Taiwanese Journal of Obstetrics & Gynecology最新文献

{"title":"Fertility outcomes after conservative versus radical surgery in moderate to severe endometriosis with deep endometriosis","authors":"Hsin-Mei Liu ,&nbsp;Shang-Min Liu ,&nbsp;Pei-Shan Lee ,&nbsp;Tanvi Desai ,&nbsp;Kuan-Gen Huang ,&nbsp;Chyi-Long Lee","doi":"10.1016/j.tjog.2025.08.007","DOIUrl":"10.1016/j.tjog.2025.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>Does laparoscopic radical excision of deep endometriosis (DE) and enucleation of endometrioma improve fertility outcomes and reduce recurrence rates in patients with moderate to severe endometriosis?</div></div><div><h3>Methods and results</h3><div>All patients (n = 77) with moderate to severe endometriosis and DE underwent either partial or radical excision as part of their treatment. Patients were divided into two groups. Group 1 (conservative treatment, n = 22) underwent laparoscopic enucleation of endometrioma and ablation of DE. Group 2 (radical excision, n = 55) underwent laparoscopic enucleation of endometrioma with radical excision of extra-ovarian endometriosis. Group 2 showed significantly higher surgical complexity, higher revised American Fertility Society classification scores, a more severe form of endometriosis, multiple endometriotic lesion sites, and longer surgical time. Group 2 also tended to have a higher pregnancy rate (84 % vs. 67 %, p = .56) and live birth rate (80 % vs. 67 %, p = .59). In stage IV endometriosis cases, Group 2 showed significantly reduced recurrence (9 % vs. 50 %, p = .04). Overall recurrence rates were not significantly different between groups (HR = 1.90, 95 % CI: 0.47–7.59, p = 0.37). Radical surgery was associated with significantly higher cumulative pregnancy rates and a shorter median time to pregnancy (38.7 vs. 49.5 months). Cox regression showed a 3.75-fold increased likelihood of pregnancy after radical surgery (HR = 3.75, 95 % CI: 1.25–11.29, p = 0.01).</div></div><div><h3>Conclusion</h3><div>The group that underwent laparoscopic radical excision resulted in more complex surgeries and was associated with significantly improved fertility outcomes, while recurrence rates were comparable between radical and conservative surgery, particularly in Stage IV disease. Radical surgery is advisable to limit disease progression and ensure complete symptom resolution. Additionally, the laparoscopic radical excision group had a higher rate of natural conception, indicating benefits for fertility in patients with moderate to severe endometriosis with DE. This study also confirmed significantly higher cumulative pregnancy rates and a shorter median time to pregnancy, with a 3.75-fold increase in the likelihood of conception following radical excision of deep endometriosis.</div></div><div><h3>Trial registration number</h3><div>None.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 265-270"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the margins to the mainstream: The quiet force in innovation of minimally invasive therapy","authors":"Chyi-Long Lee","doi":"10.1016/j.tjog.2025.06.007","DOIUrl":"10.1016/j.tjog.2025.06.007","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 177-178"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating advanced technology, artificial intelligence, and medical ethics in surgical training: Lessons from the evolution of minimally invasive gynecologic oncology","authors":"Chyi-Long Lee","doi":"10.1016/j.tjog.2025.12.005","DOIUrl":"10.1016/j.tjog.2025.12.005","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 175-176"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the symptoms of dysmenorrhea and menorrhagia of women with adenomyosis and myoma in short- and long-term treatment effectiveness of microwave ablation: A systematic review and meta-analysis","authors":"Altangerel Otgontuya ,&nbsp;Cherng-Jye Jeng ,&nbsp;Linus T. Chuang ,&nbsp;Jenta Shen","doi":"10.1016/j.tjog.2025.05.023","DOIUrl":"10.1016/j.tjog.2025.05.023","url":null,"abstract":"<div><div>To identify improvement of symptoms of dysmenorrhea and menorrhagia of women who underwent treatment of Microwave ablation for adenomyosis and myoma. 463 articles were searched; 15 were included in the qualitative systematic review, and 13 were quantitively included in the meta-analysis and searched from TAYLOR FRANCIS, SCIENCE DIRECT, COCHRANE LIBRARY, WILLEY ONLINE LIBRARY, PUBMED. A total of 1123 of 652 women were diagnosed with adenomyosis, and 471 women were diagnosed with myoma. Studies were analyzed by pooling the weighted mean difference (WMD) with the 95 % CI in terms of study provided as a mean + (SD) and pooled results assessed with a random effect. Heterogeneity was evaluated using the I2 statistic. Visual analog scale (VAS) score and symptom severity scores (SSS) for adenomyosis was compared to post-microwave ablation (MWA) at 3,6, and 12 months showed significantly different heterogeneity with all statistically significant improved. Health-related quality of Life (HRQL) for adenomyosis were compared to post-MWA at 3,6, and 12 months showed significant improved. Hemoglobin (Hb) level for adenomyosis was compared to post-MWA at 3,6, and 12 months showed significantly different heterogeneity with all statistically significant increased the level of Hb. Hb level for myoma was compared to post-MWA and showed significantly different heterogeneity with no statistically significance. Myoma volumes were compared to post-MWA and showed significantly different heterogeneity with statistically significant reduced. Microwave ablation (MWA) is an effective and safe treatment for women with both adenomyosis and myoma in short- and long-term treatment and significantly improved symptoms and quality of life.