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Original Article01-23-2022
Oncological Outcomes of Nipple-Sparing Mastectomy in an Unselected Population Evaluated in a Single Center
- Francisco Pimentel Cavalcante
, - Mirella Macedo Parente Araújo ,
- Igor Moreira Veras ,
- Ruffo Freitas Junior
Abstract
Original ArticleOncological Outcomes of Nipple-Sparing Mastectomy in an Unselected Population Evaluated in a Single Center
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1052-1058
- Francisco Pimentel Cavalcante ,
- Mirella Macedo Parente Araújo ,
- Igor Moreira Veras ,
- Ruffo Freitas Junior
Views155Abstract
Objective
Nipple-sparing mastectomy (NSM) has been traditionally used in selected cases with tumor-to-nipple distance > 2 cm and negative frozen section of the base of the nipple. Recommending NSM in unselected populations remains controversial. The present study evaluated the oncological outcomes of patients submitted to NSM in an unselected population seen at a single center.
Methods
This retrospective cohort study included unselected patients with invasive carcinoma or ductal carcinoma in situ (DCIS) who underwent NSM in 2010 to 2020. The endpoints were locoregional recurrence, disease-free survival (DFS), and overall survival (OS), irrespective of tumor size or tumor-to-nipple distance.
Results
Seventy-six patients (mean age 46.1 years) (58 invasive carcinomas/18 DCIS) were included. The most invasive carcinomas were hormone-positive (60%) (HER2 overexpression: 24%; triple-negative: 16%), while 39% of DCIS were high-grade. Invasive carcinomas were T2 in 66% of cases, with axillary metastases in 38%. Surgical margins were all negative. All patients with invasive carcinoma received systemic treatment and 38% underwent radiotherapy. After a mean of 34.8 months, 3 patients with invasive carcinoma (5.1%) and 1 with DCIS (5.5%) had local recurrence. Two patients had distant metastasis and died during follow-up. The 5-year OS and DFS rates for invasive carcinoma were 98% and 83%, respectively.
Conclusion
In unselected cases, the 5-year oncological outcomes following NSM were found to be acceptable and comparable to previous reports. Further studies are required.
Key-words Breast neoplasmsMastectomynipple-sparing mastectomysegmental mastectomysubcutaneous mastectomySee moreViews155
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. Abstract
Original ArticleOncological Outcomes of Nipple-Sparing Mastectomy in an Unselected Population Evaluated in a Single Center
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1052-1058
- Francisco Pimentel Cavalcante ,
- Mirella Macedo Parente Araújo ,
- Igor Moreira Veras ,
- Ruffo Freitas Junior
Views155Abstract
Objective
Nipple-sparing mastectomy (NSM) has been traditionally used in selected cases with tumor-to-nipple distance > 2 cm and negative frozen section of the base of the nipple. Recommending NSM in unselected populations remains controversial. The present study evaluated the oncological outcomes of patients submitted to NSM in an unselected population seen at a single center.
Methods
This retrospective cohort study included unselected patients with invasive carcinoma or ductal carcinoma in situ (DCIS) who underwent NSM in 2010 to 2020. The endpoints were locoregional recurrence, disease-free survival (DFS), and overall survival (OS), irrespective of tumor size or tumor-to-nipple distance.
Results
Seventy-six patients (mean age 46.1 years) (58 invasive carcinomas/18 DCIS) were included. The most invasive carcinomas were hormone-positive (60%) (HER2 overexpression: 24%; triple-negative: 16%), while 39% of DCIS were high-grade. Invasive carcinomas were T2 in 66% of cases, with axillary metastases in 38%. Surgical margins were all negative. All patients with invasive carcinoma received systemic treatment and 38% underwent radiotherapy. After a mean of 34.8 months, 3 patients with invasive carcinoma (5.1%) and 1 with DCIS (5.5%) had local recurrence. Two patients had distant metastasis and died during follow-up. The 5-year OS and DFS rates for invasive carcinoma were 98% and 83%, respectively.
Conclusion
In unselected cases, the 5-year oncological outcomes following NSM were found to be acceptable and comparable to previous reports. Further studies are required.
