USA))

    1990-06-01

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

  2. Influence of margin status and radiation on recurrence after radical hysterectomy in Stage IB cervical cancer

    Purpose: To examine the relationship between margin status and local recurrence (LR) or any recurrence after radical hysterectomy (RH) in women treated with or without radiotherapy (RT) for Stage IB cervical carcinoma. Methods and Materials: This study included 284 patients after RH with assessable margins between 1980 and 2000. Each margin was scored as negative (≥1 cm), close (>0 and <1 cm), or positive. The outcomes measured were any recurrence, LR, and relapse-free survival. Results: The crude rate for any recurrence was 11%, 20%, and 38% for patients with negative, close, and positive margins, respectively. The crude rate for LR was 10%, 11%, and 38%, respectively. Postoperative RT decreased the rate of LR from 10% to 0% for negative, 17% to 0% for close, and 50% to 25% for positive margins. The significant predictors of decreased relapse-free survival on univariate analysis were the depth of tumor invasion (hazard ratio [HR] 2.14/cm increase, p = 0.007), positive margins (HR 3.92, p = 0.02), tumor size (HR 1.3/cm increase, p = 0.02), lymphovascular invasion (HR 2.19, p = 0.03), and margin status (HR 0.002/increasing millimeter from cancer for those with close margins, p = 0.03). Long-term side effects occurred in 8% after RH and 19% after RH and RT. Conclusion: The use of postoperative RT may decrease the risk of LR in patients with close paracervical margins. Patients with other adverse prognostic factors and close margins may also benefit from the use of postoperative RT. However, RT after RH may increase the risk of long-term side effects

  3. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer

    From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy

  4. Variability of bladder dysfunction in post radical hysterectomy effect of pelvic autonomic nerve preservation with/without postoperative radiation therapy

    The objective of this study was to demonstrate an improved method for radical hysterectomy procedures to prevent post-operative variable bladder dysfunction. This study presents the results of a Urodynamic Study performed in subjects who underwent radical hysterectomy to clarify the efficacy of the new surgical method. Participants in this study consisted of 40 Stage 1B cervical cancer patients. These 40 participants were divided into two categories. The control group, consisting of 21 patients, underwent surgery by the established procedure. The experimental group was treated by our improved surgical method for retaining pelvic autonomic nerve function after radical hysterectomy. The groups were further divided into those who received radiation therapy and those who did not require radiation therapy. Two UDS (Urodynamic Study) methods were chosen to estimate bladder function; cystometry and uroflowmetry. The cystometry measurement parameters indicate bladder pliancy at the point of maximum desire to void. The uroflowmetry measurement parameters indicate the time required from post-surgical dysfunctional urinary flow pattern to the recovery of a normal pattern. Initial cystometry and uroflowmetry measurements were established pre-operatively. Further measurements were taken 1, 3, 6, 12, and 24 months post-operation. Four groups were divided as indicated in the methods section above. The non-radiated group who underwent our improved surgical method showed significantly better quality of improvement in cystometry measurements compared to those treated by the established method on measurements obtained 24 months post-operatively. Even the group requiring post-op radiation showed significantly better results at the 1 and 24 month points. At the 24 month point, the group receiving radiation therapy showed the lowest level of pliancy improvement, indicating a tendency for a longer recovery time than this study allowed. Irrespective of radiation therapy, the groups

  5. Risk model in stage IB1-IIB cervical cancer with positive node after radical hysterectomy

    Chen Z

    2016-05-01

    Full Text Available Zhilan Chen,1,2,* Kecheng Huang,1,* Zhiyong Lu,1,3 Song Deng,1,4 Jiaqiang Xiong,1 Jia Huang,1 Xiong Li,5 Fangxu Tang,1 Zhihao Wang,6 Haiying Sun,1 Lin Wang,1 Shasha Zhou,1 Xiaoli Wang,1 Yao Jia,1 Ting Hu,1 Juan Gui,7 Dongyi Wan,1 Ding Ma,1 Shuang Li,1 Shixuan Wang11Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, 2Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, 3Hubei Key Laboratory of Embryonic Stem Cell Research, Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, 4Department of Obstetrics and Gynecology, University Hospital of Hubei University for Nationalities, Enshi, Hubei, 5Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, 6Department of Pathology and Pathophysiology, Key Laboratory of Ministry of Education of China for Neurological Disorders, Huazhong University of Science and Techonology, Wuhan, 7Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workAbstract: The purpose of this study was to identify risk factors in patients with surgically treated node-positive IB1-IIB cervical cancer and to establish a risk model for disease-free survival (DFS and overall survival (OS. A total of 170 patients who underwent radical hysterectomy and bilateral pelvic lymphadenectomy as primary treatment for node-positive International Federation of Gynaecology and Obstetrics (FIGO stage IB1-IIB cervical cancer from January 2002 to December 2008 were retrospectively analyzed. Five published risk models were evaluated in this population. The variables, including common iliac lymph node metastasis and parametrial invasion, were independent predictors of outcome in a multivariate analysis using a Cox regression model. Three distinct prognostic groups (low, intermediate, and high risk

  6. Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

    Ramirez, Pedro T.; Pareja, Rene; Rendón, Gabriel J.; Millan, Carlos; Frumovitz, Michael; Schmeler, Kathleen M.

    2013-01-01

    The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies h...

  7. Description of preoperative risk factors and postoperative complications of radical hysterectomy in patients of Hospital Dr. Rafael Angel Calderon Guardia: period 2000-2006

    Preoperative risk factors and postoperative complications were determined in patients with radical hysterectomy in gynecologic oncology service of Hospital Rafael Angel Calderon Guardia in 2000-2006. Radical hysterectomy Piver type II and III was carried out among women in the gynecology service. The information derived from the qualitative variables were analyzed using frequency distributions and percentages. The most common preoperative comorbidity has been hypertension, the most frequently encountered complication has been urinary incontinence. Postoperative complications have been located in a period less than three months.

  8. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  9. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  10. Sentinel lymph node identification in patients with early stage cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy

    李斌; 章文华; 刘琳; 吴令英; 张蓉; 李宁

    2004-01-01

    Background In general, sentinel lymph node (SLN) can reflect the whole state of the entire drainage area. The present study evaluated the clinical significance of sentinel lymph node identification in the treatment of early stage cervical cancer.Methods Twenty-eight patients with early stage (Ia-Iia) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in this study. At two locations 8 hours before operation, 0.4 ml 37 Mbq technicium-99 labeled dextran was injected intracervically. After that, preoperative lymphoscintigraphy was performed to detect SLNs. During the operation, lymph nodes were detected ex vivo by a γ-counter to identify SLNs. The samples of SLNs and non-SLNs were used for pathological examination separately and compared with the final results. Results SLNs were identified in 27 of 28 (96.4%) patients. A total of 123 SLNs were identified from 814 nodes. Six patients had altogether 11 positive lymph nodes, which were all SLNs. No patient had false-negative sentinel node. Conclusion SLNs can successfully predict the lymphatic metastasis in patients with cervical cancer. The clinical validity of this technique should be evaluated prospectively.

  11. Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients

    Flores Vladimir

    2009-02-01

    Full Text Available Abstract Background A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment in patients treated with external beam chemoradiation (EBRT-CT and radical hysterectomy versus those treated with identical chemoradiation followed by brachytherapy. Methods In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated. Results A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31 and 22 (3–27 months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups. Conclusion The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.

  12. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    Huang, Yi-Ting; Wang, Chun-Chieh; Tsai, Chien-Sheng [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China); Lai, Chyong-Huey; Chang, Ting-Chang; Chou, Hung-Hsueh [Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Lee, Steve P. [Department of Radiation Oncology, University of California, Los Angeles School of Medicine, Los Angeles, CA (United States); Hong, Ji-Hong, E-mail: jihong@adm.cgmh.org.tw [Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan (China); Department of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan, Taiwan (China)

    2012-10-01

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  13. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated by Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy

    Purpose: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods and Materials: A total of 318 Stage IB–IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. Results: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. Conclusions: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

  14. Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

    Đurđević Srđan

    2015-01-01

    Full Text Available Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix. Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients’ age ranged from 24-79 years (x : 46 years, and the operation duration was 120-300 minutes (x : 210 min.. Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml, and the number of removed lymph nodes per operation was 14-75 (x : 32. Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5% patients, most often in paraaortic lymph nodes (3.4% and parametria (2.8%, while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

  15. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer

    Yang, Lu; Guo, Jianfeng; Shen, Yi; Cai, Jing; Xiong, Zhoufang; Dong, Weihong; Min, Jie; Wang, Zehua

    2015-01-01

    Objective: To assess the efficacy and toxicity of the combination of paclitaxel plus carboplatin as neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC) prior to radical hysterectomy and pelvic lymphadenectomy. Methods: We reviewed patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin followed by radical hysterectomy (NACT group) or only received primary radical surgery (PRS group) in our hospital between Jan 2007 and Jan 2012. Toxicity, NACT response, surgery pathological factors and survival data were collected and analyzed. Results: In the NACT group, the overall response rate was 71.3% (82/115). Eighteen (15.7%) patients achieved complete remission. Well differentiated tumors showed a more favorable response to NACT (P=0.011). Myelosuppression was the most common adverse effect (51.7%) and serious adverse effects were rare (3.4%). The median follow-up period was 44 months (range, 6-75). The NACT responders had significantly longer OS and PFS when compared to the non-NACT responders and patients in the PRS group. Conclusion: Patients with LACC can benefit from neoadjuvant chemotherapy with paclitaxel plus carboplatin when they have response to the chemotherapeutic agents. PMID:26550314

  16. Therapeutic comparison of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer

    Objective: To compare the short-term and long-term therapeutic response of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer. Methods: One hundred and fifty-one patients with stages I b2-II a cervical cancer were treated with preoperative intra-arterial chemotherapy before radical hysterectomy was carried out. Patients in study group (n = 113) received uterine artery chemoembolization (UACE), while patients control group(n = 38) received internal iliac anterior trunk arterial chemotherapy. Radical hysterectomy was carried out in all patients within 2-4 weeks after UACE or chemotherapy. The tumor size was measured before and after the procedure,and the survival rate at 2 and 5 years after treatment was calculated. Results: The mean maximum diameter of the tumors was (4.58 ± 0.37) cm before interventional therapy, and it was (2.11 ± 0.24) cm in two weeks after interventional therapy. The complete response rate of study group and control group was 31.9% and 21.1% respectively. The total effective rate of study group and control group was 94.7% (107/113) and 76.3% (29/38) respectively. The effective rate of study group two weeks after therapy was significantly higher than that of control group. No surgical margin infiltration was observed in both groups. Pathological findings in study group included vascular invasion around surgical margin (n = 3), parametrial invasion (n = 5) and pelvic lymph node metastasis (n = 6), while in control group vascular invasion around surgical margin, parametrial invasion and pelvic lymph node metastasis were found in one, two and one cases respectively. The two-year and five-year survival rate in study group were 80.9% (68/84) and 73.4% (47/64) respectively, while the two-year and five-year survival rate in control group were 81.3% (26/32) and 75.0% (18/24) respectively. No significant difference in survival

  17. Chemoradiation With Paclitaxel and Carboplatin in High-Risk Cervical Cancer Patients After Radical Hysterectomy: A Korean Gynecologic Oncology Group Study

    Lee, Taek Sang [Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Soon Beom, E-mail: tslee70@gmail.com [Department of Obstetrics and Gynecology, Konkuk University Medical Center, Seoul (Korea, Republic of); Kim, Young Tak [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Park, Byung Joo [Department of Preventive Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Man [Department of Obstetrics and Gynecology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jong Min [Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jae Hoon [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Tai [Department of Obstetrics and Gynecology, Hanyang University Medical Center, Seoul (Korea, Republic of)

    2013-06-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiation with paclitaxel and carboplatin in patients with high-risk cervical cancer. Methods and Materials: Patients after radical hysterectomy for cervical cancer, with at least 1 high-risk characteristic, were administered paclitaxel 135 mg/m{sup 2}, carboplatin area under the curve = 5 every 3 weeks for 3 cycles concomitant with radiation therapy as adjuvant treatment. Results: This prospective study enrolled 71 consecutive patients. Sixty-six patients (93%) completed the planned treatment. The majority of grade 3/4 neutropenia or nonhematologic toxicities were usually self-limited. Diarrhea grades 3/4 were observed in 4 patients (5.6%). One patient developed anaphylactic shock after infusion of paclitaxel. With a median follow-up of 57 months, recurrences occurred in 16 patients. Multivariable analysis indicated that common iliac lymph node involvement is an independent risk factor for disease recurrence (odds ratio 13.48; 95% confidence interval 2.93-62.03). In the intent-to-treat population (n=71), the estimated 5-year disease-free survival and overall survival rates were 77.3% and 80.3% respectively. In the per-protocol population (n=62), disease-free survival was 78.9% and overall survival was 83.9%. Conclusions: Concurrent chemoradiation with paclitaxel/carboplatin is well tolerated and seems to be effective for patients who undergo radical hysterectomy. Therefore, a prospective, randomized controlled study should be designed to evaluate efficacy of this approach for patients with high-risk cervical cancer.

  18. Longer waiting times for early stage cervical cancer patients undergoing radical hysterectomy are associated with diminished long-term overall survival

    Nanthamongkolkul, Kulisara

    2015-01-01

    Objective The aim of this study was to evaluate the impact of surgical waiting time on clinical outcome in early stage cervical cancer. Methods The cohort consisted of 441 patients diagnosed with stages IA2-IB1cervical cancer who underwent radical hysterectomy and pelvic node dissection. The patients were divided into two groups based on surgical waiting time. The associations between waiting time and other potential prognostic factors with clinical outcome were evaluated. Results The median surgical waiting time was 43 days. Deep stromal invasion (hazard ratio [HR], 2.5; 95% confidence interval [CI], 1.4 to 4.6; p=0.003) and lymph node metastasis (HR, 2.9; 95% CI, 1.3 to 6.7; p=0.026) were identified as independent prognostic factors for recurrence-free survival while no prognostic significance of surgical waiting time was found (p=0.677). On multivariate analysis of overall survival (OS), only deep stromal invasion (HR, 2.6; 95% CI, 1.3 to 5.0; p=0.009) and lymph node metastasis (HR, 3.6; 95% CI, 1.5 to 8.6; p=0.009) were identified as independent prognostic factors for OS. Although OS showed no significant difference between short (≤8 weeks) and long (>8 weeks) waiting times, multivariate analysis of OS with time-varying effects revealed that a waiting time longer than 8 weeks was associated with poorer long-term survival (after 5 years; HR, 3.4; 95% CI, 1.3 to 9.2; p=0.021). Conclusion A longer surgical waiting time was associated with diminished long-term OS of early stage cervical cancer patients. PMID:26404122

  19. Randomized phase III trial of radiotherapy or chemoradiotherapy with topotecan and cisplatin in intermediate-risk cervical cancer patients after radical hysterectomy

    . Concurrent chemoradiotherapy with topotecan and cisplatin showed severe hematologic toxicity in intermediate-risk cervical cancer patients after radical hysterectomy. Thus, the study was closed ahead of schedule. ClinicalTrials.gov Identifier: https://www.clinicaltrials.gov/ct2/show/NCT01418859?term

  20. 早期宫颈癌(Ⅰb-Ⅱa期)预后相关因素的回顾性分析%Clinical outcome following radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer

    Hongbo Wang; Suhui Wu; Zehua Wang

    2008-01-01

    Objective: To estimate the impact of parametrial infiltration and lymph node metastasis on clinical outcome in women with early-stage cervical cancer following radical hysterectomy and pelvic lymphadenectomy. Methods: Clinical re-cords and pathologic slides of 532 patients with early-stage cervical cancer (330 Ib and 202 Ila) treated with radical hyster-ectomy and pelvic lymphadenectomy were reviewed. The study group comprised 520 patients with squamous cell carcinoma and 12 patients with adenocarcinoma of the cervix. Median follow-up time was 67 months. The association among the various histopathologic predictors of outcome was determined with analysis. The influence of the predictors on outcome was exam-ined with log rank survival methods and the Cox regression model. Results: FIGO stage, histologic type, tumor size, depth of invasion, parametrial infiltration, lymph node metastasis, and remote metastasis were identified as significantly biologically relevant and therefore were included as candidate predictors in multivariate analysis. In particular, parametrial infiltration and lymph node metastasis were found to be simultaneous predictors of death on multivariate analysis (P < 0.05). After controlling for these two factors, the other variables considered were not statistically significant up to a two-way interaction. Conclusion: Presence of parametrial infiltration and/or lymph node metastasis in women with early-stage cervical cancer is an indepen-dent poor prognostic factor. In addition, the relatively poor survival of women with more than one lymph nodes identified with cancer cells.

  1. 腹腔镜宫颈癌根治术中腹膜阴道延长术的应用%The application of vaginal extension with peritoneum in the laparoscopic radical hysterectomy

    杨尚武; 王小婕; 梦灵; 仲勇; 李莉芳; 黄浩

    2013-01-01

    Objective To explore the value of vaginal extension with peritoneum in the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve .Methods Seven cases with cervical carcinoma at the stage of the Ⅰb-Ⅱa had the laparoscopic radical hysterectomy with the preservation of pelvic autonomic nerve and the operation of vaginal extension with peritoneum at the same time.Post-operative vaginal length and sexual life status of the patients were studied .Results The length of vagina 3 months after the operation was 8 to 11cm, with the average length of 8.8 ±2.2cm.No obvious side effect on sex life was found after the surgery . Conclusion It is feasible and advisable that the patients with cervical carcinoma have vaginal extension with peritoneum to ensure their life quality while they have laparoscopic radical hysterectomy with the preservation of the pelvic autonomic nerve .%目的探讨腹膜阴道延长术在腹腔镜下保留盆腔自主神经广泛子宫切除术中的价值。方法对7例Ⅰb~Ⅱa宫颈癌患者在行保留盆腔自主神经广泛性子宫切除术的同时行腹膜阴道延长术,研究患者术后阴道长度、性生活的情况。结果术后3个月测量阴道长度为8~11cm,平均长度为8.8±2.2cm。性生活质量术后与术前相比无明显影响。结论宫颈癌患者在行腹腔镜下保留盆腔自主神经的同时,采用腹膜进行阴道延长是可行的,保证了患者术后的生活质量,值得推广。

  2. Current Issues with Hysterectomy.

    Barker, Matthew A

    2016-09-01

    Hysterectomy is one of the most common gynecologic surgeries. Early adoption of surgical advancements in hysterectomies has raised concerns over safety, quality, and costs. The risk of potential leiomyosarcoma in women undergoing minimally invasive hysterectomy led the US Food and Drug Administration to discourage the use of electronic power morcellator. Minimally invasive hysterectomies have increased substantially despite lack of data supporting its use over other forms of hysterectomy and increased costs. Health care reform is incentivizing providers to improve quality, improve safety, and decrease costs through standardized outcomes and process measures. PMID:27521886

  3. Chronic pain after hysterectomy

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  4. [Peripartal hysterectomy - review].

