Résumé
OBJECTIVE: The aims of this study were to compare the efficacy and morbidity of optimal debulking operation with those of suboptimal operation for patients with advanced gynecologic malignancies and to establish the precluding factors for performing the optimal cytoreductive surgery. METHODS: From January 1998 to December 2003, debulking operation for advanced gynecologic malignancy was performed in thirty-nine patients with ovarian cancer (32), tubal cancer (4), and primary peritoneal carcinoma (3) at the department of obstetrics and gynecology, Ghil Medical Center. Of them, 38 patients had FIGO Stage IIIC disease and only one patient had FIGO Stage IV disease. Most informations were obtained by hospital records and were analyzed retrospectively. RESULTS: The mean follow-up was 23 months (range, 1-62 months). The optimal debulking operation could be performed in 25 patients (64.1%). In multivariate analysis, the largest diameter of residual tumor was the most important prognostic factor. Two-year overall survival rate of optimally debulked patients was 86.5% and that of suboptimally debulked patients was 41.3% (p=0.015). Two-year disease free survival rates were 75.9% and 7.1%, respectively (p=0.0003). Complication rates associated with surgery were 40% in optimally debulked patients and 35.7% in suboptimally debulked patients (p=0.083). Major causes of suboptimal surgery were old age (>69 yrs), poor medical condition (cardiac problem, intraoperative unstable vital sign, bronchiectasis), no submission of permission, and involvement of the base of mesentery and small bowel. CONCLUSION: Optimal debulking operation is possible if there were no significant clinical problem and involvement of base of mesentery and small bowel. It appears acceptable surgical morbidity and better prognosis. Therefore, the surgeon should use every technique aimed at removing the tumor as much as possible.
Sujets)
Humains , Survie sans rechute , Études de suivi , Gynécologie , Archives administratives hospitalières , Mésentère , Analyse multifactorielle , Maladie résiduelle , Obstétrique , Tumeurs de l'ovaire , Pronostic , Études rétrospectives , Taux de survie , Signes vitauxRésumé
OBJECTIVE: To evaluate the clinical outcome and characteristics of laparoscopy assisted vaginal hysterectomy (LAVH) in gynecologic patients. METHODS: From September, 2001 to February, 2004, total 570 cases of patients were performed LAVH at Gacheon medical school Ghil Hospital. We reviewed medical records and analyzed these cases about age, parity, weight, previous surgery history, operation indication, operation outcome, duration of hospitalization and complication. RESULTS: The results of this study summarized as follows. The mean age of patients was 46.4 +/- 7.2 years old. Average parity of patients was 2.4 +/- 1.4. Average weight of patients was 63.4 +/- 8.2 kg. Previous operation history was 195 cases (34.2%). Most common operation indication was uterine leiomyoma, followed by adenomyosis, combination of leiomyoma and adenomyosis and endometriosis. The mean operation time was 72 +/- 20.6 minutes. The mean duration of hospitalization was 4.5 +/- 0.6 days. The major complication of operation was trocar site bleeding, followed by bladder injury, bowel injury, and ureteral injury. CONCLUSION: LAVH is safe and useful. So it is recommendable to gynecologic patients.
Sujets)
Femelle , Humains , Endométriose intra-utérine , Endométriose , Hémorragie , Hospitalisation , Hystérectomie vaginale , Laparoscopie , Léiomyome , Dossiers médicaux , Parité , Écoles de médecine , Instruments chirurgicaux , Uretère , Vessie urinaireRésumé
The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary. It is the most common type of all virillizing ovarian tumors, accounting for less than 0.5% of all primary ovarian neoplasm. Recently, we experienced two cases of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Sujets)
Femelle , Aménorrhée , Tumeurs de l'ovaire , Ovaire , Tumeur à cellules de Sertoli et de Leydig , Tumeurs des cordons sexuels et du stroma gonadiqueRésumé
The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary. It is the most common type of all virillizing ovarian tumors, accounting for less than 0.5% of all primary ovarian neoplasm. Recently, we experienced two cases of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.