Gynaecological Endoscopy最新文献

{"title":"Endometrial destruction by thermal coagulation: evaluation of a new form of treatment for menorrhagia","authors":"Britt Friberg,&nbsp;Bertil R. R. Persson,&nbsp;Roger Willén,&nbsp;Mats Ahlgren","doi":"10.1046/j.1365-2508.1998.00157.x","DOIUrl":"https://doi.org/10.1046/j.1365-2508.1998.00157.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To report the first clinical evaluation of a new balloon endometrial, thermal destruction system Cavaterm^TM, for outpatient treatment of menorrhagia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>To elucidate possible technical problems during treatment, to evaluate how the patients tolerated the treatment and to judge which patients were suitable for this form of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Measurements of bleeding volumes in pads and tampons before and after treatment were performed as well as subjective evaluation by bleeding charts. Patients also estimated their degree of satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Gynaecology department at a university hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects</h3>\u0000 \u0000 <p>36 patients under 52 years of age with menorrhagia, without suspicion of intracavitary pathology including malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No procedure-related complications occurred. The patients tolerated the treatment well. There was a significant reduction in measured bleeding volumes in pads and tampons, collected during one menstruation, 2–7 months after treatment compared with measurements before treatment. Four patients subsequently underwent hysterectomy and should not have been included in the study (two with pedunculated myoma and one with a septum; the fourth showed premalignant endometrial changes in the curettage preceding the treatment). At 18–28-month follow up, 29 of the suitable patients (91%) reported a significant reduction in bleeding and another three patients reported reduced but still profuse bleeding compared with pretreatment; 88% (28/32) rated the treatment results as excellent, and a further 9% (3/32) as good.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found the Cavaterm^TM system for endometrial destruction to be safe, efficient and easy to use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 2","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2008-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00157.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91819956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forthcoming Events","authors":"","doi":"10.1046/j.1365-2508.2000.009006419.x","DOIUrl":"https://doi.org/10.1046/j.1365-2508.2000.009006419.x","url":null,"abstract":"","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"9 6","pages":"419-421"},"PeriodicalIF":0.0,"publicationDate":"2008-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109166690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear cell carcinoma arising in an endometrial polyp","authors":"Amelia Maltez,&nbsp;Hugo Maia,&nbsp;Maita C. Oliveira,&nbsp;Dilson Marques,&nbsp;Elsimar M. Coutinho","doi":"10.1046/j.1365-2508.1998.00148.x","DOIUrl":"10.1046/j.1365-2508.1998.00148.x","url":null,"abstract":"<p>This paper describes the appearance of a clear cell carcinoma in an endometrial polyp of an 80-year-old patient. The transition between benign and malignant tissue in the polyp was abrupt and did not involve the presence of atypical hyperplasia. Overexpression of p53 protein was detected in the tumour but not in the benign tissue. There was a lack of oestrogen receptors in the clear cell carcinoma but not in the polyp.</p>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"51-53"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00148.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81993541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic vs. laparotomic ovarian cystectomy in reproductive age women: an economic evaluation","authors":"Damiani MD,&nbsp; Campo MD,&nbsp; Dargenio MD,&nbsp; Garcea MD","doi":"10.1046/j.1365-2508.1998.00135.x","DOIUrl":"10.1046/j.1365-2508.1998.00135.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study was carried out to assess both the efficacy and the economic advantages of two different surgical techniques in the treatment of ovarian cysts in women of reproductive age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A prospective randomized clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Endocrinological Gynaecology Department of the Catholic University of S. Cuore, Rome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects</h3>\u0000 \u0000 <p>These were 68 women of reproductive age (16–39 years) who were hospitalized for ovarian cysts which had persisted for at least 3 months, or who were noted to have an increase in ovarian volume detected by consecutive ultrasound investigations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Of these patients, 34 received laparotomic treatment using a Pfannewstiel incision and traditional techniques. The other 34 patients underwent a laparoscopic stripping of the capsule of the cyst with no sutures on the ovary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The two techniques showed similar levels of safety and efficacy. The comparison of direct and indirect costs for the two procedures showed an average total cost of $4940 for laparotomic surgery and $3543 for laparoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study demonstrates that ovarian cysts can be as well treated using laparoscopic access as with laparotomy, but with an average cost reduction of 28% for the former.