Facts Views and Vision in ObGyn最新文献_第10页

Uterine septum and reproductive outcome. From diagnosis to treatment. How, why, when? 子宫间隔与生殖结局。从诊断到治疗。如何，为什么，何时?

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.002

A. Daniilidis, P. Papandreou, G. Grimbizis

{"title":"Uterine septum and reproductive outcome. From diagnosis to treatment. How, why, when?","authors":"A. Daniilidis, P. Papandreou, G. Grimbizis","doi":"10.52054/FVVO.14.1.002","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.002","url":null,"abstract":"Background Septate uterus is a benign congenital malformation and represents the most common uterine anomaly in women with poor reproductive outcome. Objectives To review the available scientific data concerning the biological context of the intrauterine septum and the association with poor reproductive outcome, the best methods for diagnosis and treatment. Materials and methods From July 2020 to October 2020, we searched for relevant free full text articles in PubMed, written in English, and published from the 1st of January 2000 to 31st of July 2020. Main outcome measures Association of the pathophysiology of septate uterus with poor reproductive outcome, evaluation of the different classification systems, the accuracy of diagnostic methods and the efficacy of the available treatment options. Results 259 articles were screened, and 22 articles were finally included in our study. Many theories regarding the pathophysiology of this congenital anomaly and its’ association with reproductive problems have been proposed along the recent decades. Combination of diagnostic methods should be used to avoid misclassification of this congenital anomaly. Conclusions Lack of uniformity in the different classification systems makes the diagnosis of septate uterus challenging as there is no universally accepted definition. Data regarding the reproductive outcome of women with septate uterus are still limited, thus recommendations regarding optimal treatment of these women are biased. What is new? According to new insights regarding the pathophysiology of the uterine septum, differences in the underlying embryological defects are associated with changes in the histological composition and vascularisation of septa, as well as in clinical significance.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"31 - 36"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47869898","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}

引用次数: 0

The impact of COVID-19 on O&G trainees; where are we now? 新冠肺炎疫情对O&G学员的影响我们现在在哪里?

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.007

I. Duggan, R. Hablase, L. Beard, F. Odejinmi, R. Mallick

{"title":"The impact of COVID-19 on O&G trainees; where are we now?","authors":"I. Duggan, R. Hablase, L. Beard, F. Odejinmi, R. Mallick","doi":"10.52054/FVVO.14.1.007","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.007","url":null,"abstract":"Background and Objectives Obstetrics and Gynaecology (O&G) training continues to face challenges caused by the COVID-19 pandemic, particularly in gynaecological surgical training. This follow-up survey captures the ongoing effect on O&G trainees and highlights the future recovery plan considering the historical training gaps in benign gynaecology. Materials and Methods an anonymised survey was emailed to all O&G trainees in Kent, Surrey and Sussex (KSS). Responses were collected over 6 weeks. Main Outcome Measures and Results 53% of trainees responded. In total, 78% of trainees agreed that the pandemic had an ongoing negative effect on their physical and mental wellbeing respectively. Trainees felt the prior negative impact on obstetric training is improving, whilst 88% still experience a negative impact on their gynaecology surgical training despite the resumption of elective services in the National Health Service (NHS). 80% continue to feel the negative impact on their educational activities and 88% felt their overall training continues to be negatively impacted. 70% were positive that they would recover from this. Responses were representative of each training year. Interestingly, 95% of trainees had accepted the COVID vaccine. Conclusion despite “restoration” of normal services, the negative impact on trainees particularly benign gynaecology surgical training continues. Addressing pre-pandemic training gaps whilst tackling the surgical back- log and the needs of service provision will continue for years to follow. What is new? Future training needs to incorporate creative ways of acquiring surgical skills. It is imperative to imbed simulation training into O&G training programmes. Pastoral support is key to ensure trainees’ mental and physical well-being are prioritised and the already high burn-out rates do not worsen.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"69 - 75"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48066198","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}

引用次数: 3

Reproductive performance following hysteroscopic treatment of intrauterine adhesions: single surgeon data 宫腔镜治疗宫内粘连后的生殖性能:单个外科医生的数据

