Research progress and enlightenment of unplanned readmission in postoperative gynecologic malignancy patients / 中国实用护理杂志

The high incidence of unplanned readmission of postoperative patients with gynecologic malignancies not only seriously affects the quality of life of patients, but also increases the medical burden. This paper reviews the current situation, common causes, relevant factors and insights of unplanned readmission of postoperative gynecologic malignancy patients, and further explores the unplanned readmission of postoperative gynecologic malignancy patients in China by drawing on existing foreign studies and combining them with the actual situation in China, with the aim of providing a basis for clinical health care professionals to develop targeted intervention plans, so as to effectively reduce the unplanned readmission of postoperative gynecologic malignancy patients.

Ovarian dysgerminoma with Müllerian anomaly: a case report

Effectiveness of semi-open suturation of vaginal stump in prevent the development of pelvic lymphocele after pelvic lymphadenectomy / 中国实用妇科与产科杂志

OBJECTIVE: To evaluate the effectiveness of semi-open suturation of vaginal stump in preventing pelvic lym-phocele after pelvic lymphadenectomy during gynecologic cancer surgery.METHODS:This study is a retrospectivestudy.Totally 348 patients with cervic cancer or endometrial cancer who underwent pelvic lymphadenectomy and/or para-aortic lymphadenectomy from January 2012 to September 2018 were divided into two groups according to the suturationof vaginal stump:102 patients were in the semi-open group and 246 patients were in the closed group.The two groupswere compared concerning the surgery time,harvested lymph node,drainage time,albumin level,hemoglobin content,and the incidence of lymphocele and symptomatic lymphocele.RESULTS:There were no differences between two groupswith respect to surgery time,harvested lymph node,drainage time,albumin level or hemoglobin content(P>0.05).Theincidence of lymphocele and symptomatic lyphocele in semi-open group was significantly lower than that in closed group(35.3%versus79.3%,3.9%versus19.5%,P<0.05);the average diameter of lymphocele in semi-open group was also sig-nificantly lower than that in closed group(4.1cm versus 5.9cm,P<0.05).CONCLUSION:The result of this study indicatesthat the application of semi-open saturation of vaginal stump is an effective way to reduce the incidence of pelvic lym-phocele after gynecologic malignancy,which is simple and with reliable effect.It doesn′t increase the incidence of postop-eration complications and deserves clinical application.

Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature / 부인종양

OBJECTIVE: Postoperative acute renal failure (PO-ARF) is an important cause of mortality among surgical patients. Although there have been many reports on PO-ARF after cardiac surgery and liver transplantation, less is known about the risk of PO-ARF after gynecologic operations. We aimed to investigate the risk of PO-ARF on gynecologic malignancy operations. METHODS: 1,155 patients' medical charts were reviewed who underwent therapeutic surgery for gynecologic malignancies from January 1, 2005 to December 31, 2007, at the Asan Medical Center, Seoul, Korea. RESULTS: Of these, 10 patients, comprising 0.89% of those who underwent radical hysterectomies and 0.86% of those who underwent debulking operations, were diagnosed with PO-ARF. Their mean age was 61.9+/-10.1 years. Five patients had preoperative risk factors. Mean operating time was 360.8+/-96.2 minutes. Five patients experienced intra-operative hypotension and all patients were given blood transfusions during surgery. Eight patients underwent hemodialysis, with two continuing on dialysis to date. Only two patients fully recovered. CONCLUSION: Patients undergoing surgery for gynecologic malignancies may be at high risk for PO-ARF, because of old age, long operation times, and profuse bleeding. It is necessary to monitor these patients for postoperative renal function and urine output. If a postoperative oliguric state is detected, aggressive volume expansion should be started immediately, followed by hemodialysis.

PET Imaging for Gynecologic Malignancy / 한양의대학술지

The utility of positron emission tomography (PET) in gynecologic malignancy has increased rapidly in recent years. This review examines publications in this area. PET scans in gynecologic malignancy are mostly performed using F-18 FDG. It is valuable in primary staging of untreated advanced cervical cancer, for post-treatment unexplained tumor marker elevation, and restaging of potentially curable recurrent cervical cancer. However, its value in early-stage cervical cancer is limited. In ovarian cancer, sequential imaging predicts response to neoadjuvant chemotherapy and survival. It is also very useful when increases in CA 125 or CT/MRI defined recurrence is noted, but biopsy deemed infeasible. The role of PET or PET/CT has evolved from a iagnostic tool into a potential indicator of response to treatment and prognosis. Evaluating PET or PET/CT using clinical impact is an attractive new endpoint.

Surgical Management for Recurrent Gynecologic Malignancy / 대한산부인과학회지

Surgery continues to be an important option in the management of recurrent gynecologic malignancies. As a single modality, it can be the sole curative treatment for a selected group of patients with localized recurrent malignancy and contributes to the management of patients with more disseminated recurrent malignancy as part of multimodal treatment. The use of exenterative surgery for localized recurrence has been extended, and complications have been minimized. Our understanding of the role of cytoreduction in disseminated recurrence has increased, but care must be taken in order to maximize the benefit of cytoreduction and minimize morbidity until the evidences are more clarified in prospective randomized trial. Morbidity related to radical surgery can be reduced without compromising patient cure by individualizing surgery. Moreover, newer reconstructive techniques can improve quality of life. Sometimes, surgery can be performed with relatively simple procedures, such as wide local excision. However, for more disseminated cancers, such as metastatic ovarian cancer, surgery can be very complex, requiring resection of several non-gynecological organs. Therefore extensive surgical training and experience is needed to successfully manage patients with these challenging conditions, and this has resulted in the development of the subspecialty of gynecological oncology. A brief update on the role of surgery in the management of recurrent gynecologic malignancies is presented in this article.

