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Artigos Originais
Laparoscopy for diagnosis and treatment of adnexal masses
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):124-130
03-01-2014
Summary
Artigos OriginaisLaparoscopy for diagnosis and treatment of adnexal masses
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):124-130
03-01-2014DOI 10.1590/S0100-72032014000300006
Views100See morePURPOSE:
To assess clinical factors, histopathologic diagnoses, operative time and differences in complication rates between women undergoing laparoscopy or laparotomy to diagnose and treat an adnexal mass and their association with laparoscopy failure.
METHODS:
In this prospective study, 210 women were invited to participate and 133 of them were included. Eighty-eight women underwent laparotomy and 45 underwent laparoscopy. Fourteen of the 45 laparoscopies were converted to laparotomy intraoperatively. We assessed whether age, body mass index (BMI), previous abdominal surgeries, CA-125, Index of Risk of Malignancy (IRM), tumor diameter, histological diagnosis, operative time and surgical complication rates differed between the laparoscopy group and the group converted to laparotomy and whether those factors were associated with conversion of laparoscopy to laparotomy. We also assessed surgical logs to evaluate the reasons, as stated by the surgeons, to convert a laparoscopy to laparotomy.
RESULTS:
In this research, 30% of the women had malignant tumors. CA-125, IRM, tumor diameter and operative times were higher for the laparotomy group than the laparoscopy group. Complication rates were similar for both groups and also for the successful laparoscopy and unsuccessful laparoscopy groups. The surgical complication rate in women with benign tumors was lower for the laparoscopy group than for the laparotomy group. The factors associated with conversion to laparotomy were tumor diameter and malignancy. During laparoscopy, adhesions a large tumor diameter were the principal causes of conversion.
CONCLUSION:
This study suggests that laparoscopy for the diagnosis and treatment of adnexal masses is safe and does not increase complication rates even in patients who need conversion to laparotomy. However, when doubt about the safety of the procedure and about the presence of malignancy persists, consultation with an expert gynecology-oncologist with experience in advanced laparoscopy is recommended. A large tumor diameter was associated with the necessity of conversion to laparotomy.
Views100
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisLaparoscopy for diagnosis and treatment of adnexal masses
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):124-130
03-01-2014DOI 10.1590/S0100-72032014000300006
Views100See morePURPOSE:
To assess clinical factors, histopathologic diagnoses, operative time and differences in complication rates between women undergoing laparoscopy or laparotomy to diagnose and treat an adnexal mass and their association with laparoscopy failure.
METHODS:
In this prospective study, 210 women were invited to participate and 133 of them were included. Eighty-eight women underwent laparotomy and 45 underwent laparoscopy. Fourteen of the 45 laparoscopies were converted to laparotomy intraoperatively. We assessed whether age, body mass index (BMI), previous abdominal surgeries, CA-125, Index of Risk of Malignancy (IRM), tumor diameter, histological diagnosis, operative time and surgical complication rates differed between the laparoscopy group and the group converted to laparotomy and whether those factors were associated with conversion of laparoscopy to laparotomy. We also assessed surgical logs to evaluate the reasons, as stated by the surgeons, to convert a laparoscopy to laparotomy.
RESULTS:
In this research, 30% of the women had malignant tumors. CA-125, IRM, tumor diameter and operative times were higher for the laparotomy group than the laparoscopy group. Complication rates were similar for both groups and also for the successful laparoscopy and unsuccessful laparoscopy groups. The surgical complication rate in women with benign tumors was lower for the laparoscopy group than for the laparotomy group. The factors associated with conversion to laparotomy were tumor diameter and malignancy. During laparoscopy, adhesions a large tumor diameter were the principal causes of conversion.
CONCLUSION:
This study suggests that laparoscopy for the diagnosis and treatment of adnexal masses is safe and does not increase complication rates even in patients who need conversion to laparotomy. However, when doubt about the safety of the procedure and about the presence of malignancy persists, consultation with an expert gynecology-oncologist with experience in advanced laparoscopy is recommended. A large tumor diameter was associated with the necessity of conversion to laparotomy.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Relato de Caso
A bilateral fallopian tube pregnancy: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):357-360
04-11-1998
Summary
Relato de CasoA bilateral fallopian tube pregnancy: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):357-360
04-11-1998DOI 10.1590/S0100-72031998000600009
Views59See moreBilateral ectopic pregnancy is the most unusual twin gestation considering that less than 250 cases have been reported in the literature. Our case fulfills the diagnostic criterion determined by Norris9 which requires demonstration of chorionic villi in each fallopian tube. We report the case of a 36-year-old multiparous woman who had an hemorrhagic acute abdomen. A laparotomy performed under general anesthesia revealed hemoperitoneum of 1.8 liters and both swelled tubes with laceration of their walls, besides two embryos with 2,7 and 3,0 cm in length free in the intra-abdominal blood. A literature review on bilateral ectopic pregnancy is presented.
