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Trabalhos Originais
Office Microlaparoscopy in Patients with Chronic Pelvic Pain
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):95-100
10-10-2000
Summary
Trabalhos OriginaisOffice Microlaparoscopy in Patients with Chronic Pelvic Pain
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):95-100
10-10-2000DOI 10.1590/S0100-72032000000200006
Views66See moreSUMMARY Purpose: to study the usefulness of minilaparoscopy in diagnosing the cause of pelvic pain. Methods: women with pelvic pain were prospectively analyzed and underwent an office video-microlaparoscopy. We analyzed the data regarding procedure time, stay in the recovery room, acceptance of anesthesia, and morbidity. Results: the average procedure time of the office video-microlaparoscopy was 19 min, the average stay for recovery was 43 min, and the technical quality of the image was excellent or good in 100% of the selected patients. The following laparoscopic findings were reported: 34.4% endometriosis, 28.1% pelvic adhesion, 12.5% pelvic varices, and 25% normal. Based on Bordhal et al.’s¹ criteria, a low frequency of pain manifestation during local anesthesia (12.5%) and discomfort on pneumoperitoneum (46.9%) were noticed. It could also be observed that, according to Milki and Tazuke’s² criteria, the tolerance to the method was excellent and good (96.9%). Twenty-four hours after the procedure the morbidity rate was in accordance with Chung et al.’s³ criteria, showing a high frequency of pain at the incision area (59.4%) and sleepiness (43.8%). Only 3.1% reported they felt pain during the procedure, which shows the acceptance of the method by the patients. Conclusions: the acceptance of anesthesia and of the surgical procedure and the low morbidity allow the use of minilaparoscopy as a very important method in investigating patients with pelvic pain.
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. -
Trabalhos Originais
Lipid Profile in Patients with Polycystic Ovary Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):89-94
10-10-2000
Summary
Trabalhos OriginaisLipid Profile in Patients with Polycystic Ovary Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):89-94
10-10-2000DOI 10.1590/S0100-72032000000200005
Views86See morePurpose: to evaluate the lipid profile (cholesterol, triglycerides, HDL and LDL) of women with polycystic ovary syndrome (PCO) and compare it to that of women with ovulatory menstrual cycles. Methods: the patients were divided into two groups, obese and nonobese, based on body mass index, so that it would be possible to determine the joint effect of PCO and obesity on the lipid metabolism of the studied women. We studied 117 women divided into 4 groups: group I (PCO–obese), n = 33; group II (PCO–nonobese), n = 27; group III (control–obese), n = 28; group IV (control–nonobese), n = 29. Results: cholesterol levels were elevated (179 mg/dl) in obese patients with ovulatory cycles (group III) compared to group I (147 mg/dl) and group II (149 mg/dl), as also were triglyceride levels (117 mg/dl) compared to group IV (77 mg/dl) and LDL levels (117 mg/dl) compared to group I (82 mg/dl). Conclusion: these data suggest that alterations in lipid profile are related to obesity only.
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. -
Trabalhos Originais
Analysis of Esthetic Results of Breast-conserving Treatment for Breast Cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):79-87
10-10-2000
Summary
Trabalhos OriginaisAnalysis of Esthetic Results of Breast-conserving Treatment for Breast Cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):79-87
10-10-2000DOI 10.1590/S0100-72032000000200004
Views116See morePurpose: to assess the esthetic results and personal satisfaction of patients submitted to conservative surgery for cancer of the breast. The study was conducted on 44 patients with breast cancer diagnosed at the mastology outpatient clinic of HCFMRP-USP from January 1990 to December 1994, who fulfilled inclusion criteria according to a previously established protocol. The study consisted of analysis of the esthetic results after conservative treatment of breast cancer and analysis of the degree of patient satisfaction, with a comparison of the morphometry of the treated breast to that of the normal breast. The results were obtained on the basis of five previously established parameters using the esthetic evaluation score proposed by Westreich¹. Methods: of the 44 patients studied, 10 had been submitted to neoadjuvant chemotherapy (CT) because they presented locally advanced tumors, and 2 because of an unfavorable tumor/breast ratio for conservative treatment. Mean follow-up time was 65 months. All 27 patients followed-up at the outpatient clinic received a convocation letter. An evaluation questionnaire was applied to the 20 patients who came to the clinic, followed by breast measurement. Fifteen of these patients had been submitted to surgery with separate incisions and 5 to surgery with a single incision. Results: according to morphometry, the results were classified as excellent in 17 cases (85%), as good in two (10%), and as poor in only one case (5%), an evaluation comparable to the subjective evaluation made by the patients themselves. Considered separately, both measurement “A” (distance from the manubrium of the sternum to the nipple) and measurement “B” (distance from the cranial articulation of the xyphoid appendix to the nipple) showed a greater discriminative power than the measurements as a whole, since with these measurements the cases classified as poor by the patients would have also been classified as poor according to these same criteria separately (A and/or B). Conclusion: there was a significant difference in esthetic results between surgical treatment with a single incision or separate incisions, with the separate incision providing better results. There was high agreement between the classification made by the patients and the morphometric results obtained by us.
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. -
Trabalhos Originais
Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):71-77
10-10-2000
Summary
Trabalhos OriginaisLaparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):71-77
10-10-2000DOI 10.1590/S0100-72032000000200003
Views47See morePurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH), reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient’s records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01). LAVH showed to be 40.2% more expensive than TAH (p<0.01). Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002). Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better postoperative conditions and faster recovery than TAH. When done in a community general hospital, despite being more expensive, LAVH is an excellent option for uterine removal, and should be part of the therapeutical arsenal of gynecologic surgeons.