Clinical impact of recombinant human erythropoietin in the treatment of anemia of gynecologic malignancies / 대한산부인과학회지

OBJECTIVE: To examine the influence of erythropoietin (Epokaine prefil(R)) on transfusion requirements, serum hemoglobin levels in patients with gynecologic malignancies under polychemotherapy and chemotherapy associated anemia. METHODS: From January 2001 to March 2003, 70 patients treated with chemotherapy due to gynecologic cancer from Severance hospital were included into this study. Patients were assigned to one of two groups (case group (n=28) and control group (n=42)). Patients in case group received 2000 U or 6000 U Epokaine(R) subcutaneously two or three times a week for more than 3 cycles (9 weeks), and patients in control group didn't received Epokaine(R) (n=42). If the hemoglobin levels of 1st, 2nd and 3rd cycle >1 g/dL above the baseline value and/or >12 g/dL, patients were classified as responders. Patients who required blood transfusions or if the hemoglobin levels of 1st, 2nd and 3rd cycle <1 g/dL were as non-responders. RESULTS: 28 cases of 70 patients were assessable for response and complication to Epokaine(R) application. In the Epokaine(R) group, 53%, 64%, 71% of the patients responded to the treatment (at 1st, 2nd and 3rd cycle, respectively) and only 7 patients (21.4%) required blood transfusions, whereas 28 patients in control group (66.7%) needed transfusion. Mean transfused units were 1.56 in case group and 3.55 in the control group (P=0.03). In case group, mean hemoglobin levels were significantly increased after the 1st, 2nd and 3rd cycle of chemotherapy (0.73 g/dL, 1.34 g/dL, 1.65 g/dL, respectively) compared with the mean baseline value. CONCLUSION: We concluded that Epokaine(R) significantly decreases transfusions requirements and increases serum hemoglobin levels in patients with gynecological malignancies who are undergoing polychemotherapy. Therefore, Epokaine(R) would be effective in the treatment of anemia of gynecologic cancer patients receiving polychemotherapy.

Lymph Node Metastasis in a Gynecologic Malignancy

A radical hysterectomy was performed on patients with stage IA2 to IIB cervical cancer. For these patients, many histopathological parameters have been reported to be prognostic factors of cervical cancer, such as a pelvic lymph node (PLN) metastasis, the histological subtype, the tumor diameter, the depth of the stromal invasion, a lymph-vascular space invasion (LVSI), a parametrial invasion, a corpus invasion and a vaginal invasion. Ovarian cancer is normally treated with cytoreductive surgery followed by chemotherapy. Although physicians have paid a great deal of attention to intraperitoneal disease, a substantial number of ovarian cancers have reported to involve the retroperitoneal lymph nodes. Therefore, a lymph node metastasis has been introduced into FIGO staging. However, the prognostic significance of a lymph node metastasis is controversial. In order to determine the possibility of individualizing a pelvic lymph node (PLN) dissection in patients with endometrial cancer, the relationship between PLN metastasis and the various prognostic factors was investigated. In this paper, various prognostic variables including a lymph node metastasis were analyzed in cervical cancer, enodometrial cancer, and ovarian cancer.

Analyses of Gynecologic Cancer Registry in Kuri hospital Hanyang university for 5 years (July. 1, 1995 - Jun. 30, 2000) / 대한부인종양콜포스코피학회잡지

The purpose of this study was to review the clinical features, histological types and the mode of treatment of malignant gynecologic tumors. Retrospective reviews of the medical recordings for 75 cases with malignant gynecologic tumors in department of Obstetrics and Gynecology, Kuri hospital Hanyang University from July. 1, 1995 to Jun. 30. 2000. We analysed clinical characteristics, stage, histopathologic type and treatment modality. Of 75 cases, 44 cases were carcinoma of the uterine cervix, 21 cases were ovarian cancer and 10 cases were uterine cancer. The mean age of cervix cancer is 53.3 years, ovarian cancer is 50.9 years and uterine cancer is 49.5 years old. The main treatment modality of cervix and uterine cancer were surgery followed radiotherapy and ovary cancer was surgery plus adjuvant chemotherapy. However, as the number of patients were small in our study, further study with large number of patients are warranted.

The Clinical Effect of Recombinant Human Granulocyte-Colony Stimulating Factor to the Leukopenia During Chemotherapy in the Patients with Gynecologic Malignancies / 대한부인종양콜포스코피학회잡지

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.

Angiographic Embokization in the Control of Bleeding Related to Gynecologic Malignancy / 대한부인종양콜포스코피학회잡지

The use of angiographic embolization gas been well described for the control of gynecologic bleeding. Recently, we have experienced the successful embolization in two case of serons bleeding related to giynecologic malignancy. Clinical evaluation revealed a gynecologic cancer with active bleeding. Becaause we judged that conservative management was unable to cuntrol the bleeding, we underwent an angiographic embolization. The result presented here indicates that angiographic embolization is a relatively safe, effective and rapid procedure that should be considered early in management of gynecohogic cancer bleeding that is unresponsive to conservative management.