A Clinical Study on 1594 Cases of Operative and Diagnostic Laparoscopy / 대한산부인과학회잡지

OBJECTIVE: Laparoscopic surgery provides patients with the benefits of shortened hospital stay and faster return to normal activity. The objective is to evaluate the efficacy of laparoscopic surgery in gynecologic patients. METHODS: From January, 1999 to December, 2002, total 1594 patients were performed laparoscopic surgery at Uijongbu St. Mary's Hospital. We reviewed the medical record and analyzed these cases about age, parity, diagnosis, name of operation, operation time, duration of hospitalization and side effect. RESULTS: The results of this study summarized as follows: 1. The mean age of patients was 34.0 years old and the great incidence occurred in 26-30 years old group (24.7%). 2. The average parity of patients was 1.05. 3. The common indications were ovarian cyst (34.4%), myoma uteri (19.1%), infertility (9.5%), ectopic pregnancy (15.0%), etc. In diagnostic pelviscopy, the most common indication was infertility (50.6%), and ovarian cyst (38.3%) was the most common indication in operative pelviscopy. 4. The major types of operative pelviscopy were cystectomy, LAVH, TLH, salpingectomy, adnexectomy, electrocauterization. 5. The mean duration of hospitalization was 3.72 days. 6. The major complication of surgery were intestinal injury, postoperative paralytic ileus, bleeding at resection site, but they were controlled without difficulty. CONCLUSION: Pelviscopic surgery is useful and recommended for the treatment of gynecologic disease, because this is safe and has many advantages.

A case of Primary Malignant Fibrous Histiocytoma of the Round Ligament / 대한산부인과학회잡지

In adults, although malignant fibrous histiocytoma (MFH) is the most frequent malignant soft tissue tumor. Primary malignant fibrous histiocytoma of the round ligament of the uterus is comparatively very rare. A patient presented with severe lower abdominal pain and a palpable pelvic mass in the lower abdomen. Emergency laparotomy revealed a 15 X 15 cm tumor located in the left round ligament and adhered with uterus and intestine. The patient underwent total abdominal hysterectomy and bilateral salpingectomy. The final diagnosis was based on the pathological report of the surgical specimen.

Clinical Study of Borderline Ovarian Malignancy / 대한산부인과학회잡지

OBJECTIVES: The purpose of this study is to investigate the clinicopathologic characteristics and the risk factors affecting the recurrence in patients with borderline ovarian malignancy. METHODS: From January 1996 to January 2001, 37 patients with borderline tumors of the ovaries were retrospectively investigated in the Department of Obstetrics and Gynecology, Catholic University, Kangnam and Uijongbu St. Mary's Hospital. Several clinicopathologic factors including DNA ploicly was analyzed for the prognosis and recurrence. Analysis for the kinds of treatment and recurrence were conducted to test the prognostic significance of several clinicopathologic factors including DNA analysis. RESULTS: Histologically, 27 borderline tumors were serous, 9 were mucinous and 1 was mixed epithelial type. The FIGO stage I was 91.8% (34/37) and stageII was 8.2% (3/37). Mean value of CA125 in mucinous borderline malignancy was significantly higher (162.4 IU/mL) than serous types (52.2 IU/mL) (p35 IU/mL) were 56.3% (9/16) in serous type and 75% (6/8) in mucinous tumors. Ten of 13 cases with DNA flow cytometry showed aneuploidy (76.9%). When considering pathologic types between diploid and aneuploid groups, there were no statistically significant differences. However, the patients with old age (>40) were more likely to be aneuploid (p<0.05). Mean duration of follow-up investigation was 26 months after primary operation. In this period, only one patient with serous borderline tumor stage Ia had recurrence on the contra-lateral ovary at 13-month. CONCLUSION: Data from this study showed that the majority of borderline tumors have good prognosis. And young patients who have not completed childbearing can be safely treated with unilateral salpingo- oophorectomy and omentectomy in stage I diploid tumor. In ovarian bordeline tumors, further studies on DNA ploidy would be needed.