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 188-197"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlapping shadows of OHSS and ovarian cancer: A call for refined diagnostic algorithms","authors":"Mishu Mangla","doi":"10.1016/j.tjog.2025.12.012","DOIUrl":"10.1016/j.tjog.2025.12.012","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Page 397"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up of a 3-year-and-2-month-old girl with a prenatal history of mosaic trisomy 18 at amniocentesis","authors":"Chih-Ping Chen","doi":"10.1016/j.tjog.2026.01.009","DOIUrl":"10.1016/j.tjog.2026.01.009","url":null,"abstract":"","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 362-363"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High frequency of BRAF mutations and concomitant KRAS mutations in Taiwanese ovarian clear cell carcinoma","authors":"Huang-Pin Shen ,&nbsp;Ming-Yung Lee ,&nbsp;Wan-Ru Chao ,&nbsp;Yi-Ju Lee ,&nbsp;Gwo-Tarng Sheu ,&nbsp;Pi-Chieh Wang ,&nbsp;Chi-Kuan Chen ,&nbsp;Chih-Ping Han","doi":"10.1016/j.tjog.2024.12.036","DOIUrl":"10.1016/j.tjog.2024.12.036","url":null,"abstract":"<div><h3>Objectives</h3><div>Given encouraging clinical evidence of BRAF inhibitors for melanoma, etc., we investigated BRAF mutation status in ovarian clear cell carcinoma (OCCC) from Taiwanese women and assessed the association of BRAF mutation with KRAS mutation.</div></div><div><h3>Materials and Methods</h3><div>DNA was extracted from microdissected tissue samples and analyzed for <em>BRAF</em> mutations in exon 15, around the activation segment (AS), using a highly sensitive BRAF mutant enrichment kit (FemtoPath®) with Sanger sequencing.</div></div><div><h3>Results</h3><div>All 17 OCCC cases were evaluated. 16 (94.12 %) harbored BRAF missense mutations, categorized as Class I – p.V600M (n = 3); Class II - p.A598V (n = 8), p.T599I (n = 10); Class III - none; and unclassified (UC) variants – p.A598T (n = 1), p.A598I (n = 1), p.S602A (n = 1), p.S602F (n = 7). These mutations occurred as single-point (n = 6), double-point (n = 5), or triple-point (n = 5) mutations. The most frequent mutation observed was p.T599I (n = 10), followed by p.A598V (n = 8) and p.S602F (n = 7). The p.A598I, p.S602A, and p.S602F are novel BRAF alterations. Merging our previous KRAS data, we found that concurrent KRAS and BRAF mutations in 11 of 17 cases (64.71 %) suggest a possible synergistic effect in OCCC tumorigenesis.</div></div><div><h3>Conclusions</h3><div>Activating BRAF mutations are common in OCCC in Ascian Taiwanese, with p.T599I most prevalent. This suggests the potential for reduced response to current BRAF V600 inhibitors but possible sensitivity to dual BRAF/MEK or MEK inhibitors, other multi-targeted approaches, and new avenues for cancer immunotherapy. Further studies are encouraged to investigate the clinical benefits of these approaches for advanced OCCC with various BRAF mutation classes.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 232-240"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal management of intracervical-type varices without placenta previa","authors":"Rika Iseki ,&nbsp;Machiko Kojima ,&nbsp;Haruka Mieda ,&nbsp;Miki Ohtsuki ,&nbsp;Shihori Nakamura ,&nbsp;Kota Yamauchi ,&nbsp;Aya Takaori ,&nbsp;Natsumi Iwai ,&nbsp;Eri Kawai ,&nbsp;Ayako Moribe ,&nbsp;Yuki Kozono ,&nbsp;Akiko Okuda ,&nbsp;Yumiko Yoshioka ,&nbsp;Shigeto Kubo ,&nbsp;Toshihiro Higuchi ,&nbsp;Akihito Horie","doi":"10.1016/j.tjog.2025.12.006","DOIUrl":"10.1016/j.tjog.2025.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>Intracervical-type varices, dilated venous structures extending from the lower uterine segment to the cervix, are sometimes observed on transvaginal ultrasonography and magnetic resonance imaging (MRI). This study aimed to evaluate the anatomical and clinical significance of these imaging findings and propose appropriate management strategies based on the results.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis of 43 patients with intracervical-type varices diagnosed using MRI at our institution between 2019 and 2023 was conducted, excluding those with abnormal placental positioning. Maternal characteristics, bleeding patterns, delivery outcomes, hemostatic interventions, and transfusion requirements were assessed.</div></div><div><h3>Results</h3><div>Spontaneous resolution occurred in two patients. Of the remaining 41, severe hemorrhage occurred in 20 (48.8 %) during delivery. Four planned vaginal deliveries required emergency cesarean sections due to antenatal bleeding. Among 16 cesarean deliveries, 10 (62.5 %) experienced blood loss exceeding 1,500 mL (mean: 2,339 ± 1,027 mL). Among 25 vaginal deliveries, 10 (40 %) exceeded 800 mL blood loss (mean: 2,035 ± 1,215 mL), with six spontaneous vaginal deliveries exceeding 1,000 mL, all requiring transfusion.