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. -
Trabalhos Originais
Correlation between the Histological Report of Biopsy and Conization by the Loop Electrosurgical Excision Procedure (LEEP) in the Treatment of Cervical Intraepithelial Neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):65-70
10-10-2000
Summary
Trabalhos OriginaisCorrelation between the Histological Report of Biopsy and Conization by the Loop Electrosurgical Excision Procedure (LEEP) in the Treatment of Cervical Intraepithelial Neoplasia
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):65-70
10-10-2000DOI 10.1590/S0100-72032000000200002
Views128Purpose: to evaluate conization by the loop electrosurgical excision procedure (LEEP) for the diagnosis and treatment of cervical intraepithelial neoplasms (CIN), the importance of the margins and follow-up of these women. Methods: 95 women who underwent conization by LEEP for CIN and microinvasive carcinoma from January 1996 to December 1997 were evaluated. For statistical analysis, we used the kappa agreement coefficient and the tendency test of Cochran Armitage. Results: among 63 cases who underwent colposcopically directed biopsy before the conization, the cone presented the same grade of lesion in 20 and no residual disease in 8. The cone lesion presented a higher grade in 24 cases and one of them was a microinvasive carcinoma. Among the 25 women who underwent the cone biopsy with a previous biopsy suggestive of cervicitis or CIN 1, 56% had CIN 2 or 3 in the cone. Among the 32 women without previous biopsy, 15 had CIN 2 or 3, and four had microinvasive carcinoma in the cone. Regarding the margins of the cone, 25 cases presented some grade of CIN in the endocervical margins and 2/10 who underwent a second procedure presented residual disease on histological analysis. Among the 70 women with free cone margins, 2/4 who underwent a second procedure had residual disease on histological analysis. Conclusion: conization by LEEP without previous directed biopsy depends on the experience of the colposcopist. The second resection after LEEP for the diagnosis and treatment of CIN depends not only on the presence of disease in the cone margins but also on the follow-up. A second histological analysis is recommended in cases with microinvasive carcinoma and glandular lesion and affected margins.
Key-words Cancer screeningCervical intraepithelial neoplasiaCervical neoplasiaColposcopyLoop electro-surgical cone biopsySee 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. -
Editorial
FEBRASGO e o Ministério da Saúde: A Parceria Lógica
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):64-64
10-10-2000
Summary
EditorialFEBRASGO e o Ministério da Saúde: A Parceria Lógica
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):64-64
10-10-2000This 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. -
Resumos de Teses
Efeito do Tamoxifeno na Expressão do Antígeno Nuclear de Proliferação Celular (PCNA) no Epitélio e no Estroma do Fibroadenoma de Mulheres no Menacme
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):461-461
10-06-2000
Summary
Resumos de TesesEfeito do Tamoxifeno na Expressão do Antígeno Nuclear de Proliferação Celular (PCNA) no Epitélio e no Estroma do Fibroadenoma de Mulheres no Menacme
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):461-461
10-06-2000DOI 10.1590/S0100-72032000000700014
Views59Efeito do Tamoxifeno na Expressão do Antígeno Nuclear de Proliferação Celular (PCNA) no Epitélio e no Estroma do Fibroadenoma de Mulheres no Menacme[…]See 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. -
Trabalhos Originais
Risk Factors for Infection after Total Abdominal Hysterectomy
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):443-448
10-06-2000
Summary
Trabalhos OriginaisRisk Factors for Infection after Total Abdominal Hysterectomy
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):443-448
10-06-2000DOI 10.1590/S0100-72032000000700007
Views81See morePurpose: to determine the main factors associated with the occurrence of surgical site infection in patients submitted to total abdominal hysterectomy at the Instituto Materno ¾ Infantil de Pernambuco (iMIP). Methods: a cross-sectional study was conducted, enrolling patients submitted to total abdominal hysterectomy at IMIP who returned to postsurgical consultation for infection control, between January, 1995 and December, 1998 (n = 414). The frequency of surgical site infection (defined according to the CDC criteria, 1998) was 10% (42 cases). Prevalence risk (PR) of infection (dependent variable) and its 95% confidence interval (CI) were calculated for independent variables: age, obesity, hypertension, diabetes, malignant pathology, type of incision, duration of surgery and antibiotic prophylaxis. Multiple logistic regression analysis was used to determine adjusted risk of infection. Results: a significantly increased risk of infection was found for the following variables: age >60 years (PR = 2.39, 95% CI = 1.15-4.94), obesity (PR = 3.2, 95% CI = 1.83-5.59), duration of surgery >2 hours (PR = 2.35, 95% CI = 1.32-4.21) and diabetes (PR = 6.0, 95% CI = 3.41-10.57). On the other hand, risk of infection was significantly reduced when antibiotic prophylaxis was administered (PR = 0.38, 95% CI = 0.21-0.68). Type of incision, malignant disease and hypertension were not associated with infection. Conclusions: the factors associated with increased risk of surgical site infection after total abdominal hysterectomy at IMIP were: age >60 years, obesity, diabetes and surgical duration >2 hours. Antibiotic prophylaxis showed a protective effect with reduction of risk of infection.
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.
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