Key-words Breast neoplasmsMastectomynipple-sparing mastectomysegmental mastectomysubcutaneous mastectomySee 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. - Francisco Pimentel Cavalcante
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Original Article01-23-2022
Association of Swede Score and 2011 IFCPC Nomenclature in Women with Abnormal Cytology
- Priscila Loyola Campos ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Susana Cristina Aidé Viviani Fialho ,
- Caroline Alves Oliveira Martins ,
- Fabiana Resende Rodrigues , [ ... ],
- Daniela da Silva Alves Monteiro
Abstract
Original ArticleAssociation of Swede Score and 2011 IFCPC Nomenclature in Women with Abnormal Cytology
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):938-944
- Priscila Loyola Campos ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Susana Cristina Aidé Viviani Fialho ,
- Caroline Alves Oliveira Martins ,
- Fabiana Resende Rodrigues ,
- Luiz Guilhermo Coca Velarde ,
- Daniela da Silva Alves Monteiro
Views146See moreAbstract
Objective
To assess the association between two colposcopic indices, the Swede score and the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) Nomenclature as well as to determine the efficacy of the Swede score with cutoffs of 7 and 8.
Methods
In the present cross-sectional pilot study, 34 women who had at least 1 colposcopy-directed biopsy due to abnormal cytology were enrolled. The colposcopic findings were scored by both the Swede score and the 2011 IFCPC Nomenclature and were compared with each other. The Kappa coefficient and the McNemar test were used. Accuracy, sensitivity, specificity, and positive and negative predictive values (NPV and PPV, respectively) were calculated, as well as the effectiveness with cutoffs of 7 and 8 in identifying cervical intraepithelial neoplasm (CIN) 2+ when using the Swede score.
Results
The correlation between the 2 colposcopic indices was 79.41%. The Kappa coefficient and the McNemar p-value were 0.55 and 0.37, respectively. The IFCPC Nomenclature had sensitivity, specificity, accuracy, PPV, and NPV of 85.71, 55.00, 67.64, 57.14, and 84.61%, respectively. The Swede score had sensitivity, specificity, accuracy, PPV, and NPV of 100, 63.15, 79.41, 68.18, and 100%, respectively. A Swede score cutoff of 7 for CIN 2+ detection had a specificity of 94.73%, while with a cutoff of 8 it increased to 100%. The sensitivity for both values was 60%. The PPV and NPV for cutoffs of 7 and 8 were 90 and 75 and 100 and 76%, respectively.
Conclusion
Although both colposcopic indices have good reproducibility, the Swede score showed greater accuracy, sensitivity, and specificity in identifying CIN 2 + , especially when using a cutoff of 8.
Views146This 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. Abstract
Original ArticleAssociation of Swede Score and 2011 IFCPC Nomenclature in Women with Abnormal Cytology
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):938-944
- Priscila Loyola Campos ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Susana Cristina Aidé Viviani Fialho ,
- Caroline Alves Oliveira Martins ,
- Fabiana Resende Rodrigues ,
- Luiz Guilhermo Coca Velarde ,
- Daniela da Silva Alves Monteiro
Views146See moreAbstract
Objective
To assess the association between two colposcopic indices, the Swede score and the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) Nomenclature as well as to determine the efficacy of the Swede score with cutoffs of 7 and 8.
Methods
In the present cross-sectional pilot study, 34 women who had at least 1 colposcopy-directed biopsy due to abnormal cytology were enrolled. The colposcopic findings were scored by both the Swede score and the 2011 IFCPC Nomenclature and were compared with each other. The Kappa coefficient and the McNemar test were used. Accuracy, sensitivity, specificity, and positive and negative predictive values (NPV and PPV, respectively) were calculated, as well as the effectiveness with cutoffs of 7 and 8 in identifying cervical intraepithelial neoplasm (CIN) 2+ when using the Swede score.
Results
The correlation between the 2 colposcopic indices was 79.41%. The Kappa coefficient and the McNemar p-value were 0.55 and 0.37, respectively. The IFCPC Nomenclature had sensitivity, specificity, accuracy, PPV, and NPV of 85.71, 55.00, 67.64, 57.14, and 84.61%, respectively. The Swede score had sensitivity, specificity, accuracy, PPV, and NPV of 100, 63.15, 79.41, 68.18, and 100%, respectively. A Swede score cutoff of 7 for CIN 2+ detection had a specificity of 94.73%, while with a cutoff of 8 it increased to 100%. The sensitivity for both values was 60%. The PPV and NPV for cutoffs of 7 and 8 were 90 and 75 and 100 and 76%, respectively.
Conclusion
Although both colposcopic indices have good reproducibility, the Swede score showed greater accuracy, sensitivity, and specificity in identifying CIN 2 + , especially when using a cutoff of 8.
