Ginekologia polska最新文献

{"title":"Retained intrauterine device as cause of thrombotic thrombocytopenic purpura.","authors":"Mateusz Klimek, Aleksandra Machnik, Monika Białowas, Krzysztof Nowosielski, Andrzej Witek","doi":"10.5603/gpl.101684","DOIUrl":"https://doi.org/10.5603/gpl.101684","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443072","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 impact of mismatch repair (MMR), p53, and LCAM-1 immunohistochemical expression on prognosis in low-risk endometrial cancer.","authors":"Şener Gezer, Büşra Yaprak Bayrak, Müzeyyen Dilşad Eser, Esra Betül Tunce","doi":"10.5603/gpl.101983","DOIUrl":"https://doi.org/10.5603/gpl.101983","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between mismatch repair (MMR) deficiency, TP53, and L1 cell adhesion molecule (L1CAM) immunohistochemical staining and their impact on progression-free survival (PFS) and overall survival (OS) in low-risk endometrial cancer.</p><p><strong>Material and methods: </strong>A total of 253 low-risk endometrial cancer patients were retrospectively screened. Immunohistochemical stains were applied to tumor tissue samples to assess MMR deficiency, TP53, and L1CAM expression, and survival analysis were performed.</p><p><strong>Results: </strong>The expected PFS time was 78.6 months for the MMR-proficient group and 70.3 months for the MMR-deficient group (p = 0.011). OS was 71.6 months for the MMR-proficient group and 68.2 months for the MMR-deficient group (p = 0.755). L1CAM overexpression was associated with a poorer PFS, 62.7 months compared to 77.7 months (p = 0.039). However, there was no statistically significant difference in OS, 58.5 months versus 72.1 months, respectively (p = 0.242). p53 abnormal (p53-abn) staining was associated with a worse prognosis in terms of PFS, 62.8 months versus 77.7 months (p = 0.035), and OS, 43.4 months versus 73 months, respectively (p < 0.001), compared to patients with wild-type staining. No significant statistical relationship was observed in survival times concerning tumor diameter, grade, and lymphadenectomy status. In a multivariate analysis, MMR deficiency emerged as an independent poor prognostic factor for PFS, while p53-abn was identified as an independent poor prognostic factor for OS.</p><p><strong>Conclusions: </strong>p53-abn staining was associated with a poor prognosis for both PFS and OS in low-risk endometrial cancer patients. Meanwhile, MMR deficiency and L1CAM positivity were found to be associated solely with a poorer prognosis for PFS.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443084","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":"Neoadjuvant chemotherapy in patients with vulvar carcinoma: a systematic review.","authors":"Magda Piechowicz, Wojciech Staskiewicz, Joanna Spaczyska, Milosz Pietrus, Kazimierz Pitynski","doi":"10.5603/gpl.97789","DOIUrl":"https://doi.org/10.5603/gpl.97789","url":null,"abstract":"<p><p>Neoadjuvant chemotherapy is one of the options of treating patients with vulvar carcinoma. In this systematic review we searched three databases (Medline, EMBASE, Cochrane Library) for literature regarding this method of therapy. Additional sources were also searched. We included primary studies of any design with no language or date restrictions. Fourteen full-text studies were found; due to heterogeneity of data no quantitative synthesis was performed. Quality of evidence was very low, mainly due to population sizes and no available comparative data with other types of treatment. The results were mixed, however some of the studies reported promising results regarding survival and possibility of more conservative surgery. In general chemotherapy was well-tolerated, but in some studies regimens containing bleomycin and methotrexate presented particularly severe toxicity.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443066","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":"Prognostic evaluation of systemic immune inflammatory index and hematological parameters in postpartum hemorrhage: a retrospective analysis.","authors":"Emrullah Akay, Gizem Şirin Donbalıoğlu, Ali Selçuk Yeniocak, Emrah Dağdeviren, Can Tercan, İbrahim Polat","doi":"10.5603/gpl.100739","DOIUrl":"https://doi.org/10.5603/gpl.100739","url":null,"abstract":"<p><strong>Objectives: </strong>Postpartum hemorrhage (PPH) is a significant global health risk for mothers. This study investigated the predictive capacity of the systemic immune inflammatory index (SII) to assess the risk of PPH. The SII, which is predicated on cell types of integral to inflammatory processes, correlates with high values of increased inflammatory activity and potentially adverse prognoses.