Comparison of pregnancy prognosis by surgical management for Adnexal mass in pregnancy / 대한산부인과학회지

OBJECTIVE: To compare pregnancy prognosis by surgical management methods for adnexal mass in pregnancy, we evaluated laparoscopic surgery and laparotomy. METHODS: Between January 2000 and April 2008, 62 patients diagnosed with adnexal mass in pregnancy from St. Mary's hospital, Kangnam St. Mary's hospital, and Daejeon St. Mary's hospital were included. We performed a systemic retrospective chart review of patient who received by exploratory laparotomy or laparoscopy. The following factors were assessed: preoperative diagnosis, gestational age at the time of surgery, operative time, hospital stay, pathology, gestational age at delivery, complication and pregnancy outcome in both groups. Student's t-test and Fisher's exact test were used for statistical analysis. P-value below 0.05 was considered statistically significant. RESULTS: Laparoscopy 23 cases and exploratory laparotomy 39 cases underwent surgery during the study period. Lower abdominal pain due to cystic mass (50.0%) was the first operative indication and cystic torsion (30.6%) was followed. There was no difference in operative time, hospital stay, pregnancy outcome (spontaneous abortion, threatened abortion, preterm labor or birth) between two groups. But threatened abortion and preterm labor were increased in emergency operation than elective operation (P=0.028). Pregnancy outcomes were similar between laparoscopy and laparotomy. CONCLUSION: There was no difference in pregnancy complication and prognosis. Laparoscopic surgery can be managed safely as laparotomy in pregnancy women with adnexal mass.

Comparison of pregnancy prognosis by surgical management for Adnexal mass in pregnancy / 대한산부인과학회지

OBJECTIVE: To compare pregnancy prognosis by surgical management methods for adnexal mass in pregnancy, we evaluated laparoscopic surgery and laparotomy. METHODS: Between January 2000 and April 2008, 62 patients diagnosed with adnexal mass in pregnancy from St. Mary's hospital, Kangnam St. Mary's hospital, and Daejeon St. Mary's hospital were included. We performed a systemic retrospective chart review of patient who received by exploratory laparotomy or laparoscopy. The following factors were assessed: preoperative diagnosis, gestational age at the time of surgery, operative time, hospital stay, pathology, gestational age at delivery, complication and pregnancy outcome in both groups. Student's t-test and Fisher's exact test were used for statistical analysis. P-value below 0.05 was considered statistically significant. RESULTS: Laparoscopy 23 cases and exploratory laparotomy 39 cases underwent surgery during the study period. Lower abdominal pain due to cystic mass (50.0%) was the first operative indication and cystic torsion (30.6%) was followed. There was no difference in operative time, hospital stay, pregnancy outcome (spontaneous abortion, threatened abortion, preterm labor or birth) between two groups. But threatened abortion and preterm labor were increased in emergency operation than elective operation (P=0.028). Pregnancy outcomes were similar between laparoscopy and laparotomy. CONCLUSION: There was no difference in pregnancy complication and prognosis. Laparoscopic surgery can be managed safely as laparotomy in pregnancy women with adnexal mass.

Primary Carcinoma of the Fallopian Tube: Report of Two Cases with Literature Review / Journal of the Korean Cancer Association, 대한암학회지

Primary fallopian tube carcinoma (PFTC) is a rare tumor that histologically and clinically resembles epithelial ovarian cancer. PFTC has a worse prognosis than ovarian cancer as it is not routinely suspected and so treatment may be delayed. The early clinical manifestations and a prompt investigation can often lead to a correct diagnosis at an early stage. The preoperative diagnosis is usually difficult, and most patients with PFTC undergo laparotomy with the presumed diagnosis of ovarian carcinoma according to the presence of an adnexal mass. PFTC can present preoperatively as a tubo-ovarian abscess and it should be considered in the differential diagnosis of acute pelvic peritonitis. PFTC should be suspected by clinicians even if the presenting symptoms are atypical. We report here on two cases of PFTC along with a brief review of the literature.

A case of extraosseous ewing's sarcoma/primitive neuroectodermal tumor of the ovary / 대한산부인과학회지

Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) family mainly occurs from skeletal system. ES/PNET from the female reproductive organs such as ovary and uterus has been reported very rarely. Recently, we experienced one case of malignant ovarian neoplasm, which was diagnosed as extraosseous ES/PNET of ovary and received operation and chemotherapy. So, we report this case and include a brief literature review.

Two cases of small bowel herniation through 5 mm trocar site following removal of drains after gynecologic laparoscopy / 대한산부인과학회지

After laparoscopic surgery, most cases of incisional hernia occur when a trocar greater than 10 mm is used and this rarely occurs when a 5 mm trocar is used. We recently experienced two cases of incisional herniation at a 5 mm port site in connection with withdrawal of the drain after laparoscopic procedure.

