RESUMO
OBJECTIVE: The purpose of this study was to review the incidence, clinicopathological feature, treatment, outcome in the series of childhood and adolescence with ovarian mass PATIENTS AND METHODS: Retrospective reviews of the medical recordings for 116 patients with ovarian mass under the age of twenty years old who were admitted, operated and confirmed with histopatholgical study at the department of obstetric and gynecology, Gachon medical school, Inchon, Korea for 8 years from Jan. 1993 till Dec. 2000. RESULTS: Of 116 the patients who underwent surgical treatment, the incidence of malignant ovarian tumors was 15 cases(12.9%). If ovarian neoplasm alone are considered, the rate of malignancy increases to 17.6%. The frequency of ovarian malignancies correlated inversely with patient age. In the 0-10 age group ,40% had malignancies, as compared with 20.3% in the 11-15 age group and 15.3% in the 16-20 age group. On histopathological classification, the tumors originated from germ cell tumors were 55.2%, epithelial cell tumors were 40%, and sex-cord stromal tumors were 4.7%. According to FIGO classification of malignant ovarian tumor, stage I(80%) was most common, followed stage IV(13.3%), stage II(6.6%) and III(0%). 13 of the 15 malignant ovarian tumors, unilateral salpingoophorectomy was done in an attempt for reproductive organ conservation; 2 cases of stage IV disease were treated with hystrectomy, bilateral salpingoophorectomy and omentectomy. On follow up, only two ovarian malignancy stage IV died within 3 months and another is well. CONCLUSION: The frequency with which ovarian meoplasms malignancy in the under 20 age group is 17.6%. Because of their malignant potential in young girl, prompt evaluation and treatment is imperative.
Assuntos
Adolescente , Feminino , Humanos , Classificação , Células Epiteliais , Seguimentos , Ginecologia , Incidência , Coreia (Geográfico) , Prontuários Médicos , Neoplasias Embrionárias de Células Germinativas , Neoplasias Ovarianas , Estudos Retrospectivos , Faculdades de MedicinaRESUMO
OBJECTIVE: To compare the second and third cesarean section by clinical and statistical analysis. METHODS: From June 1993 to February 1997, we experienced 296 cases of the third cesarean section and 541 cases of the second cesarean section. We analyzed their incidence, age distribution, gestational week at operation, weight distribution of baby at birth, hemoglobin change, estimated blood loss during operation, obstetrical complication, combined operation, and degree of pelvic adhesion, presence of wound dehisence of uterus, post operative complication. RESULTS: Of the total deliveries, overall incidence of cesarean section was 51.4%, while the incidence of the second cesarean section was 16.0%, and that of the third cesarean section was 1.1%. In the third cesarean section the age group of 31-35 was most common(49.7%), and the most common gestational week at operation was 39th week(43.9%). In the third cesarean section, the hemoglobin change of 1.0g% less was most common(95.2%), and the most common amount of estimated blood loss was 400-600ml(61.0%). There was statistically significant difference of the blood transfusion rate between the third cesarean section(41 cases, 13.8%, p=0.04) and second cesarean section(27 cases, 5.0%). The most common combined operation in the third cesarean section was tubal ligation(51.7%), and the others were bladder wall repair(2.0%), cesarean hysterectomy(1.7%). In the third cesarean section, the incidence of mild intraabdominal adhesion was 16. 9% and that of severe adhesion was 11.8%. It was statistically significant compared to the second cesarean section. Among the complications of the third cesarean section, there were 9 cases of placenta accreta(3.0%), 4 cases of placenta previa totalis(1.4%), and 1 case of uterine rupture, uterine atony, uterine arterial rupture(0.3% each other), and did not proved statistical significance. CONCLUSION: In this study, we found that the rate of blood transfusion, cesarean hysterectomy, bladder wall repair, and the degree of intraabdominal adhesion were more common in the third cesarean section than second section. But, if pre- & postoperative management is adequate, maternal mobidity and neonatal mobidity is not affected.