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. - Priscila Loyola Campos
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Original Article01-23-2022
Legal Pregnancy Interruption due to Sexual Violence in a Public Hospital in the South of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):945-952
Abstract
Original ArticleLegal Pregnancy Interruption due to Sexual Violence in a Public Hospital in the South of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):945-952
Views183See moreAbstract
Objective
To analyze the cases of all women who attend to a service of legal termination of pregnancy in cases of sexual violence in a public reference hospital and to identify the factors related to its execution.
Methods
Cross-sectional observational study with information from medical records from January 2014 to December 2020. A total of 178 cases were included, with an evaluation of the data referring to the women who attended due to sexual violence, characteristics of sexual violence, hospital care, techniques used, and complications. The analysis was presented in relative and absolute frequencies, medians, means, and standard deviation. Factors related to the completion of the procedure were assessed using binary logistic regression.
Results
Termination of pregnancy was performed in 83.2% of the cases; in 75.7% of the cases, the technique used was the association of transvaginal misoprostol and intrauterine manual aspiration. There were no deaths, and the rate of complications was 1.4%. Gestational age at the time the patient's sought assistance was the determining factor for the protocol not being completed. Pregnancies up to 12 weeks were associated with a lower chance of the interruption not occurring (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.12–0.88), while cases with gestational age > 20 weeks were associated with a greater chance of the interruption not happening (OR: 29.93; 95%CI: 3.91–271.50).
Conclusion
The service studied was effective, with gestational age being the significant factor for resolution.
Views183This 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. Abstract
Original ArticleLegal Pregnancy Interruption due to Sexual Violence in a Public Hospital in the South of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):945-952
Views183See moreAbstract
Objective
To analyze the cases of all women who attend to a service of legal termination of pregnancy in cases of sexual violence in a public reference hospital and to identify the factors related to its execution.
Methods
Cross-sectional observational study with information from medical records from January 2014 to December 2020. A total of 178 cases were included, with an evaluation of the data referring to the women who attended due to sexual violence, characteristics of sexual violence, hospital care, techniques used, and complications. The analysis was presented in relative and absolute frequencies, medians, means, and standard deviation. Factors related to the completion of the procedure were assessed using binary logistic regression.
Results
Termination of pregnancy was performed in 83.2% of the cases; in 75.7% of the cases, the technique used was the association of transvaginal misoprostol and intrauterine manual aspiration. There were no deaths, and the rate of complications was 1.4%. Gestational age at the time the patient's sought assistance was the determining factor for the protocol not being completed. Pregnancies up to 12 weeks were associated with a lower chance of the interruption not occurring (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.12–0.88), while cases with gestational age > 20 weeks were associated with a greater chance of the interruption not happening (OR: 29.93; 95%CI: 3.91–271.50).
Conclusion
The service studied was effective, with gestational age being the significant factor for resolution.
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. -
Original Article01-23-2022
Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
- Karen Hiromi Mori ,
- Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Abstract
Original ArticleExperience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1014-1020
- Karen Hiromi Mori ,
- Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Views181See moreAbstract
Objective
Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years.
Methods
A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018.
Results
We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome.
Conclusion
Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
Views181This 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. Abstract
Original ArticleExperience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1014-1020
- Karen Hiromi Mori ,
- Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Views181See moreAbstract
Objective
Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years.
Methods
A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018.
Results
We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome.
Conclusion
Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
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. - Karen Hiromi Mori
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Original Article01-23-2022
Development and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada , [ ... ],
- Patrícia Constante Jaime
Abstract
Original ArticleDevelopment and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1021-1031
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada ,
- Vanessa Del Castillo Couto ,
- Jacqueline Resende Berriel Hochberg ,
- Patrícia Constante Jaime
Views195Abstract
Objective
To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).
Methods
Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.
Results
As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.
Conclusion
The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.
Key-words dietary guidelinespractice guidelinesPrenatal nutritionPrimary health carevalidation studySee moreViews195This 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. Abstract
Original ArticleDevelopment and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1021-1031
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada ,
- Vanessa Del Castillo Couto ,
- Jacqueline Resende Berriel Hochberg ,
- Patrícia Constante Jaime
Views195Abstract
Objective
To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).
Methods
Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.
Results
As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.
Conclusion
The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.
Key-words dietary guidelinespractice guidelinesPrenatal nutritionPrimary health carevalidation studySee 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. - Cláudia Raulino Tramontt
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Original Article01-23-2022
Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo , [ ... ],
- Omar Féres
Abstract
Original ArticlePostoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views146See moreAbstract
Objective
The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.
Methods
The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.