</div></div><div><h3>Conclusion</h3><div>Intracervical-type varices, identifiable using transvaginal ultrasonography and MRI, pose a significant risk of antenatal bleeding and severe intrapartum hemorrhage. Anticipatory management, including autologous blood storage and tailor delivery planning, is crucial for optimizing maternal outcomes.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 312-320"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can callosal angle (CA), anterior callosal angle (ACA), and Evans index be used as parameters to predict postnatal outcomes in fetuses with ventriculomegaly","authors":"Hasan Süt ,&nbsp;Seda Kaynak Şahap ,&nbsp;Batuhan Turgay ,&nbsp;Gülşah Aynaoğlu Yıldız","doi":"10.1016/j.tjog.2025.10.006","DOIUrl":"10.1016/j.tjog.2025.10.006","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the efficacy of the callosal angle (CA), the anterior callosal angle (ACA) and the Evans Index in predicting poor prognosis in fetuses with cranial ventriculomegaly (VM) and contribute these parameters to the current literature.</div></div><div><h3>Materials and methods</h3><div>This study is a retrospective cross-sectional analysis of patients with fetal cranial VM. Fetal MRI was used to determine axial and coronal VP (posterior diameter of the lateral ventricle), ACA, CA, and Evans Index values. The antenatal and postnatal outcomes of VM were determined. The factors that predict a poor prognosis were calculated.</div></div><div><h3>Results</h3><div>The analysis included 39 cases of fetal VM. The fetuses were divided into the following categories: mild VM (59 %), moderate VM (18 %), and severe VM (23 %). Severe VM (p = 0.042; OR: 6.04 (95 % CI: 1.06–34.37)) and additional anomalies (p &lt; 0.001; OR: 33.25 (95 % CI:5.32–207.77)) most significantly elevate the risk of a poor prognosis. A moderately significant correlation was observed between VP length and Evans Index (r = 0.471, p = 0.002), but not with CA and ACA (p = 0.967, p = 0.448, respectively). In predicting postnatal ventriculo-peritoneal shunt, severe VM, additional anomalies, and an increased Evans index antenatally were statistically significant (p &lt; 0.001, p = 0.018, p = 0.041). There is no effect for ACA and CA (p = 0.1, p = 0.5, respectively).</div></div><div><h3>Conclusion</h3><div>The detection of fetal VM during antenatal ultrasonography can give rise to conflicts in informing parents. The most important factor in prognosis is determining the stage of VM and associated anomalies. Although our study demonstrated a significant effect of the Evans Index in predicting the requirement for postnatal shunt surgery, further large-scale prospective studies are needed to investigate the relationship between ACA, CA, and the Evans Index and poor prognosis, as well as the necessity for postnatal shunt surgery.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 321-325"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative umbilical cellulitis probably related to incidental colonic puncture by Veress needle entry during insufflation","authors":"Kuan-Tu Peng ,&nbsp;Jen-Ruei Chen","doi":"10.1016/j.tjog.2025.12.007","DOIUrl":"10.1016/j.tjog.2025.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>Laparoscopic surgery has become increasingly prevalent in modern gynecologic practice. However, this approach is not without risks. The most dangerous step is insufflation of the abdomen using a Veress needle or the blind creation of the camera port at the beginning of the surgery. Here, we report an interesting case of an umbilical camera port abscess, probably resulting from an incidental puncture of the colon by a Veress needle during initial insufflation.</div></div><div><h3>Case report</h3><div>A 61-year-old Taiwanese postmenopausal woman underwent laparoscopic surgery for bilateral adnexal solid masses, incidentally discovered during regular follow-up for B-cell lymphoma. Insufflation and trocar placement were uneventful, but over-distended colon was observed without an identifiable cause. Bilateral broad ligament myomas, enlarged right ovarian solid mass, and an atrophic left ovary were noted. Only a right salpingo-oophorectomy was performed, and final pathology revealed a benign Brenner's tumor. Postoperative fever and leukocytosis occurred but subsided spontaneously. However, the patient later experienced spiking fever and a significant abscess at the umbilical trocar site. The abscess culture confirmed the presence of enteric bacteria. Her condition improved with broad-spectrum antibiotic therapy and wound care.</div></div><div><h3>Conclusion</h3><div>An incidental puncture of colon by a Veress needle can lead to over-distension of the colon and bacterial contamination of the umbilical port tract. Greater postoperative vigilance and timely antibiotic coverage may help prevent this rare complication.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"65 2","pages":"Pages 346-348"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}