    Pálová, E; Borovsky, M

    2012-06-01

    Peripartal hysterectomy is one of the life - threatening procedures needed to be performed in an urgent situation. Women at highest risk of peripartal hysterectomy are multiparas, women who had a caesarian delivery in either previous or present pregnancy or women who had an abnormal placentation. This report presents the basic issues and brief review of the major indications of peripartal hysterectomy. It also compares the effectiveness of the selected types of operation. PMID:22779724

  5. 腹腔镜下宫颈癌根治术32例临床分析%Clinical Analysis of 32 Cases of Laparoscopic Radical Hysterectomy for Cervical Cancer

    倪琴; 米鑫; 张风格

    2015-01-01

    Objective:To explore the clinical efficacy of laparoscopic radical hysterectomy in the treatment of cervical cancer.Method:A retrospective chart review identified stageⅠa2 toⅡa cervical cancer patients who underwent laparoscopic radical hysterectomy and pelvic lymph node dissection and abdominal aorta lymph node dissection from January 2011 to November 2014,the treatment effect was observed.Result:All the 32 cases were successfully treated by laparoscopic surgery,no one turned to undergo laparotomy.The mean operative time was (240.06±31.99)min.The average intraoperative blood loss was (245.31±102.45)ml.The average pelvic lymph node resected and abdominal aorta lymph node resected were (23.41±1.72) and (4.13±0.94).Postoperative anal exhaust time was (42.63±5.98)h,and bladder function recovery time was (16.78±4.72)d.One case complicated with external iliac vein injury.All cases of vaginal stump and cutting edge were negative.Seven cases received supplementary postoperative radiotherapy and chemotherapy.32 cases followed up 1 to 48 months postoperatively no recurrence.Conclusion:Laparoscopic radical hysterectomy for cervical cancer is safe and feasible,and has satisfactory result,but the surgeon must have skilled operation technique and treatment experience of operation complication.%目的:探讨腹腔镜下宫颈癌根治术的临床疗效。方法:回顾性分析笔者所在医院32例Ⅰa2~Ⅱa期宫颈癌患者腹腔镜下广泛子宫切除术及盆腔淋巴结和腹主动脉旁淋巴结清扫术的临床资料,观察腹腔镜手术治疗效果。结果:32例患者手术均成功,无一例中转开腹。手术时间(240.06±31.99)min,术中出血量(245.31±102.45)ml,切除盆腔淋巴结(23.41±1.72)枚,切除腹主动脉旁淋巴结(4.13±0.94)枚,术后肛门排气时间(42.63±5.98)h,膀胱功能恢复时间(16.78±4.72)d;1例髂外静脉损伤;所有病例断端及阴道切缘均阴性,术后7例补充放疗、化疗。32

  6. Sentinel node detection with 99mTc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy

    If the sentinel-lymph-node (SLN) concept is valid in cervical cancer, most patients could avoid pelvic lymphadenectomy when absence of metastasis is intraoperatively confirmed in the SLN. We assessed feasibility and accuracy of SLN detection using 99mTc phytate in patients with cervical cancer. Eighty-two women with stage Ia-IIb cervical cancer enrolled in this study. All underwent hysterectomy or trachelectomy with accompanying total pelvic lymphadenectomy. On the day before surgery, we injected fluid containing 99mTc-labeled phytate subepithelially into four cervical quadrants outside the tumor. Intraoperatively, SLNs were identified as radioactive ''hot nodes'' by gamma probe. Systematic bilateral pelvic lymphadenectomy was performed after the hot node sampling to evaluate the predictive ability of hot nodes. A total of 157 lymph nodes were detected as SLNs in 72 of 82 patients. SLN detection rate was 88%. Detection rate was 95% for the subgroups of patients with stage Ia-Ib1 disease and smaller tumor size (≤3 cm in maximal diameter). Lymph node metastasis was found in 15 patients. In 3 of them, no SLNs were detected. In the remaining 12 patients, each ipsilateral SLN contained metastasis when the pelvic lymph nodes contained metastases. Sensitivity was 100%, the false negative rate was 0%, and the negative predictive value of SLN was 100%. We conclude SLN detection using 99mTc-labeled phytate is satisfactory to assess pelvic nodes in patients with early cervical cancer; if validated with other research, it should be incorporated into clinical practice. (author)

  7. "STUDY OF CONCURRENT CISPLATIN AND EXTERNAL RADIOTHERAPY PRIOR TO RADICAL HYSTERECTOMY AND LYMPHADENECTOMY IN PATIENTS WITH STAGE IB-IIB CERVICAL CANCER"

    M. Modares Gilani

    2004-06-01

    Full Text Available The purpose of this study was to describe the feasibility of a combined preoperative chemoradiation program Ib-IIa, bulky and suspicious IIb by radical surgery in patients with stage Ib-IIb cervical cancer. From September 1999 to April 2002, 30 patients with carcinoma of the cervix were treated with preoperative external beam radiotherapy of 45 Gy in 5 weeks. Patients received concurrent continuous infusion of cisplatin 50 mg/m2 for one day in week during 5 weeks of radiation. Radical surgery was performed 4-6 weeks after completion of the preoperative treatment. Toxicity with chemoradiation was usually mild. Two patients developed vesicovaginal fistula, and four developed long-term hydronephrosis that needed ureteral stenting. Clinical response was observed in 100% of the patients (23.7% complete response. The analysis of the surgical specimens revealed complete pathological response in 43.3% of the cases and partial pathological response in 56.7%. The degree of pathological response was not predictable by the degree of clinical response. Thirty months disease-free survival and overall survival were 66.3% and 77.31%, respectively. Patients with complete and partial pathological response were not significantly different in terms of disease-free survival (p= 0.08 and overall survival (p= 0.3. Cisplatin in preoperative chemoradiation is effective and usually welltolerated in bulky cervical cancer and parametrial invasion, inducing a high rate of clinical and pathological complete responses. When this therapy is followed by radical surgery, disease-free and overall survival rates are higher. The latter may be possible only through extensive surgical resection with a parallel increase in complication rates.

  8. Emergency peripartum hysterectomy

    Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin;

    2015-01-01

    OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy. DESIGN: Nordic collaborative study. POPULATION: 605 362 deliveries across the five Nordic countries. METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within...... 7 days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. MAIN OUTCOME MEASURES: Emergency peripartum hysterectomy rate. RESULTS: The total number of emergency.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  9. Emergency peripartum hysterectomy

    Mehmet Sıddık Evsen

    2009-03-01

    Full Text Available The aim of the present study was to determine the incidence, indications and maternal characteristics of emergency peripartum hysterectomy (EPH.Medical records belong to 49 patients, that undergone EPH at Diyarbakır Gynecology and Obstetrics Hospital, between September 2005 and August 2008 were retrospectively reviewed. During three years, from 63463 deliveries, hysterectomy was performed to 49 patients (0.77/1000 due to obstetrical hemorrhage. Indications for EPH were uterine atony (49.6%, uterine rupture (42.9% and placenta accreata (8.2%. The mean age of patients was 34.6±5.7 years, and mean gravida was 5.5±2.4. Subtotal hysterectomy was performed to 31 (63.3% patients and total hysterectomy to 18 (36.7% of them. Bilateral hypogastric artery ligation was performed to 8 (16.3% and unilateral ooferectomy to 7 (14.3%. Two of our patients died secondary to uncontrolled uterine bleeding.In conclusion, uterine atony and uterine rupture were the most frequent causes of EPH. Emergent and appropriate management of these patients is the most important life saving procedure.

  10. Total versus subtotal hysterectomy

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe; Gluud, Christian; Ottesen, Bent S; Tabor, Ann

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...

  11. Radicals

    Jahn, Ullrich; Cornils, B.

    Weinheim: Wiley-VCH, 2013 - (Cornils, B.; Herrmann, W.; Wong, C.; Zanthoff, H.), s. 1897-1898 ISBN 978-3-527-33307-3 Institutional support: RVO:61388963 Keywords : radicals * enzymatic catalysis * coenzyme B12 * ribonucleotide reductase * mutases Subject RIV: CC - Organic Chemistry

  12. Salpingectomy as standard at hysterectomy?

    Guldberg, Rikke; Wehberg, Sonja; Skovlund, Charlotte Wessel; Mogensen, Ole; Lidegaard, Ojvind

    2013-01-01

    To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation.......To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation....

  13. Laparoscopic Radical Trachelectomy

    Rendón, Gabriel J.; Ramirez, Pedro T.; Frumovitz, Michael; Schmeler, Kathleen M.; Pareja, Rene

    2012-01-01

    Introduction: The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported. Case Description: We report the first case of a laparoscopic radical trachelectomy performed in a developing country. The patient is a nulligravid, 30-y-old fem...

  14. Sexuality after total vs. subtotal hysterectomy

    Zobbe, Vibeke Bahn; Gimbel, Helga Margrethe Elisabeth; Andersen, Birthe Margrethe;

    2004-01-01

    The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.......The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies....

  15. Preoperative teaching and hysterectomy outcomes.

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  16. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... abdominal hysterectomy? Well the vaginal hysterectomy has some limitations. It is somewhat of a blind procedure, as we know, with limited exposure. Inherent with that may be some fear ...

  17. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... taking all that into account, taking experience and skill, for most of us, the abdominal hysterectomy is ... You’ll basically converting that into a two-step procedure, a myomectomy first, and then a hysterectomy. ...

  18. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ... perform the hysterectomy procedure; however I believe the information that we present and discuss tonight will be ...

  19. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... discuss an innovative approach to do a hysterectomy. It’s called the “minilap hysterectomy.” I’m very excited ... settle for large incisions and prolonged recoveries when it comes time to have your hysterectomy. With that, ...

  20. Peripartum hysterectomy: an evolving picture.

    Turner, Michael J

    2012-02-01

    Peripartum hysterectomy (PH) is one of the obstetric catastrophes. Evidence is emerging that the role of PH in modern obstetrics is evolving. Improving management of postpartum hemorrhage and newer surgical techniques should decrease PH for uterine atony. Rising levels of repeat elective cesarean deliveries should decrease PH following uterine scar rupture in labor. Increasing cesarean rates, however, have led to an increase in the number of PHs for morbidly adherent placenta. In the case of uterine atony or rupture where PH is required, a subtotal PH is often sufficient. In the case of pathological placental localization involving the cervix, however, a total hysterectomy is required. Furthermore, the involvement of other pelvic structures may prospectively make the diagnosis difficult and the surgery challenging. If resources permit, PH for pathological placental localization merits a multidisciplinary approach. Despite advances in clinical practice, it is likely that peripartum hysterectomy will be more challenging for obstetricians in the future.

  1. The decline of hysterectomy for benign disease.

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  2. Total Vaginal NOTES Hysterectomy: A New Approach to Hysterectomy.

    Baekelandt, Jan

    2015-01-01

    The aim of this study was to demonstrate the feasibility of a total hysterectomy performed entirely by transvaginal natural orifice transluminal endoscopic surgery (vNOTES). Conventional, reusable laparoscopic instruments were used, inserted through an inexpensive, self-constructed single-port device. Ten total vaginal NOTES hysterectomies (TVNHs) were performed by a single surgeon. The self-constructed single-port device was made by assembling a surgical glove, a wound protector or modified laryngeal mask airway, 1 reusable 10-mm trocar, and 4 reusable 5-mm trocars. This gloveport was inserted into the vagina to create a pneumovagina. The conventional steps of a vaginal hysterectomy were followed, but performed endoscopically with standard reusable endoscopic instruments. The patient and perioperative data were analyzed. No conversion to standard laparoscopy or laparotomy was necessary in any of the 10 patients who underwent a TVNH. Mean operation time was 97 min (range: 60-120); mean drop in hemoglobin level was 1.5 g/dL (range: 0.5-2.4). There were no operative complications, and postoperative pain scores were very low. This first report on a small number of patients demonstrates that TVNH is possible. By incorporating the advantages of endoscopic surgery, TVNH broadens the indications for vaginal hysterectomy and helps overcome its limitations. At the same time, the NOTES approach avoids abdominal wall wounds and trocar-related complications. TVNH is feasible, even when performed with reusable, conventional laparoscopic instruments. This frugally innovative technique also enables surgeons to perform hysterectomies by vNOTES in low resource settings. PMID:26009278

  3. HYSTERECTOMY ………. WHY?

    Swati

    2014-08-01

    Full Text Available OBJECTIVE: This study was designed to identify various factors affecting women’s decision to undergo hysterectomy, to know the reasons for preference of hysterectomy over medical and surgical conservative management and observe occurrence of various uterine pathologies in relation to age. METHODS: A prospective observational study of 600 patients who underwent hysterectomy for various etiologies by different routes at Sola Civil Hospital, Ahmedabad over a period of 1 year (from jan-13 to Dec 13 was carried out. RESULT: percentage of patients undergoing hysterectomy in prolapse and adenomyosis group patients are 100% and 96.29% In DUB 64.39% and the fibroid group 68.10-% patients preferred hysterectomy as a first line of treatment. CONCLUSION: DUB was recognized as the most common indication for hysterectomy amongst reproductive age women whereas prolapse was the commonest indication in women over 50 years of age. A considerable number of patients with PID preferred medical management Patients with DUB and fibroid preferred conservative surgical and medical management before finally opting for hysterectomy but more than 64% patients in both group opted hysterectomy as first-line treatment.. Cost of medical management and affection of quality of life were identified as major reasons for diverting to permanent cure (hysterectomy in DUB patients. Belief of uterus as a vestigial organ after completion of childbearing was reason for hysterectomy in PID and prolapse patients.

  4. Total Laparoscopic Hysterectomy Compared with Abdominal Hysterectomy; Clinical Outcomes

    Cem Celik

    2013-10-01

    Full Text Available Aim: The purpose of this study was to confirm the positive intraoperative and postoperative outcomes of total laparoscopic hysterectomy (TLH and total abdominal hysterectomy (TAH. Material and Method: We presented surgical procedures performed at Namik Kemal University Faculty of Medicine, Department of Obstetrics and Gynecology between September 2010 and December 2012, 47 patients who underwent TLH and 30 patients who underwent TAH  were included in the present study. Results: Operating time in TLH group was significantly longer than in the TAH group (202.56±61.53 vs 138.06±40.52 min. There were no significant differences between the two groups regarding complications, conversion to laparotomy, intraoperative bleeding. We observed no differences in reoperation and transfusion rates between the two groups. Duration of hospital stay was statistically shorter in TLH group compared to the TAH group (3.93±0.70 vs 5.26±1.63 day. Discussion: Laparoscopic hysterectomy, compared to laparotomy regarding equal outcomes and lower perioperative morbidity, improvement of quality of life, shorter hospital stay and faster return to activity.

  5. Abandoned vehicles

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  6. Lower urinary tract symptoms after subtotal versus total abdominal hysterectomy

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: Lower urinary tract symptoms (LUTS) are common after hysterectomy and increase after menopause. We aimed to compare subtotal with total abdominal hysterectomy regarding LUTS, including urinary incontinence (UI) subtypes, 14 years after hysterectomy. Main results from ...

  7. Total laparoscopic hysterectomy versus vaginal hysterectomy: a retrospective study

    Jayashree S.

    2015-10-01

    Full Text Available Background: Total laparoscopic hysterectomy (TLH is now emerging as a safe procedure even in patients suitable for vaginal hysterectomy (VH due to its advantages like better visualisation, less post-operative pain and shorter hospital stay. This study was done to compare the duration of surgery, intra-operative and postoperative complications, hospital stay and post-operative analgesia requirement in TLH and VH. Methods: A retrospective study of women undergoing TLH and VH between June 2013 and September 2014 in JSS Hospital, Mysore was done. Patients with suspected genital malignancy and uterine prolapse were excluded. Baseline characteristics like age, BMI, parity, indication for hysterectomy, uterine size and previous pelvic surgeries were noted. Intra-operative and post-operative parameters like duration of surgery, complications, post-operative analgesic dosage and hospital stay were compared between the two surgeries and the results were analysed using Chi square test and independent t test. Results: The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with VH, i.e. 61.18 minutes ( p <0.0001. But the duration of stay in the hospital was shorter for the women undergoing TLH, mean duration being 3.74 days as opposed to 5.85 days in women undergoing VH (p<0.0001. Also, women undergoing VH required more analgesic doses (mean 1.79 than those undergoing TLH (mean 1.36. When we studied the rate of complications in both the groups, we found no statistically significant difference. Conclusions: TLH was as safe as VH and had advantages like shorter hospital stay and reduced analgesia dose. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1499-1504

  8. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... t know if I feel comfortable doing that.” Well I believe our presentation will be different. I’m confident that after this evening ... this? Why do OB-GYNs prefer abdominal hysterectomy? Well the vaginal hysterectomy ... Inherent with that may be some fear that will have some injury to ...