</p><p><strong>Material and methods: </strong>This retrospective cohort study included female patients aged 15-49 diagnosed with PPH who continued to bleed post-treatment, received transfusions of four or more units of erythrocyte suspension, or underwent laparotomy/re-laparotomy.</p><p><strong>Results: </strong>The study found that Hemoglobin, hematocrit, platelet, and SII values were significantly lower, and lymphocyte counts were elevated in the PPH group. Both univariate and multivariate analyses identified hemoglobin and SII levels as significant determinants of PPH. An SII cutoff value of 915 proved to be an effective predictor of PPH. In subjects with an SII ≥ 915, leukocyte, platelet, and neutrophil values were higher, and lymphocyte counts were lower. Furthermore, the rates of PPH and Intensive Care Unit admissions increased in this cohort.</p><p><strong>Conclusions: </strong>The findings suggest that the SII is a potentially significant marker for PPH risk prediction. Elevated SII levels beyond the threshold of 915 were associated with heightened PPH risk of PPH.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443069","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 feasibility of gasless single-port access laparoscopy in overweight patients undergoing adnexal surgery.","authors":"Jong Ha Hwang, Bo Wook Kim","doi":"10.5603/gpl.101987","DOIUrl":"https://doi.org/10.5603/gpl.101987","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and outcomes of gasless single-port access (SPA) laparoscopy in overweight patients undergoing adnexal surgery.</p><p><strong>Material and methods: </strong>A retrospective review was conducted on the medical records of 118 patients who underwent gasless SPA laparoscopic adnexal surgery using J-shaped or triangular-shaped retractors between May 2017 and June 2022. Patients were categorized into overweight (BMI ≥ 23) and standard-weight (BMI < 23) groups. Surgical characteristics and outcomes were compared between the two groups.</p><p><strong>Results: </strong>Out of 118 patients, 41 were in the overweight group, and 77 were in the standard-weight group. Significant differences were observed in age (p = 0.001), the number of previous abdominal surgeries (p = 0.001), and the number of subjects who had given birth (p = 0.004), all higher in the overweight group. There were no significant differences between the groups in setup time from umbilical skin incision to abdominal wall retraction, use of additional TROCARS: operation time, estimated blood loss, or length of postoperative hospital stay. No serious intraoperative complications, such as urologic, bowel, and vessel injuries were noted in either group. Tumor diameter (p < 0.001), bilaterality (p < 0.001), presence of adhesion (p = 0.026), and setup diameter of the retractor (p = 0.001) significantly correlated with operation time in multivariate analysis (Adjusted R² = 0.645).</p><p><strong>Conclusions: </strong>Gasless SPA laparoscopic adnexal surgery in overweight patients is a feasible and effective alternative to conventional SPA laparoscopy, mitigating the potential negative effects of carbon dioxide gas.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392811","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 of VCare and SecuFix uterine manipulator in total laparoscopic hysterectomy: a prospective randomized trial.","authors":"Emre Mat, Esra Keles, Pınar Yıldız, Murat Levent Dereli, Fatih Şanlıkan, Gazi Yıldız","doi":"10.5603/gpl.101589","DOIUrl":"https://doi.org/10.5603/gpl.101589","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the Vcare and SecuFix uterine manipulators (UM) used in total laparoscopic hysterectomy (TLH) with regard to operating time, duration of hospital stay, the time for insertion of the manipulator, time for completion of colpotomy, and maintenance of pneumoperitoneum, estimated blood loss, and perioperative complications.</p><p><strong>Material and methods: </strong>This prospective, single-center, randomized controlled trial was conducted on patients who underwent TLH for benign indications between June 2023 and January 2024. Patients were randomized to either the Vcare UM or SecuFix UM group. Both groups were compared for operative time, colpotomy time, intrauterine manipulator insertion time, pneumoperitoneum maintenance, blood loss, complications, and length of hospital stay.