Views59This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Relato de CasoA bilateral fallopian tube pregnancy: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(6):357-360
04-11-1998DOI 10.1590/S0100-72031998000600009
Views59See moreBilateral ectopic pregnancy is the most unusual twin gestation considering that less than 250 cases have been reported in the literature. Our case fulfills the diagnostic criterion determined by Norris9 which requires demonstration of chorionic villi in each fallopian tube. We report the case of a 36-year-old multiparous woman who had an hemorrhagic acute abdomen. A laparotomy performed under general anesthesia revealed hemoperitoneum of 1.8 liters and both swelled tubes with laceration of their walls, besides two embryos with 2,7 and 3,0 cm in length free in the intra-abdominal blood. A literature review on bilateral ectopic pregnancy is presented.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Relato de Caso
Torsion of the non-pregnant uterus
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):167-169
03-13-1999
Summary
Relato de CasoTorsion of the non-pregnant uterus
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):167-169
03-13-1999DOI 10.1590/S0100-72031999000300008
Views71Uterine torsion is an unusual pathology of difficult diagnosis and it is generally associated with an enlargement of uterine volume combined with other alterations of the pelvic organs. This report presents a case of a malnourished elderly woman with acute abdomen and intraoperative diagnosis of myoma and uterine torsion of 360 degrees to the right. The uterus showed signs of severe ischemia.
Key-words LaparotomyMyomaSee moreViews71This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Relato de CasoTorsion of the non-pregnant uterus
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(3):167-169
03-13-1999DOI 10.1590/S0100-72031999000300008
Views71Uterine torsion is an unusual pathology of difficult diagnosis and it is generally associated with an enlargement of uterine volume combined with other alterations of the pelvic organs. This report presents a case of a malnourished elderly woman with acute abdomen and intraoperative diagnosis of myoma and uterine torsion of 360 degrees to the right. The uterus showed signs of severe ischemia.
Key-words LaparotomyMyomaSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Comparative study of female surgery contraception access: microlaparoscopy versus minilaparotomy
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):403-409
12-06-2006
Summary
Artigos OriginaisComparative study of female surgery contraception access: microlaparoscopy versus minilaparotomy
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):403-409
12-06-2006DOI 10.1590/S0100-72032006000700005
Views51See morePURPOSE: to compare in a retrospective way, 51 women who underwent tubal ligation, 30 through microlaparoascopy (Gmicrol) and 21 through minilaparotomy (Gminil). METHODS: the analyzed parameters were: total time for accomplishment of the procedure and the surgical technique, time of hospital stay and return to the habitual activities after the surgery, postoperative pain, morbidity, satisfaction degree and esthetic effect, considering values of p<0,05 as significant, and also standard cost. RESULTS: Gmicrol took less time to accomplish the surgery than the Gminil (43 against 57 minutes respectively, p<0,05), less time to accomplish the surgical technique (6.48 against 30.32 minutes respectively, p<0,05), and lower hospital stay (9,90 hours as against 41,7 hours respectively, p <0,05). There was no significant difference between the two groups regarding time to return to the habitual activities after surgery. To evaluate postoperative pain, a scale of 0-10 it was applied. Gmicrol present a lower pain score on the 1st and 2nd postoperative days (1.13 and 0.26 to Gmicrol and 4.52 and 1.14 to Gminil, respectively, p<0,05). There was no significant difference between immediate postoperative the most common complaint being pain at the site of pain and that on the 3rd postoperative day. Gminil presented a higher morbidity rate incision. To evaluate the satisfaction degree and esthetic effect, numeric values were attributed to as good, regular, poor and very bad as answered by the patiets. Gmicrol presented a higher satisfaction degree (p<0,05) and better esthetic effect as compared to Gminil (p <0,05). The microlaparoscopy standard cost was R$ 109.30 being lower than that of minilaparotomy. CONCLUSIONS: tubal ligation by microlaparoscopy, under local anesthesia and conscious sedation presented some advantages compared to minilaparotomy.
Views51This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisComparative study of female surgery contraception access: microlaparoscopy versus minilaparotomy
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(7):403-409
12-06-2006DOI 10.1590/S0100-72032006000700005
Views51See morePURPOSE: to compare in a retrospective way, 51 women who underwent tubal ligation, 30 through microlaparoascopy (Gmicrol) and 21 through minilaparotomy (Gminil). METHODS: the analyzed parameters were: total time for accomplishment of the procedure and the surgical technique, time of hospital stay and return to the habitual activities after the surgery, postoperative pain, morbidity, satisfaction degree and esthetic effect, considering values of p<0,05 as significant, and also standard cost. RESULTS: Gmicrol took less time to accomplish the surgery than the Gminil (43 against 57 minutes respectively, p<0,05), less time to accomplish the surgical technique (6.48 against 30.32 minutes respectively, p<0,05), and lower hospital stay (9,90 hours as against 41,7 hours respectively, p <0,05). There was no significant difference between the two groups regarding time to return to the habitual activities after surgery. To evaluate postoperative pain, a scale of 0-10 it was applied. Gmicrol present a lower pain score on the 1st and 2nd postoperative days (1.13 and 0.26 to Gmicrol and 4.52 and 1.14 to Gminil, respectively, p<0,05). There was no significant difference between immediate postoperative the most common complaint being pain at the site of pain and that on the 3rd postoperative day. Gminil presented a higher morbidity rate incision. To evaluate the satisfaction degree and esthetic effect, numeric values were attributed to as good, regular, poor and very bad as answered by the patiets. Gmicrol presented a higher satisfaction degree (p<0,05) and better esthetic effect as compared to Gminil (p <0,05). The microlaparoscopy standard cost was R$ 109.30 being lower than that of minilaparotomy. CONCLUSIONS: tubal ligation by microlaparoscopy, under local anesthesia and conscious sedation presented some advantages compared to minilaparotomy.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Laparotomy Archives - Revista Brasileira de Ginecologia e Obstetrícia