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.005

L. S. Direk, M. Salman, A. Alchami, E. Sarıdoğan

{"title":"Reproductive performance following hysteroscopic treatment of intrauterine adhesions: single surgeon data","authors":"L. S. Direk, M. Salman, A. Alchami, E. Sarıdoğan","doi":"10.52054/FVVO.14.1.005","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.005","url":null,"abstract":"Background Intrauterine adhesions can negatively affect reproductive outcomes by causing infertility, miscarriage and preterm birth in women. Hysteroscopic surgery is now widely accepted as the treatment of choice in symptomatic women to restore reproductive function. Objectives To analyse the patient characteristics and long-term reproductive outcomes of women who received treatment for intrauterine adhesions under the care of a single surgeon. Materials and Methods In this retrospective analysis, all women who underwent hysteroscopic surgery for intrauterine adhesions under the care of the same surgeon between January 2001 and December 2019 were identified and their data were evaluated. Relevant demographic, diagnostic and reproductive outcome data was procured from patient notes. Referring doctors and patients were contacted to obtain missing information. Main outcome measures Live birth and miscarriage rates. Results 126 women were treated for intrauterine adhesions. Of those women who were trying to conceive, 71.4% (65/91) achieved pregnancy, 58.2% (53/91) had live births and 13.2% (12/91) had miscarriages. No statistically significant difference was found in the live birth rates when data was analysed in subgroups based on age, reason for referral/aetiology and severity of pathology. Conclusions Hysteroscopic surgery leads to live birth in the majority of women with intrauterine adhesions. The lack of statistically significant difference in live birth rates across subgroups, including advanced age and severe pathology, suggests that surgery in all women wanting to conceive can be justified. What is new? Hysteroscopic treatment can lead to successful outcomes even in the presence of severe adhesions and in older women with appropriate treatment.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"51 - 58"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41354756","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}

引用次数: 0

Infantile or hypoplastic uterus? A proposal for a modification to the ESHRE/ESGE classification of female genital tract congenital abnormalities 婴儿子宫还是发育不全子宫?修改女性生殖道先天性异常ESHRE/ESGE分类的建议

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Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.004

T. Küçük, B. Ata

引用次数: 0

The first European gynaecological procedure with the new surgical robot Hugo™ RAS. A total hysterectomy and salpingo-oophorectomy in a woman affected by BRCA-1 mutation 欧洲首个使用新型手术机器人Hugo™RAS的妇科手术。1例BRCA-1突变患者行全子宫切除和输卵管卵巢切除术

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.014

G. Monterossi, L. Pedone Anchora, S. Gueli Alletti, A. Fagotti, F. Fanfani, G. Scambia

{"title":"The first European gynaecological procedure with the new surgical robot Hugo™ RAS. A total hysterectomy and salpingo-oophorectomy in a woman affected by BRCA-1 mutation","authors":"G. Monterossi, L. Pedone Anchora, S. Gueli Alletti, A. Fagotti, F. Fanfani, G. Scambia","doi":"10.52054/FVVO.14.1.014","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.014","url":null,"abstract":"Background The benefits of minimally invasive surgery are well known in gynaecology. Robotic-assisted surgery has gained widespread acceptance within the surgical community and seems to be the most rapidly developing sector of minimally invasive surgery. Objectives This video shows the salient steps of total hysterectomy with new robotic technology, Hugo™ RAS. The objectives were to introduce and demonstrate the feasibility, efficacy, and safety of this new advanced device. Materials and Methods A sixty-two years-old woman affected by BRCA-1 mutation underwent the first European gynaecological surgical procedure using the new surgical robot Hugo™ RAS in the Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Main outcome measures Docking and operative times. Results The docking time was 6 minutes and the total operative time was 58 minutes. There were no system errors and faults in the robotic arms. The surgeon found no friction or rasping in the arms. The estimated blood loss was 30 mL. No intraoperative complications were recorded. Conclusion Gynaecological surgery with Hugo™ RAS seems feasible, safe and effective as shown by initial experiences in urological surgery. A larger case series would confirm the current experience and determine whether this technology could offer any additional benefit.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"91 - 94"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47628477","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}

引用次数: 13

Intrauterine Bigatti Shaver (IBS®) successful placental remnants removal, after caesarean section for a cervical pregnancy with placenta accreta 宫内Bigatti剃须刀(IBS®)成功清除胎盘残余，剖腹产后宫颈妊娠伴有胎盘增生

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.010

J. Shi, Y. Zhang, S. Zhang, X. Yin, D. An, J. Zhang, J. Cheng, Y. Wang, A. Zhao, W. Di, R. Campo, G. Bigatti

引用次数: 0

Total surgical time in laparoscopic supracervical hysterectomy with laparoscopic in-bag-morcellation compared to laparoscopic supracervical hysterectomy with uncontained morcellation 腹腔镜宫颈上子宫切除术的总手术时间与腹腔镜宫颈上子宫切除术的总手术时间比较