  9. 腹腔镜下广泛全子宫及盆腹腔淋巴结切除手术6例泌尿系损伤临床分析%Clinical analysis on 6 cases of urinary system injury in peritoneoscope radical hysterectomy and abdomi-nopelvic cavity lymph node excision

    陶玲; 于春霞; 李霞; 周琦

    2015-01-01

    目的:探讨我科腹腔镜广泛全子宫及盆腔淋巴结切除手术中泌尿系损伤的发生情况、处理方式以及预防的方法。方法:回顾性分析5年间我科腹腔镜广泛全子宫+盆腔淋巴结切除手术中发生泌尿系损伤患者的临床资料、疾病类型、盆腔情况、损伤、诊治情况及预后。结果:385例妇科腹腔镜手术中,共发生泌尿系损伤6例,发生率为1.56%,其中膀胱损伤2例,输尿管损伤4例。5例均有盆腔粘连,4例有盆腹腔手术史,1例合并盆腔子宫内膜异位症,2例子宫均有增大(6~10周)。2例膀胱损伤及 2例输尿管损伤均在术中发现。另 2例输尿管损伤于术后发现,其中 1例为术后复习录制手术视频时发现;1例为术后第5天行静脉肾盂造影确诊。2例膀胱损伤术中发现者均行腹腔镜下膀胱修补术。2例术中发现输尿管损伤者在术中行腹腔镜下输尿管吻合术+支架置入术及膀胱镜下输尿管支架置入术。2例术后发现者其中 1例行腹腔镜输尿管修补术及支架置入术,1例在膀胱镜下行输尿管支架置入术,预后均较好。结论:妇科腹腔镜手术泌尿系损伤是妇科腹腔镜手术少见而严重的并发症,如果注意预防损伤常可避免。术前须仔细评估患者的病情,应严格掌握腹腔镜手术指征,术中应仔细操作,术中术后尽早发现膀胱或输尿管损伤,尽可能采取及时、有效的方式减少损害。%Objectives:To discuss the occurrence rate,causes,treatment and prevention methods of urina-ry system injury in peritoneoscope radical hysterectomy and abdominopelvic cavity lymph node excision.Methods:A retrospective analysis on the clinical material,disease type,pelvic cavity condition,damage,diagnosis and treat-ment condition and prognosis of the patients suffering from urinary system injury in peritoneoscope radical hysterecto-my and abdominopelvic cavity lymph

  10. Clinicopathological review of gynaecological hysterectomies local experience

    share clinicopathological spectrum of hysterectomies performed at CMH Rawalpindi. Study Design: A cross sectional descriptive study. Place and duration of the study : This study was carried out at Obstetrics and Gynaecology department CMH Rawalpindi, from October 2010 to June 2012. Material and Methods: Total of 54 patients who underwent hysterectomy were selected for the study. Detailed history and examination of the patient pre and post-operatively were carried out to observe the indications and complications of hysterectomy. Results: In total 54 hysterectomies were carried out; all of which with the exception of one were total abdominal. The patients who underwent hysterectomies were in the 4th decade of life. The most common (48%) indication of hysterectomy in our study was found to be menstrual irregularities like menorrheagia, irregular vaginal bleeding, DUB and post-menopausal bleeding give frequently of complication as well. Delayed wound healing was the most common complaint (7%). Histopathology carried out on the uterine specimen showed adenomyosis 17(31%) being the most common finding. Conclusion: Abdominal hysterectomies carried out in our setup are most commonly done for menstrual irregularities and complication rate is low. (author)

  11. Depression Following Hysterectomy and the Influencing Factors

    Bahri, Narjes; Tohidinik, Hamid Reza; Fathi Najafi, Tahereh; Larki, Mona; Amini, Thoraya; Askari Sartavosi, Zahra

    2016-01-01

    Background Hysterectomy is one of the most common gynecological surgeries performed worldwide. However, women undergoing this surgery often experience negative emotional reactions. Objectives This study was done with the aim of investigating the relationship between hysterectomy and postoperative depression, three months after the procedure. Materials and Methods This longitudinal study was conducted in the province of Khorasan-Razavi in Iran, using multistage sampling. At first, three cities were selected from the province by cluster sampling; then, five hospitals were randomly selected from these cities. The participants included 53 women who were hysterectomy candidates in one of the five selected hospitals. The participants’ demographics and hysterectomy procedure information were entered into two separate questionnaires, and the Beck depression inventory (BDI) was employed to measure their severity of depression before and three months after the surgery. The statistical package for the social sciences (SPSS) version 16 was used for the statistical analysis, and a P value of < 0.05 was considered to be statistically significant. Results The means and standard deviations of the participants’ depression scores before and three months after their hysterectomies were 13.01 ± 10.1 and 11.02 ± 10.3, respectively. Although the mean score of depression decreased three months after the hysterectomy, the difference was not statistically significant. However, a significant relationship was found between the satisfaction with the outcome of the hysterectomy and the postoperative depression score (P = 0.04). Conclusions In this study, undergoing a hysterectomy did not show a relationship with postoperative depression three months after the surgery. Moreover, the only factor related to depression following a hysterectomy was satisfaction with the surgery. PMID:27066267

  12. Hysterectomy

    ... in the pelvic area). You may still get pregnant after myolysis. Treatments to shrink fibroids without surgery. These treatments include uterine artery embolization (UAE) and magnetic resonance (MR)-guided focused ultrasound (MR[f]US). UAE puts ...

  13. Abandoned Shipwreck Act

    National Oceanic and Atmospheric Administration, Department of Commerce — The Abandoned Shipwreck Act of 1987 (ASA) affirms the authority of state governments to claim ownership to, protect, and manage abandoned shipwrecks on state...

  14. Guam Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Guam. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  15. Florida Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Florida. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  16. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... Illinois. I practice with North Shore University Health Systems at Highland Park Hospital. I’m joined tonight ... as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show a ...

  17. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... recently issued an opinion to the OB-GYN community. They state that the vaginal hysterectomy is the ... this conflict out there in the OB-GYN community. The American College of OB-GYN wishes that ...

  18. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... taking all that into account, taking experience and skill, for most of us, the abdominal hysterectomy is ... approach. If you do not have vaginal surgery skills, again, this is not -- that’s not something you ...

  19. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... 600,000 procedures being performed annually. By the age of 60, one in three women will have ... hysterectomy (INAUDIBLE) myomectomy, adnexal masses, pretty common standard age. Most people going through this procedures are in ...

  20. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... majority of our hysterectomies as an abdominal procedure, meaning with sort of the larger abdominal incision. In ... less blood loss and a quicker recovery. We should also recognize that there have been technological advances ...

  1. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... this evening you will feel very encouraged to offer the minilap hysterectomy to your patients, and if ... that’s what you want to be able to offer your patients. You can offer them something that ...

  2. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available Expanding Patient Options: Minilaparotomy for Hysterectomy Covidien Energy Based Devices Concord, California May 26, 2010 Welcome to this OR ... a procedure that is very cost effective and patient friendly. Our agenda tonight is as follows: I’ ...

  3. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... is large; that’s not something we want as far to enter into. We are very comfortable as ... not things that are new to us as far as doing abdominal hysterectomy, C-sections, myomectomies, multiple ...

  4. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... know that all the patients in this particular analysis had supercervical hysterectomies. So back to that slide, ... patient recovery. I would say that, again, statistical analysis tells us that we’re not comfortable doing ...

  5. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... This is something that I can do.” Many times I would have attended conferences and seminars where ... large incisions and prolonged recoveries when it comes time to have your hysterectomy. With that, let me ...

  6. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... hysterectomy summer of 2009, and it was my doctor that recommended the surgery. I had this procedure ... that’s gone. My expectations were really high. My doctor, Dr. Fillmore, said it was going to be ...

  7. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... to be a question of asking, what’s the comparison of this procedure with other hysterectomies? In my ... an approach because it has many benefits. In comparison to the laparoscopy, I do a lot of ...

  8. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... is as follows: I’ll begin with some historical information regarding hysterectomy, and then we’ll show ... if feasibly possible. It does have the best historical data in terms of outcome and patient recovery. ...

  9. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... be resolved. I believe we can achieve ACOG’s goals by using the familiar abdominal hysterectomy, and using ... sealing device that can help us achieve these goals an also use what we’ve learned from ...

  10. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available Expanding Patient Options: Minilaparotomy for Hysterectomy Covidien Energy Based Devices Concord, California May 26, 2010 Welcome to this OR Live program presented by Covidien energy-based devices. Good evening, and thank ...

  11. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... women will have had a hysterectomy. The American College of OB-GYN recently issued an opinion to ... something new. About 20 years ago, the American College of OB-GYN or ACOG issued a similar ...

  12. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... By the age of 60, one in three women will have had a hysterectomy. The American College ... Alexis O, please make sure you get the right retractor. It will make all the difference in ...

  13. Women's Hysterectomy Experiences and Decision-Making

    Uskul, Ayse K.; Ahmad, Farah; Leyland, Nicholas A.; Stewart, Donna E.

    2003-01-01

    The goal of the study was to examine women's experiences with gynaecologic symptoms and how they decided to undergo hysterectomy. For this purpose, twenty-nine women were interviewed in hospital within three days of undergoing hysterectomy. The interviews elicited information about the nature of the problem that caused the women to seek medical help, actions taken to solve their problem, their relationship with their gynaecologist, information seeking patterns and decision-making about hyster...

  14. Diagnostic Neglect Regarding Ureter Ligation After Hysterectomy

    BİLGE, Yaşar

    2007-01-01

    Complications following cesarean and hysterectomy operations can occur, one of which is ureter ligation. Aims: Urological injuries that occur during hysterectomy are rare but important causes of morbidity. It was aimed to investigate in this case report whether there was any evidence to support malpractice in Court. Case Report: The patient was a woman in her 343 week of pregnancy with familial Mediterranean fever (FMF) and nephrotic syndrome with renal amyloidosis. Preterm operational di...

  15. Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience

    The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

  16. Morbidity and mortality associated with obstetric hysterectomy

    Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

  17. Laparoscopic hysterectomy with morcellation versus abdominal hysterectomy for presumed fibroids in premenopausal women: a decision analysis

    SIEDHOFF, Matthew T.; WHEELER, Stephanie B.; RUTSTEIN, Sarah E.; GELLER, Elizabeth J.; DOLL, Kemi M.; WU, Jennifer M.; CLARKE-PEARSON, Daniel L.

    2016-01-01

    Objective To model outcomes in laparoscopic hysterectomy with morcellation compared to abdominal hysterectomy for the presumed fibroid uterus, examining short-and long-term complications, as well as mortality. Study Design A decision tree was constructed to compare outcomes for a hypothetical cohort of 100,000 premenopausal women undergoing hysterectomy for presumed fibroids over a 5-year time horizon. Parameter and quality of life utility estimates were determined from published literature for postoperative complications, leiomyosarcoma incidence, death related to leiomyomsarcoma, and procedure-related death. Results The decision analysis predicted fewer overall deaths with laparoscopic hysterectomy compared to abdominal hysterectomy (98 vs. 103 per 100,000). While there were more deaths from leiomyosarcoma following laparoscopic hysterectomy (86 vs. 71 per 100,000), there were more hysterectomy-related deaths with abdominal hysterectomy (32 vs. 12 per 100,000). The laparoscopic group had lower rates of transfusion (2,400 vs. 4,700 per 100,000), wound infection (1,500 vs 6,300 per 100,000), venous thromboembolism (690 vs. 840 per 100,000) and incisional hernia (710 vs. 8,800 per 100,000), but a higher rate of vaginal cuff dehiscence (640 vs. 290 per 100,000). Laparoscopic hysterectomy resulted in more quality-adjusted life years (499,171 vs. 490,711 over five years). Conclusion The risk of leiomyosarcoma morcellation is balanced by procedure-related complications associated with laparotomy, including death. This analysis provides patients and surgeons with estimates of risk and benefit, upon which patient-centered decisions can be made. PMID:25817518

  18. Endoluminal release of ureteral ligature after hysterectomy.

    Wang, Chih-Jen; Lin, Victor Chia-Hsiang; Huang, Ching-Yu

    2016-01-01

    Iatrogenic ureteral injury is a well-recognized complication of abdominal total hysterectomy. We report a case of a 57-year-old female who underwent abdominal total hysterectomy for a uterine myoma and experienced severe right flank pain postoperatively. The imaging study displayed an obstruction of the right distal ureter. Under ureteroscopy, an extraluminal ligature was released with a holmium:yttrium-aluminum-garnet laser. The stenotic segment was immediately relieved. Two months later, the intravenous urogram illustrated patency of the distal ureter with regression of right hydronephrosis. There was no recurrent hydronephrosis during 1 year of follow-up. PMID:25241286

  19. Low adherence to cervical cancer screening after subtotal hysterectomy

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  20. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... to us as far as doing abdominal hysterectomy, C-sections, myomectomies, multiple other procedures. This is the ... standard if you use Alexis O retractors in C-sections, and they’re self-retaining. The good ...

  1. Abandoning wells working group

    NONE

    1997-03-01

    The primary objective of this working group is to identify major technical, regulatory, and environmental issues that are relevant to the abandonment of offshore wellbores. Once the issues have been identified, the working group also has the objective of making recommendations or providing potential solutions for consideration. Areas for process improvement will be identified and {open_quotes}best practices{close_quotes} will be discussed and compared to {open_quotes}minimum standards.{close_quotes} The working group will primarily focus on wellbore abandonment in the Gulf of Mexico. However, workshop participants are encouraged to discuss international issues which may be relevant to wellbore abandonment practices in the Gulf of Mexico. The Abandoning Wells Group has identified several major areas for discussion that have concerns related to both operators and service companies performing wellbore abandonments in the Gulf of Mexico. The following broad topics were selected for the agenda: (1) MMS minimum requirements and state regulations. (2) Co-existence of best practices, new technology, and P & A economics. (3) Liability and environmental issues relating to wellbore abandonment.

  2. A STUDY OF PSYCHIATRIC ASPECTS OF HYSTERECTOMY

    Vyas, J.N.; R. S. Rathore; P.Sharma; Singhal, A.K.

    1989-01-01

    SUMMARY Thirty women patients who were hysterectomized for non-malignant pathologies were compared with thirty comparable patients who underwent other gynaecological operations. Each patient was subjected to semistructured psychiatric interview, standardised Hindi version of G.H.Q., Hindi version of PEN, I.P.I.S. and BDRI. The diagnosis was made according to I.C.D. - 9. It was observed that patients undergoing hysterectomy do suffer significantly higher psychiatric morbidity (60%), had higher...

  3. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    Abha; Smrity; Anchala

    2015-01-01

    BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medic...

  4. Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies.

    O'Hanlan, Katherine A; Emeney, Pamela L; Peters, Alfred; Sten, Margaret S; McCutcheon, Stacey P; Struck, Danielle M; Hoang, Joseph K

    2016-01-01

    Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength. Four outcomes are reviewed: dehiscence, bleeding, infection, and adhesions. Results. Of 1924 patients undergoing total laparoscopic hysterectomy, 44 patients (2.29%) experienced a vaginal cuff complication, with 19 (0.99%) requiring reoperation. Five patients (0.26%) had dehiscence after sexual penetration on days 30-83, with 3 requiring reoperation. Thirteen patients (0.68%) developed bleeding, with 9 (0.47%) requiring reoperation. Twenty-three (1.20%) patients developed infections, with 4 (0.21%) requiring reoperation. Three patients (0.16%) developed obstructive small bowel adhesions to the cuff requiring laparoscopic lysis. Conclusion. A running 5 mm deep × 5 mm apart culdotomy closure that incorporates the uterosacral ligaments with the pubocervical fascia, with reperitonealization when possible, appears to be associated with few postoperative vaginal cuff complications. PMID:27579179

  5. Hawaii Abandoned Vessel Inventory, Oahu

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Oahu, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  6. Puerto Rico Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Puerto Rico. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  7. American Samoa Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for American Samoa. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  8. Hawaii Abandoned Vessel Inventory, Lanai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lanai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  9. CNMI Abandoned Vessel Inventory, Rota

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Rota. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  10. Hawaii Abandoned Vessel Inventory, Molokai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Molokai, Hawaii. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  11. CNMI Abandoned Vessel Inventory, Saipan

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Saipan. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  12. CNMI Abandoned Vessel Inventory, Tinian

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Tinian. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  13. Hawaii Abandoned Vessel Inventory, Kauai

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kauai. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  14. Hawaii Abandoned Vessel Inventory, Maui

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maui. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral habitats...

  15. Establishment of a national Danish hysterectomy database: preliminary report on the first 13,425 hysterectomies

    Hansen, Charlotte T; Møller, Charlotte; Daugbjerg, Signe;

    2008-01-01

    2%, the rate of bleeding complications from 8 to 6%, the reoperation rate from 5 to 4%, and the readmission rate from 7 to 5%. CONCLUSIONS: Clinical performance indicators, audit meetings and nationwide collaboration are useful in monitoring and improving outcome after hysterectomy on a national...

  16. A new approach to simplify surgical colpotomy in laparoscopic hysterectomy

    Van den Haak, L.; Rhemrev, J.P.; Bikkendaal, M.D.; Luteijn, A.C.; Van den Dobbelsteen, J.J.; Driessen, S.R.; Jansen, F.W.

    2016-01-01

    New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and d

  17. 42 CFR 50.207 - Sterilization by hysterectomy.

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 50.207 Section 50... GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.207 Sterilization by hysterectomy. (a) Programs or projects to which this subpart applies shall not perform...

  18. 42 CFR 441.255 - Sterilization by hysterectomy.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Sterilization by hysterectomy. 441.255 Section 441.255 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Sterilizations § 441.255 Sterilization by hysterectomy. (a) FFP is not available in expenditures for...

  19. Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    INTRODUCTION. At the present time three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH). The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH) in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR) with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05). Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93). CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery. (author)

  20. Are hysterectomies necessary? Racial-ethnic differences in women's attitudes.

    Dillaway, Heather E

    2016-01-01

    There is a dearth of comparative information about how women from diverse social locations think about, talk about, and experience the various types of reproductive aging. In this article I analyze racial-ethnic differences in attitudes toward surgically induced menopause (hysterectomy) utilizing data from an interview study of 130 menopausal women. African American women in this study were more suspect of doctors' initial offers of hysterectomies than European American women, with the former group of interviewees still fearing a legacy of racial-ethnic discrimination within medical institutions. Only after seeking a second opinion or finding a trustworthy doctor did African American women feel comfortable accepting a hysterectomy. European American interviewees were not as wary as their African American counterparts and sometimes reported wishing for a hysterectomy. I argue that attitudes toward hysterectomy must be contextualized within women's experiences of racial-ethnic oppression and privilege to be fully understood. PMID:27045199

  1. Effect of socioeconomic position on patient outcome after hysterectomy

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent;

    2014-01-01

    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... AND POPULATION: The study included nearly all Danish women (n = 22 150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in 2004-2008. METHODS: Data were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals. MAIN OUTCOME...... MEASURES: Complications following hysterectomy. RESULTS: Seventeen percent of the women experienced complications in relation to the hysterectomy. Women with less than high school education and unemployed women had higher odds of infection, complications and readmission than women with more than high...

  2. Surgeon volume and outcomes in benign hysterectomy.

    Doll, Kemi M; Milad, Magdy P; Gossett, Dana R

    2013-01-01

    Annual surgeon case volume has been linked to patient outcome in a variety of surgical fields, although limited data focus on gynecologic surgery performed by general gynecologists. Herein we review the literature addressing the associations between intraoperative injury, postoperative morbidity, and resource use among surgeons performing a low vs high volume of hysterectomies. Although study design and populations differ, individual and composite morbidity outcomes consistently favored high-volume surgeons. Given the growing emphasis on competency-based evaluation in surgery, gynecology departments may soon consider volume requirements a component of privileging. PMID:23622760

  3. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome

    Lovina S.M. Machado

    2011-01-01

    Full Text Available Background: Peripartum hysterectomy is a major operation and is invariably performed in the presence of life threatening hemorrhage during or immediately after abdominal or vaginal deliveries. Material and Methods: A Medline search was conducted to review the recent relevant articles in English literature on emergency peripartum hysterectomy. The incidence, indications, risk factors and outcome of emergency peripartum hysterectomy were reviewed. Results: The incidence of emergency peripartum hysterectomy ranged from 0.24 to 8.7 per 1000 deliveries. Emergency peripartum hysterectomy was found to be more common following cesarean section than vaginal deliveries. The predominant indication for emergency peripartum hysterectomy was abnormal placentation (placenta previa/accreta which was noted in 45 to 73.3%, uterine atony in 20.6 to 43% and uterine rupture in 11.4 to 45.5 %. The risk factors included previous cesarean section, scarred uterus, multiparity, older age group. The maternal morbidity ranged from 26.5 to 31.5% and the mortality from 0 to 12.5% with a mean of 4.8%. The decision of performing total or subtotal hysterectomy was influenced by the patient′s condition. Conclusion: Emergency peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. Antenatal anticipation of the risk factors, involvement of an experienced obstetrician at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in reducing morbidity and mortality.