</p><p><strong>Results: </strong>A total of 100 patients were enrolled, 50 with VcareUM and 50 with SecuFix UM. SecuFix UM demonstrated shorter colpotomy time (p < 0.001) and better pneumoperitoneum maintenance (p = 0.008) compared to VCare. VCare had shorter insertion time (p = 0.001) but a higher uterine rupture rate (p = 0.001). No significant differences were found in operative time, blood loss, complications, or length of hospital stay (p > 0.05).</p><p><strong>Conclusions: </strong>SecuFix may offer advantages in colpotomy and pneumoperitoneum maintenance during TLH compared to VCare. The Vcare UM demonstrated a shorter insertion time than the SecuFix UMs, yet a higher rate of uterine rupture was observed with its placement.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392806","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":"Maternal obesity, more than diabetes mellitus, predisposes to soft tissue injuries of the birth canal during vaginal delivery.","authors":"Aneta Malinowska-Polubiec, Malgorzata Kujko-Wisniewska, Ewa Romejko-Wolniewicz, Julia Zareba-Szczudlik, Agnieszka Dobrowolska-Redo, Joanna Kacperczyk-Bartnik, Krzysztof Czajkowski","doi":"10.5603/gpl.100252","DOIUrl":"https://doi.org/10.5603/gpl.100252","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the relationship between the incidence of birth canal soft tissue injuries, perineal incision procedure and maternal and neonatal characteristics.</p><p><strong>Material and methods: </strong>It was a retrospective cohort study conducted in a tertiary hospital analyzing deliveries between July 2018 and January 2019. Study group included 726 spontaneous vaginal singleton births in the longitudinal cephalic fetal position after completed 36th gestational week. Characteristics of patients who suffered from cervical ruptures and/or vaginal injuries were compared to those who gave birth without any soft tissue traumas.</p><p><strong>Results: </strong>The perineal incision procedure was performed in 561 (77.3%) women. Soft tissue injuries of the birth canal were found in 220 patients (30.3%). Cervical rupture was more frequent when perineal incision was performed (94.5% vs 74.2%, p = 0.0001), but only in primiparous women (70.6% vs 43.2%, p = 0.01). Vaginal injury happened less frequently when perineal incision was performed (56.5% vs 81.8%, p = 0.001), but only in multiparous women (12.9% vs 34.3%, p = 0.001). Vaginal injury was more common in women with higher pre-pregnancy body weight (69.4 vs 65.4 kg, p = 0.0015), higher prepregnancy BMI (24.5 vs 23.5 kg/m², p = 0.0085), higher body weight and BMI before delivery (82.2 vs 78.1 kg, p = 0.001 and 29.1 vs 28.1 kg/m², p = 0.008, respectively). In multivariate logistic regression analysis neither parity nor perineal incision increased the risk of vaginal injury. Only the obese women, but not diabetic, were at higher risk of vaginal injury, when perineal incision was performed (OR 2.25, CI 1.25-4.05, p = 0.007).</p><p><strong>Conclusions: </strong>The obese women are at higher risk of vaginal injury during delivery, when perineal incision is performed. The necessity of maintaining normal body weight while planning pregnancy, monitoring gestational weight gain, and avoiding perineal incision remain important issues.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392809","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 of blunt and sharp dissection techniques during cesarean hysterectomy in placenta percreta.","authors":"Seyhun Sucu, Ibrahim Taskum, Furkan Cetin, Muhammed Hanifi Bademkiran, Ozge Komurcu Karuserci, Huseyin Caglayan Ozcan","doi":"10.5603/gpl.101542","DOIUrl":"https://doi.org/10.5603/gpl.101542","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the effects of the blunt dissection technique (BDT) with finger and the sharp dissection technique (SDT) with scissors during cesarean hysterectomy (CH) in patients with placenta percreta.</p><p><strong>Material and methods: </strong>We included 70 patients with placenta percreta who underwent CH in a territory hospital between 2020 and 2023. The patients were divided into two groups: Group 1 included 34 patients who underwent blunt bladder dissection, and Group 2 included 36 patients who underwent sharp bladder dissection. Demographic data, operative complications, surgical parameters, and transfusion rates were compared between the two groups.</p><p><strong>Results: </strong>BDT was associated with a statistically significant reduction in operation time compared to SDT (95.62 ± 20.76 min vs 107.08 ± 26.04 min, p = 0.046). Moreover, the rate of bladder injury was significantly lower in the BDT group compared to the SDT group (11.8% vs 33.3%, p = 0.032). Although there were no significant differences in blood transfusion products between the two groups, postoperative transfusion amounts tended to be lower in the BDT group.