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  • Original Article

    Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

    Rev Bras Ginecol Obstet. 2021;43(1):35-40

    Summary

    Original Article

    Residual Disease after Operative Hysteroscopy in Patients with Endometrioid Endometrial Cancer Associated with Polyps

    Rev Bras Ginecol Obstet. 2021;43(1):35-40

    DOI 10.1055/s-0040-1719145

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    Abstract

    Objective

    To evaluate the presence of residual disease in the uterine specimen after hysteroscopic polypectomy or polyp biopsy in patients with endometrioid endometrial cancer (EC).

    Methods

    We analyzed a series of 104 patients (92 cases from the Hospital AC Camargo and 12 from the Hospital do Servidor Público Estadual de São Paulo) with polyps that were diagnosed by hysteroscopy, showing endometrioid EC associated with the polyp or in the final pathological specimen. Patients underwent a surgical approach for endometrial cancer from January 2002 to January 2017. Their clinical and pathological data were retrospectively retrieved from the medical records.

    Results

    In78cases (75%), thepolyphad EC, and in 40(38.5%), itwas restricted tothe polyp, without endometrial involvement. The pathologic stage was IA in 96 cases (92.3%) and 90 (86.5%) had histologic grade 1 or 2. In 18 cases (17.3%), there was no residual disease in the final uterine specimen, but only in 9 of them the hysteroscopy suggested that the tumor was restricted to the polyp. In 5 cases (4.8%) from the group without outside of the polyp during hysteroscopy, myometrial invasion was noted in the final uterine specimen. This finding suggests the possibility of disease extrapolation through the base of the polyp.

    Conclusion

    Patients with endometrioid EC associated with polyps may have the tumor completely removed during hysteroscopy, but the variables shown in the present study could not safely predict which patient would have no residual disease.

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  • Original Article

    Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

    Rev Bras Ginecol Obstet. 2019;41(11):673-678

    Summary

    Original Article

    Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

    Rev Bras Ginecol Obstet. 2019;41(11):673-678

    DOI 10.1055/s-0039-1698774

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    Abstract

    Objective

    To evaluate whether the use of intraoperative ultrasound leads to more conservative surgeries for benign ovarian tumors.

    Methods

    Women who underwent surgery between 2007 and 2017 for benign ovarian tumors were retrospectively analyzed. The women were classified into two groups: those who underwent intraoperative ultrasound (group A) and those who did not (group B). In group A, minimally-invasive surgery was performed for most patients (a specific laparoscopic ultrasound probe was used), and four patients were submitted to laparotomy (a linear ultrasound probe was used). The primary endpoint was ovarian sparing surgery (oophoroplasty).

    Results

    Among the 82 cases identified, only 36 met the inclusion criteria for the present study. Out of these cases, 25 underwent intraoperative ultrasound, and 11 did not. There were no significant differences in arterial hypertension, diabetes, smoking history, and body mass index for the two groups (p=0.450). Tumor diameter was also similar for both groups, ranging from 1 cm to 11 cm in group A and from 1.3 cm to 10 cm in group B (p=0.594). Tumor histology confirmed mature teratomas for all of the cases in group B and for 68.0% of the cases in group A. When the intraoperative ultrasound was performed, a more conservative surgery was performed (p<0.001).

    Conclusion

    The use of intraoperative ultrasound resulted in more conservative surgeries for the resection of benign ovarian tumors at our center.

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    Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

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