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.006

H. Krentel, G. Tchartchian, L. A. Torres de la Roche, R. D. De Wilde

{"title":"Total surgical time in laparoscopic supracervical hysterectomy with laparoscopic in-bag-morcellation compared to laparoscopic supracervical hysterectomy with uncontained morcellation","authors":"H. Krentel, G. Tchartchian, L. A. Torres de la Roche, R. D. De Wilde","doi":"10.52054/FVVO.14.1.006","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.006","url":null,"abstract":"Background A possible solution to the problem of cell dissemination through laparoscopic uncontained morcellation during laparoscopic supracervical hysterectomy (LASH) is the use of laparoscopic in-bag morcellation. One criticism regarding the use of in-bag morcellation is the additional surgical time associated with this procedure. Objectives In this retrospective study we compared the total surgical time in LASH with laparoscopic in-bag morcellation (107 cases from 2016-2018) and LASH with uncontained morcellation (47 cases from 2015-2017). Materials and Methods All surgeries were performed in the same department of minimally invasive gynaecological surgery by a total of three experienced surgeons for the indication of bleeding disorder and / or dysmenorrhea. Main outcome measures We measured and compared total surgical time, surgical outcome, blood loss and complications in LASH with in-bag morcellation and with uncontained morcellation. Results Total surgical time in both procedures do not show a significant difference. Considering the learning curve in laparoscopic bag use, the total surgical time in LASH with laparoscopic in-bag morcellation is shorter than total surgical time in LASH with uncontained morcellation. Laparoscopic in-bag morcellation consumes time for bag use and handling, but saves time as it eliminates the need for meticulous sampling of lost tissue fragments and the complex lavage of the peritoneal cavity after morcellation. There is no difference between both groups in terms of blood loss, complications and surgical results. Conclusion/What is new? We conclude that LASH with in-bag morcellation is not related to additional surgical time when compared to LASH with uncontained morcellation.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"59 - 68"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41797327","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}

引用次数: 1

Clomiphene citrate stimulated cycles – additional gonadotrophin stimulation increases endometrium thickness without increasing implantation rate 克罗米芬柠檬酸盐刺激周期-额外的促性腺激素刺激增加子宫内膜厚度而不增加植入率

IF 2

Facts Views and Vision in ObGyn Pub Date : 2022-03-01 DOI: 10.52054/FVVO.14.1.013

I. Magaton, A. Helmer, M. Roumet, P. Stute, M. von Wolff

{"title":"Clomiphene citrate stimulated cycles – additional gonadotrophin stimulation increases endometrium thickness without increasing implantation rate","authors":"I. Magaton, A. Helmer, M. Roumet, P. Stute, M. von Wolff","doi":"10.52054/FVVO.14.1.013","DOIUrl":"https://doi.org/10.52054/FVVO.14.1.013","url":null,"abstract":"It is known that Clomiphene citrate (CC) reduces endometrial thickness, but it is unknown if additional gonadotrophin stimulation increases endometrial thickness and if this has an effect on implantation rate in in vitro fertilization (IVF). The retrospective study included 263 minimal stimulation IVF-cycles stimulated with 25 mg CC per day (CC- IVF), and 161 IVF-cycles stimulated with CC plus 75IU hMG (human Menopausal Gonadotrophin) per day (CC/ hMG-IVF). Endometrial and oestradiol (E2) measurements were analysed between day -4 and 0 (0 = day of oocyte retrieval) and the association of endometrial thickness and treatment on implantation rates were studied after multiple adjustments. It was shown that on day 0, endometrium was significantly thicker in CC/hMG-IVF versus CC-IVF cycles (9.81 ±2.68 versus 9.06 ±2.54 mm, p = 0.005). However, increased endometrial thickness did not have an effect on implantation and live birth rates. In conclusion, gonadotrophins should not be added to low dose CC treated IVF cycles just to increase endometrial thickness as increased endometrial thickness does not increase implantation rate.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"77 - 81"},"PeriodicalIF":2.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47351910","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}

引用次数: 0

Impact of the COVID-19 pandemic on surgery for severe endometriosis in the UK: a national database study COVID-19大流行对英国严重子宫内膜异位症手术的影响:一项国家数据库研究

IF 2

Facts Views and Vision in ObGyn Pub Date : 2021-09-25 DOI: 10.22541/au.163256909.93155355/v1