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00135.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78814214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between medical treatment by GnRH analogue (goserelin) and conservative surgery by laparoscopic diathermy for the management of endometriosis","authors":"Mohamed A. Hefni,&nbsp;Ade Apoola,&nbsp; Omran","doi":"10.1046/j.1365-2508.1998.00154.x","DOIUrl":"10.1046/j.1365-2508.1998.00154.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the effectiveness of medical treatment of endometriosis with conservative surgical treatment, either alone or combined with medical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Case-controlled, prospective observational clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Gynaecology Department at Benenden Hospital, Kent, UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>98 women proven laparoscopically to have endometriosis which was staged using the Revised American Fertility Society Classification (rAFS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>The first group underwent medical treatment with the GnRH analogue, goserelin (3.6 mg depot) and the second group was treated using laparoscopic diathermy. Some members of the second group who had endometriomas and stage IV endometriosis (AFS classification) also had GnRH analogue in addition to laparoscopic diathermy. There was no statistically significant difference between the age, parity and severity of symptoms of the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Variations in patient-reported symptoms, physician-recorded clinical examination and in second-look laparoscopic findings, in each group, 6 months after treatment completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment with laparoscopic diathermy, either alone or in combination with GnRH analogue, was associated with a significantly better outcome, as assessed by a self-report of marked improvement in symptom score or cure, compared with treatment with GnRH analogue alone (relative risk 2.36, 95% confidence interval (CI) 1.38–4.02). The surgical treatment group were also 2.52 times more likely to show either marked improvement or cure, as judged by clinical assessment, than the group of patients who received GnRH analogue alone (relative risk 2.52, 95% CI 1.54–4.14). There was an improvement or cure in 71% of patients in the surgical group, when assessed laparoscopically at follow up, compared with 49% in the medical group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results showed that patients with endometriosis receiving conservative surgery, either alone or in combination with GnRH analogue, were at least two times more likely to have either marked improvement or cure, as assessed by pati","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00154.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91435868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy following rollerball endometrial ablation","authors":"Opperman MRACOG,&nbsp; Browning FRCOG FRACOG,&nbsp; Child MRCOG FRACOG,&nbsp; Laverty MB BS FRCPA,&nbsp; Fraser MD FRACOG FRCOG","doi":"10.1046/j.1365-2508.1998.00143.x","DOIUrl":"10.1046/j.1365-2508.1998.00143.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To report a pregnancy occurring after rollerball endometrial ablation, and to review the literature in order to place this uncommon event in a clinical perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case report</h3>\u0000 \u0000 <p>An intrauterine pregnancy proceeded to a successful Caesarean delivery at term in a 43-year-old woman who conceived 33 months after a therapeutically effective rollerball endometrial ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> World perspective</h3>\u0000 \u0000 <p>Some 39 pregnancies following endometrial ablation have now been reported in the literature. Most (<i>n</i> = 27) of the known pregnancies have miscarried or been terminated. There has been one report of an ectopic pregnancy, and 11 pregnancies have proceeded beyond 20 weeks’ gestation. In the latter group the risk of obstetric complications is very high. Many pregnancies appear to have gone unreported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Complete removal of the endometrium and complete obliteration of the tubal ostia cannot be guaranteed, and thus concurrent tubal interruption or continued contraception need to be considered for women proceeding to endometrial ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00143.