  4. The Effect of Abdominal Radical Trachelectomy on Ovarian Reserve: Serial Changes in Serum Anti-Müllerian Hormone Levels

    Miho Muraji, Tamotsu Sudo, Shinichi Iwasaki, Sayaka Ueno, Senn Wakahashi, Satoshi Yamaguchi, Kiyoshi Fujiwara, Ryuichiro Nishimura

    2012-01-01

    Full Text Available Aim: To evaluate the effect of abdominal radical trachelectomy on ovarian reserve and compare it with abdominal radical hysterectomy and a control group that did not have surgery.Method: We enrolled eighteen women who had abdominal radical trachelectomy with pelvic lymphadenectomy and sixteen patients who had abdominal radical hysterectomy for this study. Ten thousand one hundred eighty-six women were also included as a control group for comparison. The Mann-Whitney U test was used for comparison of patient characteristics and comparison of serum anti-Müllerian hormone levels between the three groups.Results: Serum anti-Müllerian hormone levels in patients with abdominal radical trachelectomy were significantly higher than those of patients with abdominal radical hysterectomy (P<0.05. Serum anti-Müllerian hormone levels in the abdominal radical hysterectomy group were significantly lower than those in the control group (P=0.02, with no significant difference between the abdominal radical trachelectomy and control groups. These data indicated that abdominal radical trachelectomy did not affect ovarian function with respect to ovarian reserve and the response to ovarian stimulation.Conclusions: Serum anti-Müllerian hormone levels could be useful as a marker of ovarian reserve after abdominal radical trachelectomy. It is important to avoid postoperative complications causing a reduction in ovarian function to accomplish fertility-sparing surgery.

  5. HYSTERECTOMY: CHANGING TRENDS IN A TERTIARY CARE CENTER

    Abha

    2015-11-01

    Full Text Available BACKGROUND: Hysterectomy is the most common gynec operation worldwide. It leads to significant morbidity and mortality hence there must be justifiable indication before procedure is undertaken. There is a lack of comprehensive data and too much variability from place to place, even in India. OBJECTIVE: To analyze the changing trends in hysterectomy in past 6 years. METHOD: A retrospective study of all women undergoing hysterectomy that were done in Dr. B.R.A.M. Hospital, Medical College, Raipur for 6yrs from 2009 to 2014. RESULTS: A total of 1032 hysterectomies were done during the study period. Most common age group was from 41-50 years. The commonest indication was symptomatic fibroid (33.52%. Vaginal and abdominal hysterectomy were done equally. A declining trend of incidence of hysterectomy was observed over the years from 14.9 to 9.61 per 1000 women per year, which is significant (p value- 0.008. CONCLUSION: This study shows changing scenario of hysterectomy in terms of age, oophorectomy and rate. A shift towards minimal invasive techniques is also evident

  6. Complications of vaginal hysterectomy - (Analysis of 1105 cases

    Bhattacharya Menna

    1978-01-01

    Full Text Available Eleven hundred and five cases of vaginal hysterectomy are analysed and their complications discussed. More than 90% of the patients were between the ages of 31 to 60 years. The common indications for hysterectomy were prolapse (51% and dysfunctional uterine bleeding (34.9%. In four cases abdominal approach was necessary to complete the operation. The overall incidence of major complications was 4% and the corrected mortality rate was 0.18%. The complications of vaginal hysterec-tomy by other authors are discussed.

  7. Gender and power: the Irish hysterectomy scandal.

    McCarthy, Joan; Murphy, Sharon; Loughrey, Mark

    2008-09-01

    In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light. We consider how sex and gender feature in the Lourdes case, draw attention to the deeply gendered asymmetries of power and privilege that existed between the men and women at the centre of this inquiry, and explore the impact such asymmetries had on this particular situation. PMID:18687818

  8. Single-incision total laparoscopic hysterectomy

    Sinha Rakesh

    2011-01-01

    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  9. Pelvic organ prolapse (POP) surgery among Danish women hysterectomized for benign conditions: age at hysterectomy, age at subsequent POP operation, and risk of POP after hysterectomy

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe the incidence of pelvic organ prolapse (POP) surgery after hysterectomy from 1977 to 2009, the time interval from hysterectomy to POP surgery, and age characteristics of women undergoing POP surgery after hysterectomy and to...

  10. Frequency of adenomyosis in hysterectomy specimens performed for benign indications

    Çakmak, Bülent; özsoy, zeki; nacar, mehmet; aysal, tülay; hısım, yeliz; Demirtürk, Fazlı

    2012-01-01

    Objective: The aim of this study is to determine the frequency of adenomyosis in hysterectomy specimens performed for benign indications. Methods: Adenomyosis frequency was retrospectively evaluated hystopathologically in hysterectomy specimens performed for benign indications on 149 patients between January 2009 and January 2012 in Gaziosmanpaşa University Medical School, Obstetric and Gynecology Clinic. Results: Adenomyosis frequency was determined as 11.7% (17) of 149 patients received f...

  11. Histopathological Analysis of 422 Nononcological Hysterectomies in a University Hospital

    Seda Ates

    2016-04-01

    Full Text Available Aim: The aim of the study was to evaluate the surgical indications, routes of surgery and the correlation between preoperative diagnosis and histopathological examination of hysterectomy specimens. Material and Method: Medical records and histopathological findings were reviewed and analyzed retrospectively, in 422 consecutive women who underwent hysterectomy over a two-year period from 2011 to 2014. Those with confirmed malignancy before operation were excluded. Cohen kappa statistics were used to measure agreement between preoperative clinical and postoperative histopathological diagnosis which was found to be fair with %u043A value being 0.4. Results: The mean age of our patients was 51.5 ± 8 years. The abdominal route was used in 378 cases (85.5%, the vaginal route in 55 patients (12.4% and the laparoscopic-assisted vaginal hysterectomy in 9 cases (2%. Abnormal uterine bleeding (28.9 % was the most common indication for hysterectomy. The histopathology of the endometrium prior to hysterectomy was reported in 75% of the cases and the most common finding was a secretory or proliferative endometrium. Leiomyomatous uterus was the most frequently encountered pathology (43.7% followed by coexistence of leiomyoma and adenomyosis (17.4% in hysterectomy specimens. Hysterectomy specimens may be unremarkable histopathologically, most of which are vaginal hysterectomies done for uterine prolapsed (kappa=0,407. Discussion: The correlation between the preoperative clinical and the pathological diagnosis were poor in cases with abdominal pain, abnormal uterine bleeding and fibroids. But there was a high correlation in cases with adnexial mass.

  12. The prevelance of adenomyosis at hysterectomy and associated factors

    Şentürk, Mehmet Baki; BUDAK, Mehmet Şükrü; Çakmak, Yusuf; DURUKAN, Ömer Birol; Polat, Mesut

    2015-01-01

    Objective: Adenomyosis is a entity characterized by the presence of endometrial glands and stroma embedded within the myometrium without apparent contact with the endo-myometrial junction. As the diagnosis of adenomyosis is based on histological examination, the condition is best described in women at the time of hysterectomy.Material and Methods: We evaluated results of 109 hysterectomized patients retrospectively. Age, parity, menopausal status and indication of hysterectomy were compared b...

  13. The effect of hysterectomy on ano-rectal physiology.

    Kelly, J L

    2012-02-03

    Hysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.

  14. Total laparoscopic hysterectomy via suture and ligation technique

    Kang, Hye Won; Lee, Ji Won; Ho Yeon KIM; Kim, Bo Wook; Moon, Chong Soo

    2016-01-01

    Objective The term 'total laparoscopic hysterectomy (TLH) with classical suture method' refers to a surgical procedure performed using only sutures and ligations with intracorporeal or extracorporeal ties, without using any laser or electronic cauterization devices during laparoscopic surgery as in total abdominal hysterectomy. However, the method is not as widely used as electric coagulation equipment for TLH because further advances in technology and surgical technique are required and oper...

  15. Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria

    Abasiattai, Aniekan Monday; Umoiyoho, Aniefiok Jackson; Utuk, Ntiense Maurice; Inyang-Etoh, Emmanuel Columba; Asuquo, Otobong Peter

    2013-01-01

    Introduction Emergency peripartum hysterectomy, a maker of severe maternal morbidity and near miss mortality is an inevitable surgical intervention to save a woman's life when uncontrollable obstetric haemorrhage complicates delivery. This study was conducted in order to determine the incidence, types, indications and maternal complications of emergency peripartum hysterectomy at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods The case records of all women who underwent emergen...

  16. Cervical removal at hysterectomy for benign disease. Risks and benefits.

    Hasson, H M

    1993-10-01

    An assessment of the risks and benefits of total and subtotal hysterectomy for benign disease was performed using the published literature, including a MEDLINE search, on all studies dealing with hysterectomy and related topics from 1946 to 1992. The shift from subtotal to total hysterectomy occurred before cytologic screening was accepted. Currently, SIL is diagnosed by cytology, evaluated by colposcopy and treated preferentially with cone biopsy. Prophylactic removal of the cervix does not eliminate the risk of cancer: it may shift the risk to the vaginal epithelium. The cervix has a role in sexual arousal and orgasm, probably due to stimulation of the Frankenhauser uterovaginal plexus. Bladder and bowel dysfunction following total hysterectomy may be related to loss of nerve ganglia closely associated with the cervix. Increased operative and postoperative morbidity, vaginal shortening, vault prolapse, abnormal cuff granulations and oviductal prolapse are other disadvantages of total hysterectomy. The cervix is not a useless organ and should not be removed during hysterectomy without a proper indication. PMID:8263867

  17. Fallopian tube prolapse after hysterectomy: a systematic review.

    Lobna Ouldamer

    Full Text Available BACKGROUND: Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. OBJECTIVES: We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. SEARCH STRATEGY: A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. RESULTS: Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy. Six patients were initially treated by silver nitrate application without success. CONCLUSIONS: This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment.

  18. Abandoned vehicles REMINDER

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  19. Abandonned vehicles - REMINDER

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  20. Abandoned vehicles - Reminder

    Relations with the Host States Service

    2004-01-01

    The services in charge of managing the CERN site have recently noted an increase in the number of abandoned vehicles. This poses a risk from the point of view of safety and security and, on the eve of several important events in honour of CERN's fiftieth anniversary, is detrimental to the Organization's image. Owners of vehicles that have been left immobile for some time on the CERN site, including on the external car park by the flags, are therefore invited to contact the Reception and Access Control Service (service-parking-longterm@cern.ch) before 1st October 2004 and, where appropriate, move their vehicle to a designated long-term parking area. After this date, any vehicle whose owner has failed to respond to this request and which is without a number plate, has been stationary for several weeks or is out of service, may be impounded at the owner's risk and expense. Relations with the Host States Service Tel. 72848

  1. Clinicohistopathological correlation of hysterectomy in rural India: an observational study

    Kumud Gupta

    2015-04-01

    Full Text Available Background: Hysterectomy - abdominal or vaginal or laparoscopic assisted, hysterectomy is the most commonly performed elective major gynaecological surgery. Rate of hysterectomy has varied between 6.1 and 8.6/1000 women of all ages. The abdominal removal of the uterus is called and lsquo;total abdominal hysterectomy' while the removal of the uterus by the vaginal route is termed as and lsquo;vaginal hysterectomy'. The supracervical removal of the uterus is termed as and lsquo;subtotal hysterectomy'. As compared to a higher frequency of hysterectomy (10-20% in other countries, a lower rate (4-6% has been reported in India. Methods: The study was conducted in the department of obstetrics and gynaecology National Institute of Medical Sciences (NIMS, Jaipur in 2013-2014. 100 patients were undergoing hysterectomy. The patients were diagnosed on the basis of history, clinical examination and ultrasonography report. Results: In our study, maximum number of clinical diagnosis made, were of DUB (with PID and Prolapse which was 35%. This was followed by leiomyoma i.e. 29%, clinically 29 cases were diagnosed of which 24 were histopathologically proven. Adenomyosis (10%, clinically 10 cases were identified but there were 15 cases histopathologically, this can be due to different clinical presentation. Clinically diagnosed cases of carcinoma endometrium and cervical erosions were 1% and 2% respectively. Overall sensitivity for clinical diagnosis in our study was 52%. The most common histopathological finding was leiomyoma (24%, followed by adenomyosis (15% and chronic cervicitis (15%. Other pathologies include combined adenomyosis and leiomyoma (6%, benign ovarian cyst in four cases. Normal histopathological report was obtained in 32 cases. Maximum correlation (100% was found with cancer cervix, cancer ovary and cancer endometrium. Conclusions: Hysterectomy still remains the widely used modality in developing as well as developed countries. Every

  2. Early Feeding After a Total Abdominal Hysterectomy

    Mary Flesher

    2009-02-01

    Full Text Available Background: Oral fluids and food are traditionally introduced slowly after total abdominal hysterectomy (TAH. This descriptive study examined the effect and tolerance of early oral intake following this surgery. Methods: A retrospective chart review was conducted on 164 patients who had been on a clinical pathway following TAH. Comparisons in initiation of fluids and foods, and gastrointestinal effects were made between the early fed group (n=82 and the traditionally fed group (n=82. Results: Both groups had the similar gastrointestinal symptoms postoperatively, but the early fed group had an earlier bowel movement. The early fed group had a statistically significant shorter length of stay. Similar usage of anti-nausea medication and pain medication usage was noted between the two groups, except for a lower usage of Tylenol #3 (acetaminophen with codeine in the early fed group. Conclusions: This study found that early feeding could be tolerated well in TAH patients, with statistically significant improvements in usage of some pain medication and length of stay were noted in the early fed group.

  3. Experience with irrigation analgesia after abdominal hysterectomy

    R. V. Garyaev

    2014-07-01

    Full Text Available A prospective randomized clinical trial was performed in 100 patients who underwent abdominal hysterectomy under endotracheal anesthesia based on sevoflurane and fentanyl. Intraoperatively, ketorolac 30 mg was administered intramuscularly after induction of anesthesia and paracetamol 1 g was injected intravenously 30–40 minutes prior to surgical termination in a control group (n = 25. For postoperative anal- gesia, promedol, tramadol, and ketorolac were used intramuscularly and paracetamol was given intravenously. Three study groups (n = 2 in each differed from the control group in that during wound suturing a multiperforated catheter was placed above the peritoneum over a length of 15 cm, through which a 10-ml bolus of 0.75 % ropivacaine was first administered, followed by continuous infusion of 0.2 % ropivacaine at a rate of 8 ml/hour for 36 hours. In one irrigation group, ketorolac 30 mg was injected intramuscularly t.i.d. for 2 days; in another group, the agent was added to a ropivacaine solution calculated with reference to 180 mg for 2 days; in the third group, ketoprofen 100 mg instead of ketorolac was used b.i.d. for 2 days. Pain level (by digital rating scale, 0–10 and the need for analgesics were measured. There was no sta- tistical significant difference in the level of pain and the need for analgesics between the wound irrigation and control groups.

  4. Mirena as an alternative to hysterectomy in cases of Dub

    Introduction: Dysfunctional uterine bleeding is the leading cause of hysterectomy due to conventional treatment failure. Levonorgestrel releasing intra uterine device (Mirena) is found to solve this issue by better control of bleeding and thus reducing hysterectomy rate. Objective: To measure the efficacy of Mirena as compared to OCP's in control of DUB and to deter-mine that it is an alternative to hysterectomy. Study Design: It was an interventional (experimental) type of study. Setting: Department of Obstetrics and gynecology Unit 11 Lady Willingdon Hospital, Lahore. Duration with Dates: In a total of 60 patients presenting with DUB in out patient department from 7th April 2004 to 31st December 2005. Subjects and Methods: In a total of 60 patients selected were randomly allocated to Group A and B to receive Mirena and OCP's respectively. Both groups were followed at 6 months and 1 year of treatment. Main outcome measures were patient satisfaction with current treatment and their decision to continue or opt for hysterectomy. 80.7% women receiving Mirena were satisfied with their treatment, while only 30% in the OCP's group (p-value < 0.05) at the end of study. 7.69% was the discontinuation rate of treatment in Mirena group while it was 50% in the control group (p-value < 0.05). Conclusion: Mirena is a better option in the treatment of DUB and it can prove to be an alternative to hysterectomy, while we want a more conservative type of treatment. (author)

  5. Analysis of 46 Hysterectomies Performed for Obstetric Indications

    Mahmut Erdemoğlu

    2006-01-01

    Full Text Available We analyzed retrospectively 52 cases of emergency peripartum hysterectomy that were performed at our clinic from January 1998 to December 2004. Fifty two patients of emergency peripartum hysterectomy were identified amoung 11098 deliveries.The mean age was 32.66±6.74, gravida 7.09±3.37, parity 6.12±3.11 , gestational weeks. 84.61% patients were underwent subtotal hysterectomy. The emergency peripartum hysterectomy was done 51.92% of the cases during cesarean section or later. The indications of hysterectomy were identified as (55.76% uterine atony, uterine rupture (15.38%, pelviperitonitis and acute abdomen (9.61%, anormal placentation (15.38%, uterine myoma (1.92%, and cervical cancer (1.92% respectively. The overall (23.07% patients developed disseminated intravascular coagulopathy (DIC, two cases had ureter injury,one case had bladder injury. Bilateral hypogastric artery ligation were performed in 30.76% of the patients and relaparatomy was performed in 5 (9.61% patients due to the intraabdominal hemorrhage. Maternal mortality occured in four cases.

  6. Extrafascial hysterectomy in IB2 cervical cancer after radio chemotherapy

    Aim: To evaluate overall and disease free survival in cervical cancer IB2 patients with concomitant chemoradiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachytherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p<0.001). Conclusion: Our survival is similar to published results with the same treatment. The presence of macroscopic residual disease in the hysterectomy specimen could be a factor of prognostic value

  7. Transformation of Abandonment

    Krag, Mo Michelsen Stochholm

    2015-01-01

    interventions are of such a radical manner it will not be possible to re-establish the former function of the building. The aim of the actions is to develop and test full-scale transformation prototypes in varying rural village environments. Interaction with local people and their response to the prototypes can...... be seen as real life peer reviewing and is considered an important impact indicator and supplement to the physical interventions. The prototypes vary in achievement and in timeframe. The geographical area for the actions is Thisted Municipality, Denmark, ideal due to its many identified small...

  8. The indication for hysterectomy as a risk factor for subsequent pelvic organ prolapse repair

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate whether the indication for hysterectomy was itself a risk factor for subsequent pelvic organ prolapse (POP) in Danish women who underwent hysterectomy from 1977 to 2009. METHODS: Data from 154,882 women who underwent hysterectomy...

  9. Water pollution from abandoned mines

    Iversen, E.; Johannessen, M.

    1987-01-01

    The report provides a country-wide overview of abandoned pyrite mines where operations have been fairly extensive. The water pollution situation is assessed on the basis of reported investigations, inspections and chemical analyses from the individual areas. In cases where larger watercourses (Orkla, Gaula), and the upper stretch of the Glåma are affected the situation appears to be adequately described. However abandoned mine areas may also cause local pollution problems, and here documentat...

