Differences in perioperative outcomes after laparoscopic management of benign and malignant adnexal masses / 부인종양

OBJECTIVE: To compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy. METHODS: Retrospective study of 694 women that underwent laparoscopic management of an adnexal mass. RESULTS: Laparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups. CONCLUSION: Laparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.

Relation between leptin and metabolic control in elderly diabetics

An inverse correlation of serum leptin level with hemoglobin A1c has been found in adults with diabetes mellitus. To assess this relation as well as the leptin levels in elderly with diabetes mellitus type 2, this study included twenty diabetic patients aged above sixty on oral hypoglycemic medications, in addition to two control groups; fifteen healthy elderly and fifteen young adults. All subjects were studies as regards serum leptin levels and other biochemical parameters such as serum uric acid, cholesterol, triglycerides, fasting blood suger, postprandial blood sugar, hemoglobin A1c. The results in both diabetic and health elderly as well as young controls were compared. Serum liptin levels were not affected by presence of diabetes but were inversely correlated with glyemic control and hemoglobin A1c. There was no significant difference as regards serum leptin levels in elderly compared to young adult controls. Serum leptin level were directly correlated with body mass index in young adults as well as in elderly, however, this correlation was disrupted in presence uncontrolled diabetes mellitus