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85993404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new electrosurgical loop technique for laparoscopic supracervical hysterectomy","authors":"Jacques Dequesne,&nbsp;Norman Schmidt,&nbsp;René Frydman","doi":"10.1046/j.1365-2508.1988.00155.x","DOIUrl":"10.1046/j.1365-2508.1988.00155.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the reduction of operating time during supracervical laparoscopic hysterectomy using an electric loop.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Lausanne Endoscopic Center, Switzerland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects</h3>\u0000 \u0000 <p>30 women who underwent supracervical laparoscopic hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention</h3>\u0000 \u0000 <p>A new electric loop has been designed, to separate the uterus from the cervix more quickly, by faster cutting, during supracervical hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measure</h3>\u0000 \u0000 <p>The time taken to separate the uterus from the cervix.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The preliminary evaluation indicates a reduction of time of at least 80%. Another advantage is the clean cut, and no complications to adjacent organs have been observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The new loop allows an evident reduction of operating time during supracervical laparoscopic hysterectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1988.00155.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76867121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The swing of the pendulum for gynaecological endoscopic surgery","authors":"Michael P. Diamond MD","doi":"10.1046/j.1365-2508.1998.00152.x","DOIUrl":"10.1046/j.1365-2508.1998.00152.x","url":null,"abstract":"","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00152.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80831723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfall of the LASH technique: an unsuspected leiomyosarcoma removed after morcellation","authors":"Vincent Anaf,&nbsp;Philippe Simon,&nbsp;Isabelle Govaerts,&nbsp;Jean-Christophe Noël,&nbsp;Frédéric Rodesch","doi":"10.1046/j.1365-2508.1998.00147.x","DOIUrl":"10.1046/j.1365-2508.1998.00147.x","url":null,"abstract":"<p>Mesenchymal uterine tumours can mimic benign uterine tumours and are therefore often diagnosed postoperatively. We report the first case of intra-abdominally morcellated unsuspected leiomyosarcoma in the laparoscopic-assisted supracervical hysterectomy (LASH) technique. This article discusses the prevention of spillage and the inadequate oncologic management which are specific to this technique in case of leiomyosarcoma or stromal sarcoma.</p>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"47-49"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00147.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80078526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of β-hCG in cul-de-sac fluid vs. serum in the rapid detection of ectopic pregnancy","authors":"Jan Bosteels,&nbsp;Philippe Delattin,&nbsp;Jean Pierre Van Boxelaer,&nbsp;Marcel De Bruyn,&nbsp;Jan Moerman,&nbsp;Paul De Vos,&nbsp;Paul Vermylen","doi":"10.1046/j.1365-2508.1998.00153.x","DOIUrl":"10.1046/j.1365-2508.1998.00153.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study was designed to assess the value of measuring the cul-de-sac fluid to serum β-hCG ratio as a rapid test for the detection of ectopic pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measure</h3>\u0000 \u0000 <p>The parameter chosen was the level of the β-hCG in cul-de-sac fluid vs. that in serum (D/S ratio).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This prospective controlled hospital-based study included 53 patients. The control group was 25 patients, who were being treated with <i>in vitro</i> fertilization. Group A comprised 15 patients who had had an intra-uterine miscarriage, histologically proven after suction curettage. Group B included 13 patients treated by laparoscopy for a histologically proven ectopic pregnancy. In each group β-hCG was measured in both serum and cul-de-sac fluid and the appropriate D/S ratio was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the control group the mean D/S ratio was 0.49 (SEM = 0.03). The mean D/S ratio in group A was 0.78 (SEM = 0.14). In group B the mean D/S ratio was 8.47 (SEM = 2.53). The differences in D/S ratio between the control group and group A were statistically significant (<i>P</i> &lt; 0.05).The differences in D/S ratio between the control group and group B were statistically highly significant (<i>P</i> &lt; 0.00001). Of more interest is the fact that the difference in the D/S ratio between group A and group B was also statistically highly significant (<i>P</i> &lt; 0.0005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The D/S ratio for β-hCG can be used as a rapid and reliable biochemical test to distinguish between eutopic and ectopic implantation in the pathological pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"7 1","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"2008-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.1998.00153.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82161828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}