  10. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard; Blaakær, Jan; Gravitt, Patti; Søgaard, Mette

    2015-01-01

    Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie. women who have had a...... hysterectomy). The incidence rate of gynecological cancers is thus likely underestimated. Since hysterectomy, as well as oophorectomy, incidence varies across countries, age, and over time, meaningful comparison of gynecological cancer incidence rates may be compromised. Without accurate estimates of...... gynecological cancer incidence rates, performed via removing the proportion of hysterectomized or oophorectomized women from the population-at-risk-denominator, the impact of prevention strategies may be masked or misinterpreted. Furthermore, since national cervical cancer screening guidelines are at least in...

  11. Hysterectomy with ovarian conservation: effect on bone mineral density

    Full text: There are conflicting data on the long-term effects of hysterectomy with ovarian conservation on bone mineral density (BMD). Accordingly, we performed a cross-sectional study on 58 women with premenopausal hysterectomy and ovarian conservation (group 1) and 59 women with natural menopause (group 2). No subjects had disorders or medications known to interfere with bone metabolism. Patients underwent bone densitometry of the lumbar spine and hip using a Norland XR-36. By chi-squared and one-way ANOVA, there were no differences in age: 55.4± 11.0 y (1)v 57.6± 9.8 y (2); exercise, alcohol or smoking consumption, family history of osteoporosis, height: 1.61 ± 0.08m (1) v 1.61 ± 0.08m (2); weight 67.7 ± 11.3kg (1) v 68.3 kg ± 12.5 kg (2); body mass index: 30.95 (1 ) v 26.26 (2). Lumbar spine BMD was also similar for the two groups [0.95 ± 0.18g/cm2 (1) v 0.94± 0.21 g/cm2 (2)]. However, hysterectomy patients had a significantly lower hip BMD: 0.63 ± 0.16 g/cm2 v 0.76 ± 0.18 g/cm2 (p>0.001). Multivariate logistic regression showed that spine BMD was influenced by age, family history, height and weight (R2 = 0.37), but not prior hysterectomy. Hip BMD was related to age, hysterectomy, smoking and weight (R2 = o 45). We conclude that prior hysterectomy with ovarian conservation has an adverse effect on hip but not spine BMD

  12. Robotic Trachelectomy After Supracervical Hysterectomy for Benign Gynecologic Disease

    Aoun, Joelle; Hanna, Rabbie; Papalekas, Eleni; Schiff, Lauren; Theoharis, Evan; Eisenstein, David

    2016-01-01

    Background and Objectives: A renewed interest in the supra cervical approach to hysterectomy has created a cohort of patients with a retained cervix at risk of persistent symptoms requiring a subsequent trachelectomy. The objective of this study was to evaluate the efficacy of robotic trachelectomy after a previous supracervical hysterectomy. Methods: This is a retrospective chart review of women who had robotic trachelectomy after supracervical hysterectomy for benign gynecologic disease from January 2009 through October 2014. Results: Eleven patients underwent robotic trachelectomy for benign conditions during the observed period. Prior supracervical hysterectomy had been performed for pelvic pain (8/11, 73%), abnormal uterine bleeding (7/11, 64%), and dysmenorrhea (5/11, 45%). In 10 of 11 patients, the symptoms leading to robotic trachelectomy were the same as those leading to supracervical hysterectomy. The time from hysterectomy to recurrence of symptoms ranged from 0.5 to 26 months (median, 6), whereas the time interval from previous surgery to robotic trachelectomy ranged from 1 to 57 months (median, 26). Mean age and body mass index at robotic trachelectomy were 42 ± 5.4 years and 32 ± 6.1 kg/m2. Mean length of surgery was 218 ± 88 minutes (range, 100–405). There was 1 major postoperative complication involving bladder perforation and subsequent vesicovaginal fistula (VVF). Endometriosis was seen in 27% of pathologic specimens and cervicitis in another 27%; 45% showed normal tissue histology. In 6 (55%) cases, symptoms leading to trachelectomy resolved completely after surgery, and the other 5 (45%) patients reported a significant improvement. Conclusions: Although trachelectomy can be a challenging surgery, our experience suggests that the robotic approach may be a valuable means of achieving safe and reproducible outcomes. PMID:27493470

  13. NON - D ESCENT VAGINAL HYSTERECTOMY ANALYSIS OF 120 CASES

    Pradeep

    2015-08-01

    Full Text Available OBJECTIVE: To evaluate the role of non - descent vaginal hysterectomy in advancing gynaecological practice and to study the safety and feasibility of performing vaginal hysterectomy for non - prolapsed uterus as primary route in benign gynaecological condition . METHODS: A prospective study of 120 cases was conducted at the department of obstetrics and g ynaecology of PES institute of medical sciences and research from January 2012 to December 2014 120 patients planned for hysterectomy for a wide range of benign indications like fibroid uterus, AUB, adenomyosis were chosen for non - descent vaginal hysterect omy. Data regarding age, parity, uterine size, and estimated blood loss, length of operation, intra - operative and post - operative complications and hospital stay were recorded. RESULTS: A total of 120 cases were selected for non - descent vaginal hysterectomy . Among them 113(94.16% cases successfully underwent non - descent vaginal hysterectomy. Majority were aged 40 - 45 years (53.33% with 8 nullipara and 21primipara. Commonest indication was fibroid (58% and largest uterine size was 16 weeks. Different morc ellation techniques were used in more than 10weeks sized uterus. Adnexal surgeries were performed in 11 cases without much difficulty. In uncomplicated cases average blood loss was 200 ml and operating time was 60minutes. Most of the patients were discharg ed by 4 th post - operative day, 7 patients were converted to abdominal route due to various difficulties, 3 patients had bladder injury and 1 patient was subjected to laparotomy due to hemoperitoneum post operatively. CONCLUSION: Proper training and proper c ase selection can lead a gynecologist to consider the vaginal approach as the standard route for hysterectomy and good patient compliance

  14. Abdominal versus vaginal hysterectomy in non-descent cases

    Kavitha Gayak

    2015-04-01

    Full Text Available Background: Hysterectomy is the most frequently performed elective major operation in gynaecology by vaginal and abdominal route. Gynaecologic surgeons worldwide said that two are not competitive procedures but each one has its own place in the operative armamentarium. Present study is done to comparative risks of complications in abdominal route versus vaginal route of hysterectomy in intra operative and post-operative periods. Methods: It's a retrospective study was done from Dec 2013 - Dec 2014 for a period of one year in 82 women who had undergone hysterectomy, divided as group A with abdominal hysterectomies (44 cases and group B with vaginal hysterectomies (38. Information on the indications, operative procedures, and complications were noted and analyzed. Results: Intra-operative blood loss, mean operating time was more in group A than in group B. The mean duration of surgery in group B was 76 +/- 12 min and that of group B was 101 +/- 14 min. The mean blood loss was also more in case of group A than that of group B (219 ml vs. 172 ml. Bladder injury occurred in 1 case in group B (3% and in 3 cases in group B (7%. Ureter injury occurred in 1 (2% case in group A. Postoperative fever (20% and 8%, UTI (13% and 11% and wound infection (10%, 0%. Only one patient underwent relaparotomy for internal bleeding via abdominal route was more common in group A as compared to group B. Only one patient underwent re-laparotomy for internal bleeding via abdominal route. Conclusions: Study results conclude that patients requiring hysterectomy for benign non prolapse cases be offered the option of vaginal route which is quicker recovery, early mobilization, shorter hospitalization, less operative and post-operative morbidity, more economical and effective. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 419-423

  15. Expanding Patient Options: Minilaparotomy for Hysterectomy

    Full Text Available ... entire piece. We’re going to use the technology of LigaSure, which has radically changed our ability ... so we’re going to need to use technology to help us, and that technology with the ...

  16. ASYMPTOMATIC MISSING INTRAUTERINE CONTRACEPTIVE DEVICE FOUND INCIDENTALLY DURING VAGINAL HYSTERECTOMY

    Reena

    2015-06-01

    Full Text Available Incidence of missing IUCD iy is 0.5% - 2%. U s ually the cause is either expulsion or perforation of uterus. Sometimes the perforated IUCD remains asymptomatic for years together and found incidentally later on. We hereby presenting a case of 55 yrs female presenting with prolapsed uterus , planned for vaginal hysterectomy. During vaginal hysterectomy asymptomatic missing IUCD was detected which was found on the anterior surface of body of uterus with omentum adherent to it. KEY WORDS: M issing Cu T , IUCD , O mentum , P erforation .

  17. The Essential Elements of a Robotic-Assisted Laparoscopic Hysterectomy.

    Simpson, Khara M; Advincula, Arnold P

    2016-09-01

    Robotic-assisted laparoscopic hysterectomies are being performed at higher rates since the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA, USA) received US Food and Drug Administration approval in 2005 for gynecologic procedures. Despite the technological advancements over traditional laparoscopy, a discrepancy exists between what the literature states and what the benefits are as seen through the eyes of the end-user. There remains a significant learning curve in the adoption of safe and efficient robotic skills. The authors present important considerations when choosing to perform a robotic hysterectomy and a step-by-step technique. The literature on perioperative outcomes is also reviewed. PMID:27521880

  18. Radical surgery in septic abortion.

    Chatterjee, P; Ghosh, M; Ghosh, S

    1979-08-01

    At R.G. Kar Medical College Hospital, Calcutta, 10 cases of septic abortion from 1975-1977 were studied. Hysterectomies were preformed on 4 cases due to emergency situations including traumatised uterine fundus and perforated cervix, and on 6 cases after conservative treatment. Upon performing laparotomy in 9 cases, a uterine rent was detected; in 1 case there was a perforation in the posterior wall of the cervix, and in 5 cases mechanical obstructions due to internal adhesions to the uterine rent were found. 4 patients died primarily because of the patients seeking help too late. It is suggested that under high risk circumstances, laparotomy is advantageous to conservative medical management since bowel injuries and mechanical obstructions can only be detected by laparotomy. Radical surgery, however, should be undertaken before the patients general condition deteriorates to the point that the patient cannot tolerate surgical intervention. PMID:12336028

  19. Risk factors associated with emergency peripartum hysterectomy

    Jin Rong; Guo Yuna; Chen Yan

    2014-01-01

    Background Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world,and the indications for EPH have changed.The object of this study is to identify risk factors associated with EPH.Methods We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1,2005 and June 30,2013,at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University,School of Medicine (IPMCH).The parametric t-test,chi-square tests and Logistic regression models were used for analysis to identify the risk factors.The results were considered statistically significant when P<0.05.Results There were 89 178 deliveries during the study period.Twenty-one women had an EPH,with an incidence of 24 per 100 000 deliveries.The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6)ml,and that of the control group was (2 040.8±723.5) ml.There was a significant difference of PHH between the EHP group and the control group (P=0.001).Independent risk factors for EPH from a logistic regression model were:disseminated intravascular coagulation (DIC) (OR:9.9,95% CI 2.8-34,P=0.003),previous cesarean section (OR:5.27;95% CI:1.48-17.9,P=0.009),placenta previa (OR:6.9; 95% CI 1.6-2.9,P=0.008),the loss of PPH (OR:1.001; 95% CI 1.001-1.002,P=0.002),placenta accreta (OR:68; 95% CI 10-456,P=0.004),the use of tocolytic agents prenatally (OR:6.55,95%CI 1.34-32.1,P=0.049),and fetal macrosomia (OR:6.9,95% CI 1.25-38,P=0.049).Conclusion Significant risk factors of EPH are DIC,placenta previa,PPH,previous cesarean delivery,and placenta accrete,the use of tocolytic agents prenatally,and fetal macrosomia.

  20. Review article: late post-hysterectomy ectopic pregnancy.

    Saad Aldin, Ehab; Saadeh, Joanna; Ghulmiyyah, Labib; Hitti, Eveline

    2012-06-01

    Ectopic pregnancy after hysterectomy is a rare but potentially life-threatening condition requiring prompt diagnosis to prevent the increased mortality associated with rupture. Twenty-seven cases of late post-hysterectomy ectopic pregnancy reported in the English literature since 1918 were reviewed and analysed for presenting symptoms, missed diagnosis rate at initial presentation, location of ectopic and rupture rate at diagnosis. The presenting symptoms were found to be non-specific. The diagnosis in this population is twice more likely to be missed than in women with intact uteri. The rupture rate is 63%, compared with 37% in women with intact uteri. The majority of late post-hysterectomy ectopic pregnancies (62%) were located in the fallopian tubes. Because of the potential risk of mortality, emergency physicians should always consider the possibility of ectopic pregnancy in childbearing women whose surgical history includes hysterectomy without oophorectomy. Evaluation of abdominal pain in this population should include a pregnancy test to ensure prompt diagnosis when the possibility of pregnancy exists clinically. PMID:22672163

  1. Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy.

    Tulandi, Togas; Leung, Annie; Jan, Noran

    2016-01-01

    The objective of this study was to evaluate nonmalignant sequelae of unconfined morcellation at hysterectomy and myomectomy. We performed a systematic review following the PRISMA statement key words of "morcellation, uterine leiomyoma, uterine fibroid, laparoscopic myomectomy, laparoscopic total hysterectomy, and laparoscopic supracervical hysterectomy" and their combination. Fifty-one articles met the inclusion criteria: 11 articles were related to endometriosis, adenomyosis, and endometrial hyperplasia; 30 articles parasitic myoma; and 9 disseminated peritoneal leiomyomatosis (DPL) and 1 DPL and endometriosis. We found that laparoscopic hysterectomy or myomectomy with unconfined morcellation is associated with the risk of iatrogenic endometriosis (1.4%), adenomyosis (0.57%), parasitic myoma (0.9%), and rarely DPL. Our study showed that benign sequelae of uterine or myoma morcellation could be found in up to 1% of cases. This is much higher than the prevalence of uterine sarcoma after morcellation. Benign conditions have less consequences than malignancy, yet they are more common and might require another operation. Accordingly, if morcellation is required, confined morcellation should be considered. PMID:26802909

  2. Millipede succession in abandoned fields

    Tajovský, Karel

    2000-01-01

    Roč. 43, - (2000), s. 361-370. ISSN 0015-9301 R&D Projects: GA ČR GA526/97/0631 Institutional research plan: CEZ:AV0Z6066911 Keywords : Millipedes * abandoned field * fallow Subject RIV: EH - Ecology, Behaviour

  3. US Virgin Islands Abandoned Vessel Inventory

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for US Virgin Islands. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  4. Hawaii Abandoned Vessel Inventory, Maro Reef, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Maro Reef, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  5. Hawaii Abandoned Vessel Inventory, Hawaii Island

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Hawaii Island. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  6. Hawaii Abandoned Vessel Inventory, Midway Island, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Midway Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of...

  7. Hawaii Abandoned Vessel Inventory, Kure, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Kure, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction of coral...

  8. Hawaii Abandoned Vessel Inventory, Lisianski Island, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for Lisianski Island, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  9. Ovarian function and ovarian blood supply following premenopausal abdominal hysterectomy

    Abdelrazak, Khaled M.; Elbiaa, Assem A.M.; Farghali, Mohamed M.; Essam, Amr; Zhurabekova, Gulmira

    2015-01-01

    Introduction The issue of conserving the ovaries at hysterectomy in premenopausal women with benign gynecologic disease has been the subject of considerable controversy. Some clinicians prefer prophylactic oophorectomy in premenopausal women during hysterectomy to prevent future development of malignant changes in conserved ovaries. Other clinicians prefer to conserve apparently normal ovaries, because bilateral oophorectomy in premenopausal women results in an abrupt imbalance, sudden onset of menopausal symptoms, decreased libido, increased cardiovascular risk and osteoporosis. Material and methods Two hundred and twenty multipara women (who had completed their families), with benign uterine pathology were included in this prospective study for abdominal hysterectomy with bilateral ovarian preservation. Pre-operative vaginal ultrasound, Doppler studies, diagnostic hysteroscopy and endometrial biopsy were done followed by laboratory studies including Anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol for all studied women. Doppler studies, AMH, FSH and estradiol were repeated 6 and 12 months post-operative for assessment of the ovarian function and ovarian blood supply after hysterectomy. Results Pre-operative AMH, FSH and estradiol of the studied women were statistically insignificant compared to AMH, FSH and estradiol 6 and 12 months post-operative. Twelve months post-operative right and left ovarian volumes (6.92 ± 0.18 and 6.85 ± 0.19 cm3, respectively) were significantly larger than pre-operative right and left ovarian volumes (6.19 ± 0.22 and 5.86 ± 0.23 cm3, respectively), and, 12 months post-operative right and left ovarian pulsatility indices (2.92 ± 0.15 and 2.96 ± 0.16 cm/s, respectively) were significantly lower than pre-operative right and left ovarian pulsatility indices (3.45 ± 0.19 and 3.36 ± 0.2 cm/s, respectively). Eight (3.6%) cases of the studied women developed an ovarian cyst 6 months after hysterectomy, 3

  10. Who abandons embryos after IVF?

    Walsh, A P H

    2010-04-01

    This investigation describes features of in vitro fertilisation (IVF) patients who never returned to claim their embryos following cryopreservation. Frozen embryo data were reviewed to establish communication patterns between patient and clinic; embryos were considered abandoned when 1) an IVF patient with frozen embryo\\/s stored at our facility failed to make contact with our clinic for > 2 yrs and 2) the patient could not be located after a multi-modal outreach effort was undertaken. For these patients, telephone numbers had been disconnected and no forwarding address was available. Patient, spouse and emergency family contact\\/s all escaped detection efforts despite an exhaustive public database search including death records and Internet directory portals. From 3244 IVF cycles completed from 2000 to 2008, > or = 1 embryo was frozen in 1159 cases (35.7%). Those without correspondence for > 2 yrs accounted for 292 (25.2%) patients with frozen embryos; 281 were contacted by methods including registered (signature involving abandoned embryos did not differ substantially from other patients. The goal of having a baby was achieved by 10\\/11 patients either by spontaneous conception, adoption or IVF. One patient moved away with conception status unconfirmed. The overall rate of embryo abandonment was 11\\/1159 (< 1%) in this IVF population. Pre-IVF counselling minimises, but does not totally eliminate, the problem of abandoned embryos. As the number of abandoned embryos from IVF accumulates, their fate urgently requires clarification. We propose that clinicians develop a policy consistent with relevant Irish Constitutional provisions to address this medical dilemma.

  11. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    Andersen, Lea L; Alling Møller, Lars M; Gimbel, Helga M

    2015-01-01

    OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total......, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group...... (443ml) (P=0.0147) according to the voiding diary. CONCLUSION: Subtotal and total abdominal hysterectomy are comparable regarding long-term objective pelvic organ prolapse and urinary incontinence. The subtotal hysterectomy group had a higher Qmax and voided volume....