</p><p><strong>Conclusions: </strong>BDT may be a proper surgical method to reduce bladder injury rates and operation time compared to SDT in CH of placenta percreta cases.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392802","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":"Evaluating the impact of red blood cell parameters on outcomes of dinoprostone-induced labor: a retrospective study.","authors":"Andrzej Jaworowski, Kuba Ptaszkiewicz, Bartosz Wrobel, Magdalena Kolak, Katarzyna Skibinska, Hubert Huras, Julia Jagiela","doi":"10.5603/gpl.100356","DOIUrl":"https://doi.org/10.5603/gpl.100356","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the relationship between red blood cell parameters and perinatal outcomes in dinoprostone insert-induced labor at the Department of Obstetrics and Perinatology of the Jagiellonian University Medical College Cracow, Poland.</p><p><strong>Material and methods: </strong>Conducted between May 2019 and February 2021, this retrospective analysis included data on maternal age, pre-pregnancy BMI, hemoglobin level, red blood cell count, mean cell volume, and red cell distribution width, alongside newborn birthweight and Apgar scores. The study evaluated the impact of anemia, a hemoglobin level lower than 12 g/dL, on the likelihood of cesarean section, labor duration, delivery time, and neonatal outcomes.</p><p><strong>Results: </strong>With 183 participants, findings indicate no significant difference in perinatal outcomes between anemic and non-anemic groups, suggesting mild anemia may not significantly influence dinoprostone insert-induced labor outcomes.</p><p><strong>Conclusions: </strong>The study highlights the importance of a nuanced approach to managing anemia in pregnancy, emphasizing the necessity for individualized treatment strategies. Our findings contribute to the ongoing discourse on anemia management during pregnancy, underscoring the need for more targeted research to develop evidence-based guidelines.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392807","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 of the efficacy of transumbilical single-port laparoscopy and traditional laparoscopy for type II/III cesarean scar pregnancy.","authors":"Min Li, Yanqing Wu, Guichun Tan, Lu Liu, Liming Wang, Ziming Huang, Xiaoling Tao, Xin Du","doi":"10.5603/gpl.99855","DOIUrl":"https://doi.org/10.5603/gpl.99855","url":null,"abstract":"<p><strong>Objective: </strong>To explore the differences in clinical and cosmetic efficacy between transumbilical single-port laparoscopy (TSPLS) and traditional laparoscopy for type II and III cesarean scar pregnancy (CSP).</p><p><strong>Methods: </strong>We retrospectively included 39 patients with type II and III CSP who were admitted to Hubei Maternal and Child Health Hospital for surgical treatment between June 2018 and June 2021 and classified them into Groups A and B according to patients' wishes. Patients in Group A (n = 15) were treated with TSPLS, and those in Group B (n = 24) were treated with traditional laparoscopy. Both groups underwent CSP resection and lower uterine segment repair via plastic surgery. Based on their condition and intraoperative bleeding, the patients were treated with uterine artery preligation. The operative time, preoperative pretreatment, intraoperative blood loss, decrease in beta-human chorionic gonadotropin (β-hCG) level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stays, complications, and scar cosmesis assessment were compared.</p><p><strong>Results: </strong>The scar cosmesis score was significantly lower in Group A than in Group B (p < 0.01). No significant differences in intraoperative blood loss, absolute decrease in β-hCG level, absolute decrease in blood hemoglobin level, absolute increase in blood C-reactive protein level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stay, and complications were observed between the two groups (p > 0.05). The operative time in the experimental group was slightly longer than that in the control group (p < 0.05).</p><p><strong>Conclusion: </strong>TSPLS had better cosmetic effects than traditional multi-port laparoscopy, without surgical results and postoperative recovery difference, making it valuable for clinical application.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392804","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}