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Introduction: Obesity is a growing problem and has signi?cant implications for a variety of diseases, including human cancers. Obesity has now become an epidemic so is the increase of gynecological malignancies in this era. So we review the association of obesity and gynecological malignancies like breast, endometrial, cervical, ovarian, tubal and Vulvo-vaginal carcinoma as an independent etiological risk factor. To Aims and objectives: estimate the prevalence of overweight and obese female in western Indian population. To ?nd the association of different gynecological malignancies and obesity. To evaluate the effect of obesity on different gynecological malignancies in accordance with age, reproductive life and socioeconomic status A cross sectional study in western . Materials and methods: Indian states Gujarat, Maharashtra and Rajasthan from January 2019 to December 2021, 10245 sample size and with overweight and obese post menarchal women up to 70 years of age with BMI >25 kg/m2 were compared to matched controls. All the consented subjects were initially screened by questionnaire by ?eld worker and examined for routine and advanced screening and examinations like Manual Palpation of breast, per abdomen, per speculum per vaginal examination and Pap smear by certi?ed professionals according to standard protocols. Investigation was performed when required like mammography, Ultrasonography and laboratory investigations. Positive association of breast and endometrial Results: carcinoma especially in postmenopausal women and cervical carcinoma. Weak positive association for ovarian carcinoma only in premenopausal woman (not statistically signi?cant). We do not ?nd enough cases to conclude anything for vulvo vaginal and tubal carcinoma. Growing epidemic of obesity can be statistically correlated with increasing Conclusion: incidence of gynecological malignancies like breast, endometrial, ovarian and cervical. Large scale studies further needed for evaluation of correlation of vulvo vaginal and tubal carcinomas
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With the improvement of therapy,the survival time of patients with gynecological malignant tumor is prolonged,so improving their quality of life has become a new challenge for doctors.These patients may be in perimenopause themselves,or be in artificial menopause due to tumor treatment,and their climacteric symptoms are more obvious than those in natural menopause.Whether hormone therapy could be used to relieve the climacteric symptoms in these patients is still controversial at present.Clinicians should give individualized hormone therapy cautiously on the basis of patients' informed consent.
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OBJECTIVE: To evaluate the clinical significance of laparoscopic extraperitoneal para-aortic lmphadenectomy(PAL)in high para-aortic lymphadenectomy.METHODS: A non-randomized controlled method was used to analyze the clinical data of laparoscopic extraperitoneal PAL in 35 patients(extraperitoneal group)and laparoscopic transabdominal PAL in 40 patients(transabdominal group)in the Gynecological Department of the First Affiliated Hospital of Xiamen University from March 2018 to April 2019.RESULTS: All the 35 cases of laparoscopic extraperitoneal PAL reached the level of renal vein.Endometrial cancer accounted for the largest proportion,with an average age of 47.57 years and an average body mass index of 23.77.The average operation time was 109 minutes in the first 6 cases and 74.73 minutes in the other 29 cases.The amount of hemorrhage was 15.19 mL,and the average number of para-aortic lymph nodes(PALN)resected was 17.87.There were 5 cases of positive PALN metastasis,and the average gastrointestinal recovery time was13.43 hours.The average postoperative pelvic drainage was 76.57 hours and the average postoperative hospital stay was8.24 days.Intraoperative and postoperative complications included 1 case of inferior vena cava rupture,1 case of chyle leakage,and 1 case of vulvar edema.None of the 40 cases of laparoscopic transabdominal PAL reached the level of renal vein,and endometrial cancer accounted for the largest proportion,with the average age of 46.78 years and the average body mass index of 24.03.The average operation time was 90.55 min;the average intraoperative blood loss was 67.40 mL The average number of para-aortic lymph nodes was 3.30.There was one case of PALN metastasis.The average gastrointestinal recovery time was 22.35 hours,and the average postoperative pelvic drainage time was 75.75 hours.The average length of hospital stay was 8.90 days.There were 2 cases of rupture of the inferior mesenteric artery,3 cases of chyle leakage,and 2 cases of vulvar edema.The number of PALN resection,intraoperative blood loss,and operation time in the extraperitoneal group were not related to the body mass index,but the number of PALN in obese patients in the laparoscopic transabdominal group was significantly reduced,the operation time was longer,the intraoperative blood loss was more,and postoperative gastrointestinal recovery time is longer(P<0.05).CONCLUSION: Laparoscopic extraperitoneal PAL can solve the problems of laparoscopic transabdominal PAL lymph node resection,which is difficult to reach the level of renal vein,intraoperative intestinal tube interference,and the number of lymph nodes resected.It is especially suitable for obese patients.Laparoscopic extra-peritoneal high-grade PAL is safe,feasible,and recommended.
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Minimally invasive treatment is of great significance to gynecological tumors. Laparoendoscopic single-site surgery(LESS)and natural orifice transluminal endoscopic surgery(NOTES)are recent advances in the field of minimally invasive treatment. At present,a variety of gynecological benign surgery can be managed by LESS or NOTES surgery,and achieved good clinical results. Operation for gynecologic malignancies are complicated,and LESS and NOTES surgery are still controversial for the treatment of gynecologic malignancies. At present,domestic and foreign scholars have made some useful attempts to apply NOTES surgery to malignant tumors.Preliminary data have confirmed the feasibility of these procedure,but due to the small operating space,the operation is difficult,and the operation skills still need to be developed.Based on the experience of our hospital's initial exploration,this article briefly explains the current situation,advantages,difficulties and technical experience in the application of NOTES surgery for gynecological malignancies.
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Introduction: Concurrent chemo-radiation is the main treatment in locally advanced cervical cancer. The change of bladder and rectum volume may lead to change in the positions of these structures and target volume during MUPIT implant which may lead to variation in dose to the organ at risk and target. Materials and Methods: Ten patients of gynecological malignancy were included. MUPIT template was positioned under anesthesia. CT scan was done for the contouring of bladder, rectum, and target and for planning purpose which generates plan (P1). CT scan was repeated before the third fraction of the treatment (CT2). The resultant plan (P2) was analyzed qualitatively and quantitatively. Results: Bladder volume variations of 88.18% to -68.15% were noted. This change in volume lead to differences in the maximum dose in bladder between fractions. The maximum dose variation ranged from 62.53% to -21.49%. The rectal volume variation ranges 11.71% to -46.20% due to the rectal filling. High variation in maximum dose to the rectum were observed which might be due to rectal filling. CTV volume is increased by 19.48% while in other by 19.05% and in all other patients the volume is decreased. CTV volume maximum decreased by 30.54% which might be due to decrease in edema developed during procedure. The volume variation in CTV is in range of19.48% to -30.54%. Conclusion: It is proposed that re-planning using repeat CT scan is required before third fraction implementation.
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Objective To study the new nursing method of patients complicated with urinary fistula after gynecological malignancy operation. Methods Nursing measures were provided with sufficient nutritional support and prevention of urinary tract infection by perineal nursing, vaginal plugging by OB sliver,and using endovaginal catheter to 23 patients complicated with urinary fistula after gynecological malignancy operation. Results 18 patients recovered by treatment and nursing, 4 mild cases cured after discharge from hospital and 1 patient died of MODS and multiple metastasis. Conclusions Vaginal plugging by OB sliver, perineal nursing and sufficient nutritional support have positive effect for patients complicated with urinary fistula after gynecological malignancy operation.