Results
One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.
Conclusion
Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.
Views146This 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. Abstract
Original ArticlePostoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views146See moreAbstract
Objective
The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.
Methods
The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.
Results
One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.
Conclusion
Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.
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. - Rogério Serafim Parra
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Original Article01-06-2022
Robson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
Abstract
Original ArticleRobson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
Views202See moreAbstract
Objective
To use the Robson Ten Group Classification (RTGC) to analyze cesarean section (CS) rates in a Honduran maternity hospital, with focus in groups that consider induction of labor.
Methods
Cross-sectional study. Women admitted for childbirth (August 2017 to October 2018) were classified according to the RTGC. The CS rate for each group and the contribution to the overall CS rate was calculated, with further analyses of the induction of labor among term primiparous (group 2a), term multiparous (group 4a), and cases with one previous CS (group 5.1).
Results
A total of 4,356 women were considered, with an overall CS rate of 26.1%. Group 3 was the largest group, with 38.6% (1,682/4,356) of the cases, followed by Group 1, with 30.8% (1,342/4,356), and Group 5, with 10.3% (450/4,356). Considering the contribution to overall CS rates per group, Group 5 contributed with 30.4% (345/1,136) of the CSs and within this group, 286/345 (82.9%) had 1 previous CS, with a CS rate > 70%. Groups 1 and 3, with 26.6% (291/1,136) and 13.5% (153/1,136), respectively, were the second and third larger contributors to the CS rate. Groups 2a and 4a had high induction success, with low CS rates (18.4 and 16.9%, respectively).
Conclusion
The RTGC is a useful tool to assess CS rates in different healthcare facilities. Groups 5, 1, and 3 were the main contributors to the CS rate, and groups 2 and 4 showed the impact and importance of induction of labor. These findings may support future interventions to reduce unnecessary CS, especially among primiparous and in women with previous CS.
Views202This 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. Abstract
Original ArticleRobson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
Views202See moreAbstract
Objective
To use the Robson Ten Group Classification (RTGC) to analyze cesarean section (CS) rates in a Honduran maternity hospital, with focus in groups that consider induction of labor.
Methods
Cross-sectional study. Women admitted for childbirth (August 2017 to October 2018) were classified according to the RTGC. The CS rate for each group and the contribution to the overall CS rate was calculated, with further analyses of the induction of labor among term primiparous (group 2a), term multiparous (group 4a), and cases with one previous CS (group 5.1).
Results
A total of 4,356 women were considered, with an overall CS rate of 26.1%. Group 3 was the largest group, with 38.6% (1,682/4,356) of the cases, followed by Group 1, with 30.8% (1,342/4,356), and Group 5, with 10.3% (450/4,356). Considering the contribution to overall CS rates per group, Group 5 contributed with 30.4% (345/1,136) of the CSs and within this group, 286/345 (82.9%) had 1 previous CS, with a CS rate > 70%. Groups 1 and 3, with 26.6% (291/1,136) and 13.5% (153/1,136), respectively, were the second and third larger contributors to the CS rate. Groups 2a and 4a had high induction success, with low CS rates (18.4 and 16.9%, respectively).
Conclusion
The RTGC is a useful tool to assess CS rates in different healthcare facilities. Groups 5, 1, and 3 were the main contributors to the CS rate, and groups 2 and 4 showed the impact and importance of induction of labor. These findings may support future interventions to reduce unnecessary CS, especially among primiparous and in women with previous CS.
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. -
Original Article09-06-2022
Is There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco , [ ... ],
- Adriana Messa Bryon
Abstract
Original ArticleIs There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):925-929
- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juan Pablo Benavides-Calvache ,
- Iván Padilla ,
- Ivonne Aldana ,
- Martha Jaramillo ,
- Ana Maria Gómez ,
- Angela María Olarte Castillo ,
- Adriana Messa Bryon
Views246See moreABSTRACT
Objective
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
Methods
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
Results
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
Conclusion
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
Views246This 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. Abstract
Original ArticleIs There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):925-929
- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juan Pablo Benavides-Calvache ,
- Iván Padilla ,
- Ivonne Aldana ,
- Martha Jaramillo ,
- Ana Maria Gómez ,
- Angela María Olarte Castillo ,
- Adriana Messa Bryon
Views246See moreABSTRACT
Objective
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
Methods
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
Results
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
Conclusion
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
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. - Albaro José Nieto-Calvache
Original Article Archives - Page 3 of 201 - Revista Brasileira de Ginecologia e Obstetrícia