J. Lewin, E. Sarıdoğan, D. Byrne, T. J. Clark, A. Vashisht

{"title":"Impact of the COVID-19 pandemic on surgery for severe endometriosis in the UK: a national database study","authors":"J. Lewin, E. Sarıdoğan, D. Byrne, T. J. Clark, A. Vashisht","doi":"10.22541/au.163256909.93155355/v1","DOIUrl":"https://doi.org/10.22541/au.163256909.93155355/v1","url":null,"abstract":"Background The COVID-19 pandemic has had a significant effect on healthcare services, particularly affecting patients who suffer from chronic conditions. However, the pandemic’s effect on endometriosis surgery is not yet known. Objectives To determine the impact of the COVID-19 pandemic on surgery for severe endometriosis in the UK at a national, regional and centre-level. Materials and Methods The British Society for Gynaecological Endoscopy (BSGE) collects data nationally on all operations for severe endometriosis which involve dissection of the pararectal space. Annual audits of this database were obtained from the BSGE. Publicly available data on COVID-19 cases and population were obtained from the UK Office for National Statistics. Main outcome measures Numbers of annual BSGE-registered endometriosis operations. Results A total of 8204 operations were performed. The number of operations decreased by 49.4% between 2019 and 2020 and then increased in 2021, but remained 10.5% below average pre-pandemic levels, indicating at least 980 missed operations between 2019-2020. Median operations per centre decreased by 51.0% in 2020 (IQR 29.4% – 75.0%) and increased in 2021 but remained 33% below pre-pandemic levels. There was no change in the type of surgery performed. All 11 administrative regions of Great Britain had reduced numbers of operations in 2020 compared with the average for 2017-2019, with a median 44.2% decrease (range 13.3% - 67.5%). Regional reduction in operations was correlated with COVID-19 infection rates (r=0.54, 95% CI of r 0.022 – 1.00, p=0.043). Conclusion The number of operations performed annually in the UK for severe endometriosis fell dramatically during the COVID-19 pandemic and is yet to normalise. What's new? This study shows the dramatic effect that the COVID-19 pandemic has had on UK services for endometriosis surgery, which may continue to affect patients and clinicians for a considerable time to come.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"14 1","pages":"309 - 315"},"PeriodicalIF":2.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44777428","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}

引用次数: 0

New approach for T-shaped uterus: Metroplasty with resection of lateral fibromuscular tissue using a 15 Fr miniresectoscope. A step-by-step technique. t型子宫的新方法:15fr微型切除术镜下子宫成形术切除外侧纤维肌肉组织。一步一步的技巧。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2021-03-31 DOI: 10.52054/FVVO.13.003

U. Catena, R. Campo, G. Bolomini, M. Moruzzi, V. Verdecchia, F. Nardelli, I. Romito, F. Camolo, V. L. Manna, M. Ianieri, G. Scambia, A. Testa

{"title":"New approach for T-shaped uterus: Metroplasty with resection of lateral fibromuscular tissue using a 15 Fr miniresectoscope. A step-by-step technique.","authors":"U. Catena, R. Campo, G. Bolomini, M. Moruzzi, V. Verdecchia, F. Nardelli, I. Romito, F. Camolo, V. L. Manna, M. Ianieri, G. Scambia, A. Testa","doi":"10.52054/FVVO.13.003","DOIUrl":"https://doi.org/10.52054/FVVO.13.003","url":null,"abstract":"T-shaped uterus is a congenital uterine malformation (CUM), only recently defined by the ESGE ESHRE classification as Class U1a. The uterus is characterised by a narrow uterine cavity due to thickened lateral walls with a correlation 2/3 uterine corpus and 1/3 cervix (Grimbizis et al, 2013). Although the significance of this dysmorphic malformation on reproductive performance has been questioned, recent studies reported significant improvement of life birth rates after surgical correction in patients with failed in-vitro fertilisation (IVF) or recurrent miscarriage (Ferro et al, 2018; Di Spiezio Sardo et al, 2020; Alonso Pacheco et al. 2019). The classical surgical technique to treat a T-shaped uterus is by performing a sidewall incision with the micro scissor or bipolar needle, resulting in a triangular cavity. \u0000In this video article, we describe a new surgical technique with a step-by-step method combining three-dimensional ultrasound (3D-US) and hysteroscopic metroplasty in an office setting, using a 15 Fr office resectoscope (Karl Storz, Tuttlingen, Germany), to treat a T-shaped uterus by resecting the lateral fibromuscular tissue of the uterine walls. No complications occurred and the postoperative hysteroscopy showed a triangular and symmetrical uterine cavity without any adhesions.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"13 1","pages":"67-71"},"PeriodicalIF":2.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45831314","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}

引用次数: 1