Two cases of small bowel herniation through 5 mm trocar site following removal of drains after gynecologic laparoscopy / 대한산부인과학회지

After laparoscopic surgery, most cases of incisional hernia occur when a trocar greater than 10 mm is used and this rarely occurs when a 5 mm trocar is used. We recently experienced two cases of incisional herniation at a 5 mm port site in connection with withdrawal of the drain after laparoscopic procedure.

Value of Human Papilloma Virus load in hybrid capture II assay to predict high grade cervical intraepithelial neoplasia in menopausal women with ASCUS or LSIL / 대한산부인과학회지

OBJECTIVE: To evaluate whether determination of the Human Papilloma Virus (HPV) viral load is helpful to predict the presence of high-grade cervical intraepithelial neoplasia (CIN) that requires aggressive treatment in menopausal women who have presented with an unsatisfactory colposcopic finding and ASCUS or LSIL. METHODS: In menopausal women with ASCUS or LSIL and with who were positive for HPV, 54 women had diagnostic conization were analyzed retrospectively. We used the Hybrid Capture II method. We classified women in a low-risk group (chronic cervicitis, CIN I) and a high-risk group (> or =CIN II) according to the pathological results of conization. We also classified patients into the HPV viral load or =100 RLU/PC group. We analyzed the relationship between the pathological results of conization and viral load. RESULTS: For the conization, 30 women had chronic cervicitis, nine women had CIN I, three women had CIN II and 12 women had CIN III. In the low Hybrid Capture titer-group ( or =CIN II pathology but in the high Hybrid Capture titer-group (> or =100 RLU/PC), 11 women had high risk pathology this finding was statistically significant (P=0.013). Compared to the low Hybrid Capture titer group, the relative risk of high grade CIN (> or =CIN II) in the high Hybrid Capture titer group was 2.043 (95% CI, 1.216~3.432). CONCLUSIONS: For menopausal women with an unsatisfactory colposcopic finding and also have ASCUS or LSIL women with high HPV viral load might have tendency of > or =CIN II pathology.

Factors affecting the satisfaction rate of radiofrequency myolysis: 18 months follow up / 대한산부인과학회지

OBJECTIVE: To report 18 months follow up results of radiofrequency myolysis and analysis the factors which effect the success rate of myolysis. METHODS: 153 patients who took radiofrequency myolysis between October 2004.~June 2006 in this hospital were enrolled this retrospective study. Except 14 patients which had incomplete data, total 139 patient's charts were reviewed. Sonographic evaluations were checked after a week, 1 month, 3 months, 6 months, 12 months, and 18 months after myolysis. Questions about complications like vaginal bleeding, abdominal pain, feber and vaginal discharge were asked to patients in every visits. Volume of the myoma were checked via 3D ultrasonography. RESULTS: Reduction rate of the volume of myoma after 18 months were 73% and reoperation rate were 4.3%. Improvement rates of patients symptom were 87% (menorrhagea 95%, dysmenorrheal 75%, pelvic pain 60%) The patients who had myomas sized over 100 ml before treatments showed statistically higher rate of reoperation, and decreased rate of satisfaction. Reoperation rate and reduction rate of myoma showed no difference through pathologic diagnosis. The patients who had initial symptoms showed higher rate of satisfaction after myolysis. Total satisfaction rate were 62%, and no serious complications like bowel injury, bladder injury, sepsis and peritonitis were not reported. CONCLUSION: Satisfaction rate after radiofrequency myolysis was increased in symptomatic leiomyoma especially smaller than 6.5 cm in diameter.

The Effect of V-Y Advancement Flap after Vulvectomy in Patients with Vulvar Cancer / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study is to evaluate the clinical effect of V-Y advancement flap after vulvectomy in patients with vulvar cancer. Local and systemic morbidity, the degree of satisfaction after operation, length of hospital stay were evaluated. PATIENTS AND METHODS: From March 2001 to september 2002, five patients with invasive vulvar cancer were eligible for this study. All the patients underwent radical vulvectomy with groin lymph nodes dissection. All of them were reconstructed by the same surgeon using ischial fasciocutaneous V-Y flaps based on perforators from the inferior border of the gluteous maximus muscle. RESULTS: Flap survival was 100%. There were no major complication including wound infection, wound disruption, urinary tract infection, and seroma in the femoral triangle. Functional outcome was excellent in all patients. CONCLUSION: The V-Y advancement flap provides a straight-forward and simple safe reliable method as a common approach in radical vulvectomy.