  12. Safe vaginal uterine morcellation following total laparoscopic hysterectomy.

    Günthert, Andreas R; Christmann, Corina; Kostov, Plamen; Mueller, Michael D

    2015-04-01

    The minimally invasive approach for hysterectomy with proven benefits and lower morbidity has become the gold standard, even in women with large uterine masses. Most women with a malignant condition present with abnormal vaginal bleeding and/or suspicious imaging such that few are diagnosed by final histopathology after surgery. However, if a malignancy is not diagnosed preoperatively, intraabdominal morcellation for uterus extraction has an increased risk for potential tumor spread and peritoneal metastases, especially in cases of unexpected leiomyosarcoma. We describe a simple method to wrap the uterus in a contained environment with a plastic bag through the posterior vaginal fornix prior to conventional coring morcellation for vaginal extraction in total laparoscopic hysterectomy. We further describe our experience with a risk stratification and treatment algorithm to implement this procedure in daily routine. A video and an illustrating sketch demonstrate the simplicity and safety of the procedure. PMID:25460836

  13. Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy

    Kelly L. Pieh-Holder

    2014-01-01

    Full Text Available Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function.

  14. Lower urinary tract symptoms after total and subtotal hysterectomy

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Birthe Jakobsen; Sørensen, Helle Christina; Toftager-Larsen, Kim; Sidenius, Katrine; Møller, Nini; Madsen, Ellen Merete; Vejtorp, Mogens; Clausen, Helle; Rosgaard, Annie; Villumsen, John; Gluud, Christian; Ottesen, Bent S; Tabor, Ann

    2005-01-01

    The aim of this Danish multicenter trial was to compare the proportion of women with lower urinary tract symptoms after total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (SAH) for benign uterine disorders. A total of 319 women were randomized to TAH (n = 158) or SAH (n = 161......). Women were followed up for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention-to-treat analyses. Urinary incontinence was found less often among TAH women than among SAH women. This was due to a larger reduction of the number of women with...... stress and urinary incontinence in the TAH group. No other differences were found between the two operation methods. The number of women with urinary incontinence and frequency was reduced from study entry for follow-up, while double/triple voiding was increased. Incontinent women had significantly lower...

  15. Influence of alcohol intake on postoperative morbidity after hysterectomy

    Felding, C; Jensen, L M; Tønnesen, H

    1992-01-01

    Postoperative morbidity after hysterectomy was prospectively studied in 229 consecutive patients in our departments. The incidence of alcohol abuse (greater than 60 gm of alcohol daily) and social drinking (between 25 and 60 gm of alcohol daily) was 6.5% for each. When compared with the social...... drinkers and the control group, the alcohol abuse group had significantly more complications (80% vs 27% and 80% vs 13%, respectively)....

  16. Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

    Amudha S.

    2016-04-01

    Conclusions: PPH is unpredictable in onset, duration and etiology and it remains a major life threatening complication of any delivery. The most common causes of hemorrhage in these women are placental abnormalities and uterine atony. When conservative treatment is not feasible or has failed, prompt peripartum hysterectomy is performed failing which the delay would contribute to the maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1171-1173

  17. Bursectomy at radical gastrectomy

    Cuneyt; Kayaalp

    2015-01-01

    Radical gastrectomy with extended lymph node dissec tion and prophylactic resection of the omentum, peri toneum over the posterior lesser sac, pancreas and/o spleen was advocated at the beginning of the 1960 s in Japan. In time, prophylactic routine resections of the pancreas and/or spleen were abandoned because of the high incidence of postoperative complications. However omentectomy and bursectomy continued to be standard parts of traditional radical gastrectomy. The bursaomentalis was thought to be a natural barrier against invasion of cancer cells into the posterior part of the stomach. The theoretical rationale for bursectomy was to reduce the risk of peritoneal recurrences by eliminating the peritoneum over the lesser sac, which might include free cancer cells or micrometastases. Over time, the indication for bursectomy was gradually reduced to only patients with posterior gastric wall tumors penetrating the serosa. Despite its theoretical advantages, its benefit for recurrence or survival has not been proven yet. The possible reasons for this inconsistency are discussed in this review. In conclusion, the value of bursectomy in the treatment of gastric cancer is still under debate and large-scale randomized studies are necessary. Until clear evidence of patient benefit is obtained, its routine use cannot be recommended.

  18. Obstetric Hysterectomy: Retrospective analytical study at P D U Medical College, Rajkot

    Parmar, Prakash; Goswami, K. D.; Dudhrejiya, Kavita M; Jain, Mahima

    2014-01-01

    Objective: To find out indications of obstetrics hysterectomy, related complications and associated maternal morbidity and mortality.Methods:  A Retrospective Analytical Study was performed at Dept of obs & gynec P D U Medical College, Rajkot over a period of 3 yrs during 2011-2013.Evaluation of Maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, indications of hysterectomy, type of hysterectomy, intra-op and post-operative complications, bl...

  19. EMERGENCY PERIPARTUM HYSTERECTOMY AT A TERTIARY CARE HOSPITAL IN KASHMIR VALLEY

    Sameena

    2015-01-01

    Full Text Available OBJECTIVE: To determine the incidence , indications , maternal and perinatal outcome of emergency peripartum hysterectomy. METHOD: A prospective observational study of all patients who underwent peripartum hysterectomy was conducted from June 2011 to November 2012 in the Department of Obstetrics and Gynecology , Lalla Ded Hospital , an associated hospital of Government Medical College , Srinagar , Kashmir. Data , specifically on the incidence of emergency peripartum hysterectomy , the total number of deliveries , the maternal parameters , the indications of peripartum hysterectomy and associated maternal morbidity and mortality were recorded on a proforma. RESULTS: There were 87 cases of peripartum hysterectom y ( 75 caesarean hysterectomies , 86.2% and 12 postpartum hysterectomies , 13.8% , making an incidence of 2.56/1000 deliveries. Most of the patients were para 3 , 32 ( 36.8% , were mostly in age group of 35 - 39 years 38 ( 43.7% and belonged to rural areas . Overa ll , the most common indication for emergency peripartum hysterectomy was morbidly adherent placenta with placenta previa 39( 44.8% followed by uterine rupture 24 ( 27.6 % , uterine atony 13 (14.9% and accidental haemorrhage 6 (6.9%. In 38 (43.7% patients total abdominal hysterectomy was performed while 49 (56.3% patients required subtotal hysterectomy. There were 9 (10.3% maternal and 40 (46% perinatal deaths; all were due to severity of conditions necessitating hysterectomy. CONCLUSION: Emergency perip artum hysterectomy is potentially a lifesaving procedure associated with significant maternal morbidity and mortality. Morbidly adherent placenta with placenta previa was the commonest indication for emergency peripartum hysterectomy. Previous scar , multip arity and abnormal placentation were the significant risk factors.

  20. Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

    Mahmut Kuntay kuntay Kokanali

    2015-03-01

    Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000: 63-71

  1. EM ERGENCY PERIPARTUM HYSTERECTOMY: A FIVE YEAR STUDY

    Saritha

    2015-10-01

    Full Text Available Emergency peripartum hysterectomy is performed as a life saving measure in uncontrolled PPH. OBJECTIVES: T o examine incidence, risk factors, indications, outcome and complications of emergency peripartum hysterectomy in a teaching hospital. METHODS: A 5 ye ar prospective study conducted between January 2010 to December 2014. Demographic data, detailed history, clinical examination and relevant investigations obtained. RESULTS: The incidence of EPH in present study was 0.6 per 1000 deliveries. Most of these p atients were young, mean age of 22.67 years, para 1 and 2, 84.21% were unbooked with no antenatal visits and delivered outside. Rupture of uterus was the commonest indication (42.10% for EPH, followed by uterine atony (26.32% and abnormal placentation (2 6.32%. Both total or subtotal hysterectomy were performed as a life saving measure after conservative measures failed. Maternal mortality in this study was 15.79%. Other complications noted were febrile illness, anaemia, coagulopathy, renal failure, wound infection. CONCLUSION: EPH performed for uncontrolled PPH is associated with significant mortality and morbidity. Its incidence can be reduced by regular antenatal check - ups, early detection and referral of high risk patients and updating knowledge and skill of doctors working in peripheral centres.

  2. Localized Detection of Abandoned Luggage

    Jing-Ying Chang

    2010-01-01

    Full Text Available Abandoned luggage represents a potential threat to public safety. Identifying objects as luggage, identifying the owners of such objects, and identifying whether owners have left luggage behind are the three main problems requiring solution. This paper proposes two techniques which are “foreground-mask sampling” to detect luggage with arbitrary appearance and “selective tracking” to locate and to track owners based solely on looking only at the neighborhood of the luggage. Experimental results demonstrate that once an owner abandons luggage and leaves the scene, the alarm fires within few seconds. The average processing speed of the approach is 17.37 frames per second, which is sufficient for real world applications.

  3. Legal aspects of abandoned facilities

    This paper outlines the basic regulatory requirements needed to identify radioactive material licensee owners/operators. Basic actions that must be taken once a radioactive material site is abandoned are also listed. Two such actions in Texas are briefly described. Civil suits requesting penalties, injunctive relief for decontamination, and recovery of response costs pursuant to the Texas regulatory acts have been filed against the potentially responsible parties

  4. Brent Spar abandonment - impact hypothesis

    This report describes the predicted fate of the Brent Spar storage and offloading platform following its proposed deep sea abandonment. Based on the characteristics of the Brent Spar and the contents of the buoy this ''Impact Hypothesis'' uses currently available knowledge of the North East Atlantic deep sea environment. Three scenarios based on possible outcomes are considered, incllcuding the release of metals into the water following corrosion of the structure. (UK)

  5. Long-term cancer risk after hysterectomy on benign indications: Population-based cohort study.

    Altman, Daniel; Yin, Li; Falconer, Henrik

    2016-06-01

    Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111,595 hysterectomized and 537,9843 nonhysterectomized women from nationwide Swedish Health Care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register between 1973 and 2009. Hysterectomy with or without concomitant bilateral salpingo-ophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome measure. Rare primary cancers (cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96, respectively). Compared to nonhysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83, respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following hysterectomy. PMID:26800386

  6. Comparative study of abdominal, vaginal and laparoscopic assisted vaginal hysterectomies with special reference to immediate sequel, late sequel and complications

    Pujitha Devi Suraneni

    2016-02-01

    Conclusions: Preference for laparoscopic assisted vaginal hysterectomy or vaginal hysterectomy depends on expertise of doctor and selections of patients. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 402-406

  7. Radical Evil

    Carlos Manrique

    2007-12-01

    Full Text Available There is an aporia in Kant’s analysis of evil: he defines radical evilas an invisible disposition of the will, but he also demands an inferential connection between visible evil actions and this invisible disposition. This inference,however, undermines the radical invisibility of radical evil according to Kant’s own definition of the latter. Noting how this invisibility of moral worth is a distinctive feature of Kant’s approach to the moral problem, the paper then asks why, in the Groundwork, he nonetheless forecloses a question about evil that seems to be consistent with this approach. It is argued that to account for this aporia and this foreclosure, one has to interrogate the way in which the category of religion orients Kant’s incipient philosophy of history in Die Religion.

  8. Port-site metastasis following robotic-assisted radical hysterectomy for squamous cell cervical cancer

    Bolles, Olivia; Borowsky, Mark

    2011-01-01

    ► Port-site metastases can occur following treatment for cervical cancer. ► Port-site metastases can occur following robotic assisted laparoscopic surgery. ► The pathogenesis of port-site metastases is poorly understood.

  9. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    Carney, John

    2008-12-01

    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  10. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair

    Lykke, Rune; Blaakær, Jan; Ottesen, Bent;

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS: We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women...

  11. Multiple factors drive regional agricultural abandonment.

    Osawa, Takeshi; Kohyama, Kazunori; Mitsuhashi, Hiromune

    2016-01-15

    An understanding of land-use change and its drivers in agroecosystems is important when developing adaptations to future environmental and socioeconomic pressures. Agricultural abandonment occurs worldwide with multiple potentially positive and negative consequences; however, the main factors causing agricultural abandonment in a country i.e., at the macro scale, have not been identified. We hypothesized that socio-environmental factors driving agricultural abandonment could be summarized comprehensively into two, namely "natural" and "social", and the relative importance of these differs among regions. To test this postulate, we analyzed the factors currently leading to agricultural abandonment considering ten natural environment variables (e.g., temperature) and five social variables (e.g., number of farmers) using the random forest machine learning method after dividing Japan into eight regions. Our results showed that agricultural abandonment was driven by various socio-environmental factors, and the main factors leading to agricultural abandonment differed among regions, especially in Hokkaido in northern Japan. Hokkaido has a relatively large area of concentrated farmland, and abandonment might have resulted from the effectiveness of cultivation under specific climate factors, whereas the other regions have relatively small areas of farmland with many elderly part-time farmers. In such regions, abandonment might have been caused by the decreasing numbers of potential farmers. Thus, two different drivers of agricultural abandonment were found: inefficient cultivation and decreasing numbers of farmers. Therefore, agricultural abandonment cannot be prevented by adopting a single method or policy. Agricultural abandonment is a significant problem not only for food production but also for several ecosystem services. Governments and decision-makers should develop effective strategies to prevent further abandonment to ensure sustainable future management of agro

  12. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

    Herling, Suzanne Forsyth; Palle, Connie; Møller, Ann M;

    2016-01-01

    AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare......INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference...

  13. Optimization of subarachanoid block by oral pregabalin for hysterectomy

    Monica Kohli

    2011-01-01

    Full Text Available Background: 80% of patients undergoing surgical procedures experience postoperative pain 1 and requires adequate pain relief. Nowadays drugs like COX2 inhibitors and calcium channel modulators (Pregabalin and Gabapentin are been increasingly used for postoperative pain management effectively. We conducted this study to find whether preoperative pregabalin has any effect in postoperative analgesic requirement in patients undergoing hysterectomy under spinal anaesthesia. Patients & Methods: This randomized, double-blind, placebo-controlled trial was conducted in 150 patients undergoing hysterectomy under spinal anaesthesia, divided in three groups - Group I (PO - Control group, Group II (P150 received 150 mg pregabalin and Group III (P300 received 300 mg pregabalin. We used VAS for anxiety, Ramsay sedation scale and VAS for patient satisfaction regarding pain relief. Results: There was significant reduction in anxiety in groups P (150 and P (300 than placebo group P (0 during intraoperative and postoperative period than preoperative period. There was significant sedation seen in groups P (150 and P (300 than placebo group P (0. First rescue analgesia in group P (300 was202.42±6.77 and in group P (150 was176.38±4.80on average, group P (0 was131.38±5.15. Dizziness was 44.44% in group P (300, 36.11% in group P (150, and 19.44% in group P (0. Patient satisfaction was better in P (300 group than other two groups. Conclusions: Pregabalin being an oral drug which would be easy for the patients to take and also its prolongation of the neuraxial block helps in immediate postoperative analgesia and further reduction of other parentral analgesics. Pregabalin 150mg would be the optimal preemptive dose for hysterectomy under spinal anaesthesia.

  14. Physiological FDG uptake in the ovaries after hysterectomy

    It is known that focal 18F-fluorodeoxyglucose (FDG) uptake is physiologically seen in the ovaries and uterus of premenopausal women in correlation with the menstrual cycle, which may cause false-positive diagnoses on the images of FDG positron emission tomography (PET). The objective of this study was to clarify whether women of reproductive age after hysterectomy whose ovaries were preserved, also showed physiological ovarian FDG uptake. We reviewed 26 women after hysterectomy (age 51.1±5.0 years), who underwent annual cancer screening, including FDG-PET and pelvic magnetic resonance (MR) imaging, three times. Seven women (age 45.9±5.8 years, range 34-52 years) had at least one ovary, showing changes in its appearance including the size and number of follicles on MR images each year, which suggested that the ovary was functioning. Four of the seven women showed focal FDG uptake (standardized uptake value 4.2±1.1) that corresponded to the normal ovaries on five PET examinations. Another group of 19 women (age 53.1±3.1 years, range 47-59 years) who had small ovaries without changes on MR images each year did not show FDG uptake in the ovaries. Physiological FDG uptake observed in the ovaries of women of reproductive age even after hysterectomy is reasonably common. As it is not easy to determine the hormonal cycle in these women, it is essential to correlate focal FDG uptake in the pelvis with anatomical and morphological findings on MR images to avoid false-positive diagnoses. (author)

  15. Hysterectomy as a Management Option for Morbidly Adherent Placenta

    Objective: To determine the outcome of interval (delayed) hysterectomy as compared to cesarean (immediate) hysterectomy in cases of placental invasion in previous cesarean sections. Study Design: Comparative study. Place and Duration of Study: Department of Obstetrics and Gynecology, Unit II, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2008 to June 2011. Methodology: The study subjects included 28 women with history of previous cesarean section who had low lying as well as morbidly adherent placenta (MAP) of variable degree. Patients were classified into two groups (group A and B) according to whether cesarean or interval hysterectomy was needed at time of delivery. Demographic data, obstetrical risk factors such as parity and number of previous cesarean sections were compared as well as radiological and histopathological findings, and details of the management. Chi-square, Fisher's exact and t-tests were used to compare proportions and mean values. Results: The frequency of MAP in previous cesarean sections turned out to be 1.83/1000 (28/15,340) deliveries. Mean maternal age (26.54 vs. 29.13 years, p=0.05), mean gestational age (33.8 vs. 36 weeks, p=0.05), estimated blood loss (2615.38 vs. 1506.6 mL, p=0.001), volume of blood transfused (9.76 vs. 2.9 pints, p=0.001) and the duration of hospital stay (10.69 vs. 32.86 days, p=0.001) differed significantly between group A and group B. One maternal death occurred in each group. Eight patients had other complications in group A compared to 3 patients in group B. Three neonatal deaths occurred in group A compared to nil in group B. Conclusion: The frequency of morbidly adherent placenta was 1.83/1000 deliveries. The management and outcome differed markedly according to emergency and scheduled antenatal diagnosis. Counselling and antenatal radiological screening can reduce the high morbidity and mortality associated with it. (author)

  16. Radical Geography

    H. Hataminezhad

    2012-07-01

    Full Text Available Interdisciplinary sciences emerging and specialization were result of historical conditions. Lack of common and grand theories have caused social sciences such as Geography disintegrated to many courses. The Geography science has been divided two main courses, Physical and Human through the time. Every one used another similar science in theoretical principles and methodologies for their domain development and strengthening of their bases. The Human Geography was influenced by Anthropology during nineteenth century and was affected by nineteenth century and dawn twentieth century by Sociology and from mid twentieth century until present time by Biological sciences, Psychology, Political economics and social theories. Radical Geography was one of the Human Geography branches that was influenced by Political economics and left ideology. Radical Geography emphasizes on investigation about quality of life in different spaces and attempts to change socio-economic and spatial relationships, therefore critical Geography is one of its similar approaches.

  17. THE ROLE OF HYSTERECTOMY IN THE THERAPY OF GESTATIONAL TROPHOBLASTIC TUMOR

    2000-01-01

    Objective.To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor.Methods.We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hysterectomy from 1985~1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole.Results.Twenty-three elder patients who didn't desire to preserve fertility were selected for hysterectomy after shorter courses of chemotherapy, 22 of them had a complete remission(95.6%), the total aver-age courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a refractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission(74.1%), the total average courses of chemotherapy were 9.4. Emergency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission(94.4%), the total average courses of chemotherapy were 7.6.Conclusion.Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it's better to perform extended hysterectomy for the indicated patients.

  18. An audit of indications and complications associated with elective hysterectomy at SVMCH and RC, Ariyur, Pondicherry

    Nidhi Bansal, Hiremath PB, Meenal C, Vishnu Prasad

    2013-04-01

    Full Text Available Background: Hysterectomy is the most common gynaecological surgery performed worldwide Menorrhagia secondary to uterine fibroids and abnormal menstrual bleeding are the two most common indications for hysterectomy. An important factor impacting on the incidence of complications of hysterectomy, apart from the indication for surgery, is the surgical approach. Most surgeons perform up to 80% of procedures by the abdominal route. The incidence of LAVH performed for benign lesions has progressively increased in recent years. Methods : Surgical indications and details, histological findings, and postoperative course were reviewed and analysed for 340 patients who underwent hysterectomy in 2011 and 2012.Results : In our study, fibroid uterus (27.9 % was the leading indication for performing hysterectomies followed by a DUB (22.9% and uterovaginal prolapse (UVP-21.8%. During the study period (2011-2012, most hysterectomies were performed abdominally (54.4%. Overall post operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the vaginal and laparoscopic group ( p value= 0.001 . Conclusion: We need to ensure that trainees acquire competency in performing hysterectomies vaginally, which is clearly safer than the abdominal approach.

  19. Histopathological Distribution of Ovarian Masses Occurring After Hysterectomy: A Five-Year Assay in Iranian Patients

    Lalooei

    2016-01-01

    Full Text Available Background Ovarian cancer, the third most important genital cancer and fifth cause of cancer-related death in women, is diagnosed at terminal stages in 70% of cases. Therefore, it is imperative to know the possible risk factors associated with ovarian cancer. Only a few studies have discussed the histopathological features of ovarian masses occurring after hysterectomy. Objectives The study aimed to investigate the five-year prevalence and histopathological distribution of ovarian masses after hysterectomy in Iranian patients and to determine the need for prophylactic salpingo-oophorectomy. Patients and Methods This descriptive cross-sectional study enrolled all patients with ovarian masses and a history of hysterectomy for benign conditions who were visiting the gynecology clinic of Baqiyatallah Hospital, Tehran, between May 2009 and May 2014. Demographic information, pathological features of ovarian masses, family history, the time between hysterectomy and ovarian mass surgery, and method of hysterectomy were recorded in a predesigned checklist. The level of tumor markers such as CA125 and alpha-fetoprotein (α-FP were measured. Results Of the 1052 patients with ovarian masses, 45patients (mean age, 53.11 ± 9.56 years who had undergone abdominal hysterectomy underwent analysis. The study participants had a mean age of 47.92 ± 1.58 years at the time of hysterectomy. The mean time interval between hysterectomy and diagnosis of ovarian mass was 5.38 ± 4.15 years. Based on pathological reports, serous cystadenoma was the most frequent (43.2% pathological diagnosis, followed by mucinous cystadenoma (17.5%. Conclusions A majority of ovarian masses, especially those diagnosed within a short duration after hysterectomy, are benign. Iranian patients with such ovarian masses when asymptomatic and associated with negative tumor markers could be followed up, and prophylactic oophorectomy may not be necessary.

  20. Roaming Radicals

    Bowman, Joel M.; Shepler, Benjamin C.

    2011-05-01

    Roaming is a recently verified unusual pathway to molecular products from unimolecular dissociation of an energized molecule. Here we present the evidence for this pathway for H2CO and CH3CHO. Theoretical analysis shows that this path visits the plateau region of the potential energy surface near dissociation to radical products. It is not clear whether roaming is a distinct isolated pathway, in addition to the conventional one via the well-known molecular saddle-point transition state. Evidence is presented to suggest that the two pathways may originate from a single, but highly complicated, dividing surface. Other examples of unusual reaction dynamics are also reviewed.

  1. Advantages of nerve-sparing intrastromal total abdominal hysterectomy

    Samimi D

    2013-01-01

    Full Text Available Daryoosh Samimi,1 Afdal Allam,2 Robert Devereaux,2 William Han,2 Mark Monroe21Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 2Department of Obstetrics and Gynecology, Fountain Valley Regional Hospital, Fountain Valley, CA, USABackground: The purpose of the prospective study was to evaluate the effect of the nerve-sparing intrastromal abdominal hysterectomy bilateral salpingo-oophorectomy (ISTAH-BSO on intraoperative, and postoperative complications namely blood loss and length of hospital stay.Methods: Forty female patients were allocated by a block randomization method into a study group and a control group. The study group consisted of 20 patients who underwent ISTAH-BSO over a 2-year period. The control group included 20 patients who underwent conventional hysterectomy by the same surgeon during the same time frame. Both groups were followed for outcomes of interest, which included length of hospital stay, blood loss, and surgical complications. The participants in both groups were as similar as possible with respect to all known or unknown factors that might affect the study outcome.Results: Postoperative hemoglobin levels were higher in the study group (blood loss 1.0 g/dL versus 1.4 g/dL in control group. Average hospital stay was significantly shorter in the study group (2.7 days versus 3.15 days in the control group, P = 0.028. No significant complications such as urinary fistula, vaginal vault prolapse, blood transfusion, or postoperative infections were identified in the study group.Conclusion: The nerve-sparing ISTAH-BSO procedure described in this study has the potential to reduce length of hospital stay after abdominal hysterectomy by reducing blood loss and postoperative complications. Follow-up observations suggest that urinary function and sexual satisfaction are also preserved. Since this research, 175 cases have been performed, with an average of 5 years of

  2. Laparoscopic Assisted Vaginal Hysterectomy, Setting Up a Service at a Peripheral Teaching Hospital

    Jim Tsaltas; Gab Kovacs; Jenny Dennis; Amanda Pratt

    1996-01-01

    The establishment of a laparoscopically assisted hysterectomy program at Box Hill Hospital is described. The first eight cases have been reviewed and recommendations are made to other gynaecology units who wish to establish a minimally invasive gynaecological surgery unit.

  3. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?

    Sanam Moradan

    2012-07-01

    Full Text Available Objectives: Post tubal ligation syndrome (PTLS is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among non-sterilized female population of the same age.Methods: This study was carried out on 160 women, 38-52 years, who underwent hysterectomy in Amir University Hospital, Semnan, Iran, from September 2008 to September 2011. After gathering of data from medical records, in this study, the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among nonsterilized female population for the same age.Results: The mean age of the study group was 44/4±5/7 and the mean age of the control group was 45/2±5/3, (p=0.424.The mean parity of the study group was 3/8±1/8 and the mean parity of the control group was 3/5±1/4, (p=0.220. So, in regard to age and parity, two groups were matched. Hysterectomies were performed for 160 cases and abnormal uterine bleeding was the cause of hysterectomy in 67 cases. Among 67 cases, 19 cases (37.3% had previous tubal sterilization + hysterectomy (study group and 48 cases (44% were not undergoing tubal sterilization but had hysterectomy for abnormal bleeding causes (control group. Statistical analyses showed that there were not significant differences between two groups, (RR=0.85; 95% CI: 0.56-1.28; p=0.418.Conclusion: The result of this study showed that previous tubal sterilization is not a risk factor for undergoing hysterectomy because of abnormal uterine bleeding.

  4. Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

    Anna Myriam Perrone; Maria Cristina Scifo; Valentina Martelli; Paolo Casadio; Paolo Giovanni Morselli; Giuseppe Pelusi; Maria Cristina Meriggiola

    2010-01-01

    Objective. To report on the use of laparoendoscopic single-site surgery (LESS) for the management of total hysterectomy (TH) with bilateral salpingoovariectomy (BSO) in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s). A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s). Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome Measu...

  5. Single-Port Access Laparoscopy-Assisted Vaginal Hysterectomy: Our Initial Experiences with 100 Cases

    Yun-Sang Oh; Ji-No Park; Jin Choi; Kwang-Sik Shin; Young-Sam Choi; Tae-Eel Rhee

    2012-01-01

    Objectives. To present our initial experiences with laparoscopically assisted vaginal hysterectomy performed using homemade transumbilical single-port system. Materials and Methods. We reviewed the medical records of one hundred patients who underwent single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH). SPA-LAVH was performed with homemade single port system and conventional rigid laparoscopic instruments. Results. All procedures were successfully completed through th...

  6. Adenomyosis among samples from hysterectomy due to abnormal uterine bleeding in Ahwaz, southern Iran

    Maryam Dehghani Mobarakeh; Ahmadreza Maghsudi; Iran Rashidi

    2012-01-01

    Introduction: Adenomyosis is one of the most common, yet underdiagnosed, underlying causes of abnormal uterine bleeding (AUB). We aimed to evaluate the prevalence of adenomyosis among subjects who underwent hysterectomy due to AUB. Materials and Methods: We studied the pathological specimens from 100 cases of AUB who underwent hysterectomy and were referred to Jundishapur University of Medical Sciences, Ahwaz (Iran) from 2007 to 2010. All specimens were reviewed by the same pathologist. ...

  7. Mood Symptoms After Natural Menopause and Hysterectomy With and Without Bilateral Oophorectomy Among Women in Midlife

    Gibson, Carolyn J.; Joffe, Hadine; Bromberger, Joyce T.; Thurston, Rebecca C.; Lewis, Tené T.; Khalil, Naila; Matthews, Karen A.

    2012-01-01

    Objective To examine whether mood symptoms increased more for women in the years after hysterectomy with or without bilateral oophorectomy relative to natural menopause. Methods Using data from the Study of Women’s Health Across the Nation (n=1,970), depression and anxiety symptoms were assessed annually for up to 10 years with the Center for Epidemiological Studies Depression Index and four anxiety questions, respectively. Piecewise hierarchical growth models were used to relate natural menopause, hysterectomy with ovarian conservation, and hysterectomy with bilateral oophorectomy to trajectories of mood symptoms before and after the final menstrual period or surgery. Covariates included educational attainment, race, menopausal status, age the year prior to final menstrual period or surgery, and time-varying body mass index, self-rated health, hormone therapy, and antidepressant use. Results By the 10th annual visit, 1,793 (90.9%) women reached natural menopause, 76 (3.9%) reported hysterectomy with ovarian conservation, and 101 (5.2%) reported hysterectomy with bilateral oophorectomy. For all women, depressive and anxiety symptoms decreased in the years after final menstrual period or surgery. These trajectories did not significantly differ by hysterectomy or oophorectomy status. The Center for Epidemiological Studies Depression Index means were .72 standard deviations lower, and anxiety symptoms .67 standard deviations lower, five years after final menstrual period or surgery. Conclusion In this study, mood symptoms continued to improve after the final menstrual period or hysterectomy for all women. Women who undergo a hysterectomy with or without bilateral oophorectomy in midlife do not experience more negative mood symptoms in the years after surgery. PMID:22525904

  8. Patient and Staff (doctors and nurses) Experiences of Abdominal Hysterectomy in Accelerated Recovery Programme

    Wagner, Lis; Carlslund, Anne Mette; Møller, Charlotte;

    2004-01-01

    Introduction: The accelerated recovery programme (ARP) is becoming commonplace in surgical specialties and has also been introduced to hysterectomy patients. Diagnostic, prognostic and other clinical indicators are well described. The aim of this article is to relay knowledge about the ARP, throu...... for purposes of information relay and dialogue between staff and patients/family members. A nursing care ambulatory unit is recommended to support with information for women prior to and following hysterectomy in the ARP....

  9. Mini laparotomy versus conventional laparotomy for abdominal hysterectomy: A comparative study

    Sharma Jai

    2004-05-01

    Full Text Available BACKGROUND: Less traumatizing measures for hysterectomies are searched for to improve the recovery from surgery. AIM: Comparison of minilaparotomy abdominal hysterectomy with conventional abdominal hysterectomy in respect to per-operative and post-operative outcome and complications. SETTING AND DESIGN: In a medical college hospital patients undergoing abdominal hysterectomy were enrolled. It was a concomitant comparative study. METHODS AND MATERIAL: We are presenting our comparative data of 100 cases of minilaparotomy abdominal hysterectomy (group I, incision =< 6 cm performed over last 4 years from January 1998 to December 2002 and comparing the outcome with 99 cases of abdominal hysterectomy (group II, incision > 6 cm done by traditional method over the same duration. STATISTICAL ANALYSIS USED: Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student′s t test was used for continuous data. RESULTS: Mean age and parity of patients were similar in the two groups. Incision was transverse in 100% cases in-group I and 22.2% cases in-group II. Estimated blood loss was significantly higher (354 ml in group II in contrast to group I (240 ml. Blood transfusion was also required more commonly (22.2% in-group II than in-group I (9%. Mean operative time was significantly more in-group II (90 minutes than in group I (41 minutes. Mean hospital stay, day of mobility, starting oral diet and days of injectable analgesics required were higher in group II than in group I. Major complications were rare in both the groups, but minor complications were significantly higher in group II (40.4% than in group I (26%. CONCLUSION: Minilaparotomy abdominal hysterectomy appears to be an attractive alternative to traditional abdominal hysterectomy with fewer complications.

  10. Chronic plasma cell endometritis in hysterectomy specimens of HIV-infected women: a retrospective analysis.

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    OBJECTIVE: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIV-infected women requiring hysterectomy to explore if endometritis may be common among these patients. METHODS: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surg...

  11. Chronic Plasma Cell Endometritis in Hysterectomy Specimens of HIV-Infected Women: A Retrospective Analysis

    Kerr-Layton, J A; Stamm, C. A.; Peterson, L. S.; McGregor, J A

    1998-01-01

    Objective: Abnormal uterine bleeding is a common and troublesome problem in human immunodeficiency virus (HIV)-infected women. We sought to evaluate endometrial pathology among HIVinfected women requiring hysterectomy to explore if endometritis may be common among these patients.Methods: We performed a retrospective analysis of uterine pathology specimens obtained from HIV-infected and control patients requiring hysterectomy in two urban hospitals between 1988 and 1997 matched for age, surgic...

  12. Continued distress among abandoned dogs in Fukushima.

    Nagasawa, Miho; Mogi, Kazutaka; Kikusui, Takefumi

    2012-01-01

    In Fukushima, Japan, a prolonged refugee situation caused by a major nuclear incident after the earthquake of March 11, 2011 has led to the unintentional abandonment of many pets. We received stray or abandoned dogs from rescue centers in Fukushima Prefecture. During re-socialization training and health care, we accessed the behavioral characteristics and the urine cortisol level of each dog and compared them with those of other abandoned dogs not involved in this earthquake. The dogs from Fukushima showed significantly lower aggression toward unfamiliar people, trainability, and attachment to their caretakers; also, urine cortisol levels in the dogs from Fukushima were 5-10-fold higher than those in abandoned dogs from another area of Japan. These results suggested that the dogs from Fukushima suffered through an extremely stressful crisis. PMID:23061007

  13. Coal Mines, Abandoned - AML Inventory Sites 201601

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  14. Coal Mines, Abandoned - AML Polygons Feature

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  15. Coal Mines, Abandoned - AML Points Feature

    NSGIC GIS Inventory (aka Ramona) — This data set portrays the approximate location of Abandoned Mine Land Problem Areas containing public health, safety, and public welfare problems created by past...

  16. Landscape reconstruction planning of abandoned quarries

    Zhou, Linjia; 周麟佳

    2015-01-01

    Zhejiang, with a rich resource of stone, has a long history of stone extraction, where scatter thousands of traditional quarries and as a result many abandoned ones are left, which is challenged economically, ecologically and socially. On account of the soil erosion, security risks and degradation of ecosystem, reusing of the large number of abandoned quarries located in the city or the suburbs have become an important topic on sustainable development in China in resent years. These a...

  17. The rail abandonment process: A southern perspective

    One factor in evaluating the desirability of rail transport for high-level radioactive wastes or spent fuels is the frequency, or lack thereof, with which railroad and railroad lines have been, and are, abandoned. If DOE makes a decision to use the rail option and a line is subsequently abandoned, the choice results in increased cost, time delays and possibly safety problems: Information is therefore needed prior to the decision-making process to evaluate the desirability of the rail shipping option. One result of the abandonments mentioned herein, as well as other later abandonments, is the creation of a US rail system undergoing an evolutionary process in the 1980s as far-reaching as the changes that occurred when the industry was in its infancy a century and-a-half ago. The purpose of this paper is to examine the factors leading to some of these changes by tracing the historical development of the rail abandonment process, with particular emphasis on the rise of regional railroads, their problems in the modern era and current trends in rail abandonments as well as their effects on the southeastern United States

  18. Pain and other symptom severity in women with fibromyalgia and a previous hysterectomy

    Vincent A

    2011-10-01

    Full Text Available Ann Vincent1, Mary O Whipple1, Connie A Luedtke2, Terry H Oh3, Richa Sood1, Robin L Smith1, Aminah Jatoi4 1Department of Medicine, 2Department of Nursing, 3Department of Physical Medicine and Rehabilitation, 4Department of Oncology, Mayo Clinic, Rochester, MN, USA Objective: Fibromyalgia is a troubling disease characterized by chronic pain. This study explored whether pain and other fibromyalgia symptoms are worse among women who had undergone a hysterectomy with or without an oophorectomy versus those who had not. Methods: Consecutive women who were seen at the Fibromyalgia Treatment Program at a tertiary medical center between 2001 and 2004 and who completed the Fibromyalgia Impact Questionnaire (FIQ and Short Form-36 Health Survey (SF-36 at initial evaluation were included in this study. Results: A total of 813 women were included; 328 had had a hysterectomy. Total FIQ scores from women who had had a hysterectomy were higher (worse symptoms than those who had not (58.1 vs 56.4, P = 0.002. FIQ subscale scores of pain (P = 0.003, fatigue (P = 0.030, stiffness (P = 0.035, and depression (P = 0.008 were also worse in women who had had a hysterectomy. Similar to the FIQ, SF-36 physical component scores were worse in women who had had a hysterectomy (P = 0.045. Conclusion: Pain and other fibromyalgia symptom severity was worse in women who had had a hysterectomy with or without an oophorectomy. Keywords: fibromyalgia, hysterectomy, oophorectomy, symptom severity, surgical menopause

  19. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  20. NON–DESCENT VAGINAL HYSTERECTOMY FOR BENIGN GYNAECOLOGICAL DISEASE – A PROSPECTIVE STUDY

    Thulasi

    2016-04-01

    Full Text Available OBJECTIVE To assess safety and feasibility of non-descent vaginal hysterectomy for benign gynaecological disease. METHODS A prospective study was conducted at the Department of Obstetrics and Gynaecology of P K Das Institute of Medical Sciences from January 2013 to December 2013. An effort was made to perform hysterectomies vaginally in women with benign or premalignant conditions in the absence of prolapse. A suspected adnexal pathology, endometriosis, immobility of uterus, uterus size more than 16 weeks was excluded from the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus, morcellation techniques like bisection, debulking, coring, myomectomy, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, intraoperative and postoperative complications and hospital stay were recorded. RESULTS A total of 100 cases were selected for non-descent vaginal hysterectomy. Among them, 97 cases successfully underwent nondescent vaginal hysterectomy. Majority of the patients (55% were in age group 40-45 yrs. Four patients were nulligravida and eight patients had previous LSCS. Uterine size was ≤ 12 weeks in 84 cases and > 12-16 weeks in 16 cases. Commonest indication was leiomyoma of uterus (43%. Mean duration of surgery was 70±20.5 minutes. Mean blood loss was 150±65 mL. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. Intra–operatively, one case had bladder injury (1% that had previous 2 LSCS. Postoperatively, complications were minimal which included postoperative fever (11%, UTI (8% and vaginal cuff infection was (4%. Mean hospital stay was 3.5 days. CONCLUSION Vaginal hysterectomy is safe, feasible in most of the women requiring hysterectomy for benign conditions with less

  1. [Radical trachelectomy -- surgery for preserving woman's fertility in patients with invasive cervical cancer].

    Kostov, I; Vasilev, N; Nacheva, A; Lazarov, I

    2013-01-01

    For the past 15 years gynecological oncologists have been seeking ways to preserve woman's fertility when treating invasive cervical cancer. Many cases of cervical cancer are diagnosed in young woman who wish to preserve their fertility. As more women are delaying childbearing, fertility preservation has become an important consideration. The standard surgical treatment for stage IA2-IB1 cervical cancer is a radical hysterectomy and bilateral pelvic lymphadenectomy. This surgery includes removal of the uterus and cervix, radical resection of the parametrial tissue and upper vagina, and complete pelvic lymphadenectomy. Obviously, the standard treatment does not allow future childbearing. For some women with small localized invasive cervical cancers, there is hope for pregnancy after treatment. Radical trachelectomy is a fertility-sparing surgical approach developed in France in 1994 by Dr. Daniel Dargent for the treatment of early invasive cervical cancer. The radical trachelectomy operation has been described and performed abdominally, assisted vaginally by laparoscopy and robotically. PMID:24505637

  2. Effects of Weather Variability on Crop Abandonment

    Kelvin Mulungu

    2015-03-01

    Full Text Available In Zambia, every year some parts of the maize fields are abandoned post-planting. Reasons for this are not clearly known. In this paper, we examine the influence of soil and climatic factors on crop abandonment using a six-year (2007–2012 panel data by modeling the planted-to-harvested ratio (a good indicator of crop abandonment using a fractional and linear approach. Therefore, for the first time, our study appropriately (as supported by the model specification tests that favour fractional probit over linear models the fractional nature of crop abandonment. Regression results, which are not very different between the two specifications, indicate that, more than anything, high rainfall immediately after planting and inadequate fertilizer are the leading determinants of crop abandonment. In the agro-ecological region where dry planting takes place, low temperature during planting months negatively affects the harvested area. The results have implications on the sustainability of farming systems in the face of a changing climate.

  3. History of abandoned infants in Greece

    Maria Athanasopoulou

    2010-01-01

    Full Text Available It is since mythology to classical ages in Greece, since Medieval Ages to the end of the 19th century in Smyrna and in Athens, that history indicates the abandonment of the infants as a phenomenon always existing. A time flashback and the research of the phenomenon through the historic examples contribute unequivocally to the remonstrance of the social facts in each era.Aim: The aim of this study was to critically review all the historical data and the evidence from the international and Greek literature and to explore the factors that are accountable for to the infant’s abandonment and especially in Greece.Method: A critical literature search was performed using of MEDLINE and CINAHL (1990-2008 databases. The literature review referred to historical data related to the care of the abandoned infants since ancient Greek times.Conclusion: The literature review leads to the conclusion that the detection of the historical sources combines a “mosaic” which reflects the multiple needs of the Greek society, with target to encounter the infant abandonment. The ways used each time in order the phenomenon to be faced, not rarely were doubted. Still they stand as the salutary solutions for the abandoned infants and they are explained and established through the social background of each era and through the needs serviced each time.

  4. Changing trends in peripartum hysterectomy over the last 4 decades.

    Flood, Karen M

    2012-02-01

    OBJECTIVE: The purpose of this study was to identify changing trends in peripartum hysterectomy (PH) in a single large obstetric population over the last 40 years. STUDY DESIGN: A retrospective cohort study was performed from 1966-2005 of patients who had PH in any of the 3 Dublin obstetric hospitals. Cases were identified, and details were obtained from the combined patient databases of each hospital. RESULTS: There were 872,379 deliveries during the study period, among which 358 women underwent PH (0.4\\/1000 deliveries). In a comparison of the study decades 1966-1975 with 1996-2005, PH decreased from 0.9 per 1000 deliveries to 0.2 of 1000 deliveries. Although the overall cesarean delivery rate has increased from 6-19% during these 2 decades, the percentage of PH that occurs in the setting of a previous cesarean delivery has increased from 27-57% (P < .00001). Indications for PH have changed significantly in this time period, with "uterine rupture" as the indication for PH decreasing from 40.5-9.3% (P < .0001) and placenta accreta as the indication increasing significantly from 5.4-46.5% (P < .00001). CONCLUSION: PH has decreased over the last 4 decades. However, alongside the rising cesarean delivery rate, there has been a marked increase in the incidence of placenta accreta.

  5. Pattern and frequency of uterine pathologies among hysterectomy specimens in rural part of northern India: a retrospective secondary data analysis

    Vineet Chaturvedi

    2014-03-01

    Full Text Available Background: Hysterectomy is the most commonly performed gynecological surgery throughout the world.  Over the last several years reported cases of hysterectomy was increasing in numbers. However, similar studies from Etawah district with high prevalence of hysterectomy are lacking. Therefore, we have conducted this study to identify the pattern of pathologies identified in hysterectomy specimen and to correlate the pathological findings with the age group of the patient along with frequency of benign, malignant pathologies identified. Material and method:  This   study was conducted on 870 hysterectomy specimen who reported to pathology department .They were compared in terms of age of the patients and pathology of hysterectomy specimens. Result: Out of the hysterectomy specimens, pathological findings were seen in 850 hysterectomies.  Most common lesion was   leiomyoma (22.47% followed by Adenomyosis (21.76% ,Endometrial hyperplasia (14.00 %, ovarian cyst (9.29%, Endometrial atrophy (8.70%, Endometritis (7.76 %, Endo cervical polyp (5.64, Carcinoma intra epithelial neoplasm (3.52%, Endometrial polyp (3.17%, Carcinoma cervix (1.17%, Carcinoma ovary (1.05%, Benign ovarian tumor (0.58%,Carcinoma endometrium(0.35%, Myometritis (0.35%, Chorio carcinoma (0.11% The most common age group was (40-49 years. Conclusion:  Our data suggest that leiomyoma was the most common pathology seen in hysterectomy .The common age group for hysterectomy was (40 -49 years. Benign pathologies are more frequent in hysterectomy than malignant. Histopathology is mandatory for ensuring diagnosis and thus management, in particular of malignant disease.         

  6. Infanticide and illegal infant abandonment in Malaysia.

    Razali, Salmi; Kirkman, Maggie; Ahmad, S Hassan; Fisher, Jane

    2014-10-01

    Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development. PMID:25048164

  7. Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

    Neetu Singh

    2014-06-01

    Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66% and in women of parity 3-4 (71.42%.Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%. Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%. Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 540-543

  8. Histopathological Study of Hysterectomy Operations in A University Clinic in Tehran From 2005 to 2009

    Mahmoud Khaniki

    2011-06-01

    Full Text Available Objective: We intended to determine causes and histological pattern of hysterectomies in an Iranianpopulation.Materials and methods: Archived reports of pathology department of a university hospital dated March2005 to March 2009 were retrospectively reviewed. Age, chief complaint, type of operation includingabdominal, vaginal and subtotal hysterectomy, the indication of the operation and the pathology of thespecimen were retrieved from the records.Results: The average rate of hysterectomy was 219 per year. The average age of the patients was49.6±11.3. About 40% of cases aged 45-54 years. The main chief compliant was abnormal uterinebleeding (62.2%. The leading preoperative indication for hysterectomy operations were uterineleiomyoma (24.8% and then abnormal uterine bleeding and abdominal/pelvic mass. The most frequentpathologic findings were leiomyoma (22.0% and adenomyosis (12.1%. In 11.8% of hysterectomyspecimens no pathologic lesion was found.Conclusion: The hysterectomy is rather common in Iran with age dependent pattern of indications andcorresponding pathologies.

  9. A Marked Increase in Obstetric Hysterectomy for Placenta Accreta

    Xiao-Yu Pan; Yu-Ping Wang; Zheng Zheng; Yan Tian; Ying-Ying Hu; Su-Hui Han

    2015-01-01

    Background:Obstetric hysterectomy (OH) as a lifesaving measure to manage uncontrolled uterine hemorrhage appears to be increasing recently.The objective of this study was to determine the etiology and changing trends of OH and to identify those at particular risk of OH to enhance the early involvement of multidisciplinary intensive care.Methods:A retrospective study was carried out in patients who had OH in China-Japan Friendship Hospital from 2004 to 2014.Maternal characteristics,preoperative evaluation,operative reports,and prenatal outcomes were studied in detail.Results:There were 19 cases of OH among a total of 18,838 deliveries.Comparing the study periods between 2004-2010 and 2011-2014,OH increased from 0.8/1000 (10/12,890) to 1.5/1000 (9/5948).Indications for OH have changed significantly during this study period with uterine atony decreasing from 50.0% (5/10) to 11.1% (1/9) (P < 0.05),and placenta accreta as the indication for OH has increased significantly from 20.0% (2/10) to 77.8% (7/9) (P < 0.05).Ultrasonography and magnetic resonance imaging (MRI) have been used to make an exact antepartum diagnosis of placenta accreta.A multidisciplinary management led to improved outcomes for patients with placenta accreta.Conclusion:As the multiple cesarean delivery rates have risen,there has been a dramatic increase in OH for placenta accreta.An advance antenatal diagnosis of ultrasonography,and MRI,and a multidisciplinary teamwork can maximize patients' safety and outcome.

  10. Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

    Anna Myriam Perrone

    2010-01-01

    Full Text Available Objective. To report on the use of laparoendoscopic single-site surgery (LESS for the management of total hysterectomy (TH with bilateral salpingoovariectomy (BSO in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s. A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s. Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome Measure(s. The procedure was performed without incident. The trocar placement was easy and safe, without inadvertent port removal. No vascular or visceral injuries, loss of pneumoperitoneum, or intraoperative port site bleeding occurred. Result(s. A detailed description of the technique of a single-site surgery for management of hysterectomy and BSO. Conclusion. Our case presents the first report of single-site surgery for surgical treatment of subjects affected by GID.

  11. Role of non-descent vaginal hysterectomy in previous cesarean section scar women

    Naina Kumar

    2015-06-01

    Results: Total ten cases were selected for NDVH with history of one, two/ three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time from below. Five patients had previous one Lower Segment Cesarean Section (LSCS, four had two LSCS and one had three LSCS. Commonest indication was leiomyoma of uterus followed by abnormal uterine bleeding. Mean duration of surgery was 50 +/- 20.5 min. Mean blood loss was 150 +/- 65 ml. Post-operative complications were minimal with no scar, patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days. Conclusions: Vaginal hysterectomy appears to be safe, cost effective alternative to abdominal hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 785-789

  12. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle;

    2015-01-01

    BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries......, the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman...

  13. Soil microbial community of abandoned sand fields

    Elhottová, Dana; Szili-Kovács, T.; Tříska, Jan

    2002-01-01

    Roč. 47, č. 4 (2002), s. 435-440. ISSN 0015-5632 R&D Projects: GA ČR GA526/99/P033 Grant ostatní: OTKA(HU) T25739 Institutional research plan: CEZ:AV0Z6066911 Keywords : microbial community * abandoned fields Subject RIV: EH - Ecology, Behaviour Impact factor: 0.979, year: 2002

  14. 18 CFR 157.216 - Abandonment.

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Abandonment. 157.216 Section 157.216 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... firm contract; or (2) A facility that did or could now qualify for automatic authorization as...

  15. Development of database on circular abandoned channel in Japan

    To develop a method for estimating late Quaternary uplift rates of inland mountainous terrains where fluvial terraces are poorly developed, we focused on 'circular abandoned channels', formed by meander cut-offs or river capture of an incised meandering river. We studied about 1,000 circular abandoned channels distributed throughout the Islands of Japan, and developed GIS database on circular abandoned channel in Japan. This database contains formation process, relative heights, degree of dissection and bedrocks of circular abandoned channels. Circular abandoned channels are distributed in inland mountainous terrains, where late Quaternary uplift rates are unknown, and indicate different relative heights along the same river. Relative heights tend to correlate with degree of dissection of the circular abandoned channels, which may indicate that degree of dissection correlate with ages of abandonment of circular abandoned channels. A CD-ROM is attached as an appendix. (J.P.N.)

  16. Hawaii Abandoned Vessel Inventory, French Frigate Shoals, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for French Frigate Shoals. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical destruction...

  17. Hawaii Abandoned Vessel Inventory, Pearl & Hermes Atoll, NWHI

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Abandoned Vessel Project Data for , Pearl & Hermes, Atoll, NWHI. Abandoned vessels pose a significant threat to the NOAA Trust resources through physical...

  18. Quarries - QUARRIES_ABANDONED_IN: Abandoned Quarries in Indiana (Indiana Geological Survey, Point Shapefile)

    NSGIC GIS Inventory (aka Ramona) — QUARRIES_ABANDONED_IN was derived from a comma-delimited text file named "QUALOC.TXT" contained on the following CD-ROM publication: Hasenmueller, W.A., and Ault,...

  19. Nurses' Attitudes and Knowledge of Their Roles in Newborn Abandonment

    Cesario, Sandra K.

    2003-01-01

    The practice of abandoning newborns shortly after birth has always existed. Occurring in primitive and contemporary societies, the motivations for newborn abandonment are varied and dependent upon the social norms of a specific geographic region at a given point in time. Because the desire to abandon an infant has had no support system in American society, such unwanted infants have been abandoned in a manner leading to their deaths. In response, many states have passed safe-haven legislation...

  20. Working Models about Mother-Child Relationships in Abandoned Children.

    Garcia-Torres, Belen; Guerrero, Pilar Garcia-Calvo

    2000-01-01

    Sixty abandoned and 36 non-abandoned school-aged children were told six short stories about mother-child relationships. Abandoned children showed less positive affect attribution to the mother, more compliant behavior in the child, and more justification of the mother when her behaviors were unfair. (Contains references.) (Author/CR)

  1. 30 CFR 256.56 - Lease-specific abandonment accounts.

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Lease-specific abandonment accounts. 256.56... OF SULPHUR OR OIL AND GAS IN THE OUTER CONTINENTAL SHELF Bonding § 256.56 Lease-specific abandonment accounts. (a) The Regional Director may authorize you to establish a lease-specific abandonment account...

  2. Radical prostatectomy - discharge

    ... prostatectomy - discharge; Laparoscopic radical prostatectomy - discharge; LRP - discharge; Robotic-assisted laparoscopic prostatectomy - discharge ; RALP - discharge; Pelvic lymphadenectomy - ...

  3. Can We Be Less Radical with Surgery for Early Cervical Cancer?

    Macdonald, Madeleine C; Tidy, John A

    2016-03-01

    Although a rare cancer in the developed world due to the success of cervical screening programmes, cervical cancer remains one of the most common cancers diagnosed in women under the age of 35 years old. Radical hysterectomy and more recently radical trachelectomy have been highly effective in curing the majority of women with early stage disease. Many, however, are left with long-term 'survivorship' issues including bowel, bladder and sexual dysfunction. In view of these chronic co-morbidities, many clinicians now consider whether a less radical approach to surgery may be an option for some women. This review focuses on the current evidence for the safety of conservative surgery for early stage cervical cancer with regard to cure rates in comparison to standard management, as well as any improvement in short and long-term morbidity associated with a more conservative approach. PMID:26838586

  4. Free radical inactivation of trypsin

    Reactivities of free radical oxidants, radical OH, Br2-anion radical and Cl3COO radical and a reductant, CO2-anion radical, with trypsin and reactive protein components were determined by pulse radiolysis of aqueous solutions at pH 7, 200C. Highly reactive free radicals, radical OH, Br2-anion radical and CO2-anion radical, react with trypsin at diffusion controlled rates. Moderately reactive trichloroperoxy radical, k(Cl3COO radical + trypsin) preferentially oxidizes histidine residues. The efficiency of inactivation of trypsin by free radicals is inversely proportional to their reactivity. The yields of inactivation of trypsin by radical OH, Br2-anion radical and CO2-anion radical are low, G(inactivation) = 0.6-0.8, which corresponds to ∼ 10% of the initially produced radicals. In contrast, Cl3COO radical inactivates trypsin with ∼ 50% efficiency, i.e. G(inactivation) = 3.2. (author)

  5. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    BACKGROUND: Uterine fibroids are benign tumors seen in 20-40% of women of childbearing age, and these fibroids are usually treated by hysterectomy. During the last decade, embolization of the uterine arteries with polyvinyl alcohol microparticles has become an alternative treatment. PURPOSE: To...

  6. Prophylactic antibiotics for hysterectomy and cesarean section: amoxicillin-clavulanic acid versus cefazolin

    Jyoti Malik

    2016-04-01

    Conclusions: Broad spectrum amoxicillin-clavulanic acid was not superior to cefazolin in prevention of post-operative infection when given as prophylaxis in hysterectomy and elective cesarean section. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 980-983

  7. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  8. Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

    Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

    2011-01-01

    The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach. PMID:22442528

  9. Peripartum hysterectomy in the first decade of the 21st century.

    Tadesse, W

    2012-02-01

    We reviewed the role of peripartum hysterectomy (PH) in the first decade of the 21st century. The study was confined to women who delivered a baby weighing 500 g or more between 2000 and 2009, and who required a hysterectomy within 72 h of delivery for obstetric reasons. Individual case records were reviewed. There were 19 cases of PH in 78,961 deliveries giving an incidence of 1 in 4,156 (0.02%). Of the 19 cases, 95% were delivered by caesarean section and 89% had one or more prior sections. The indications were placental bed pathology (79%), uterine atony (16%) and uterine trauma (5%). Of the 19 hysterectomies, 16 (84%) were total and a gynaecological oncologist was involved in nine (56%) of these cases. There were no maternal or fetal deaths, but a mother required an average blood transfusion of 10 units. The overall rate of PH was remarkably low compared with other studies but it is likely to increase in the future because of the strong association between increasing caesarean section rates and placental bed pathology. The potential involvement of the cervix and other pelvic structures by placental pathology means that PH in the future will be more challenging, and the hysterectomy will need to be total rather than subtotal.

  10. Perioperative use of etoricoxib reduces pain and opioid side-effects after total abdominal hysterectomy

    Viscusi, Eugene R; Frenkl, Tara L; Hartrick, Craig T;

    2012-01-01

    -blind, placebo-controlled, randomized clinical trial, we evaluated postoperative pain following total abdominal hysterectomy over 5 days in patients receiving placebo or etoricoxib administered 90 min prior to surgery and continuing postoperatively. Patients were randomly assigned to receive either placebo (n...