Disseminated ovarian Growing Teratoma Syndrome: a case -report highlighting surgical safety issues.

The ovarian Growing Teratoma Syndrome (GTS) is a rare condition among patients with primary Non-Seminomatous Germ Cell Tumours (NSGCT) presenting with enlarging masses during or after appropriate chemotherapy in the context of normalized serum markers. Several modes of dissemination are suggested, with the most frequent site of metastasis being the peritoneum. We report a case of a young patient with primary ovarian mixed NSGCT, who presented with Growing Teratoma Syndrome not only in the peritoneum but also within a trocar site after an initial surgery consisting in the laparoscopic morcellation and extraction of the ovarian neoplasm. Beside the rarity of this clinical entity, it also demonstrates the utmost importance of the safe laparoscopic management of all complex ovarian masses.

Laparoscopic pelvic exenteration for gynaecological malignancy: is there any advantage?

INTRODUCTION: Pelvic exenteration (PE) remains one of the most mutilating surgical procedures with important postoperative morbidity. Laparoscopic approach has emerged in an attempt to reduce postoperative complications. The aim of the present study was to compare outcomes between laparoscopic pelvic exenteration combined with a vaginal or perineal approach, versus classical approach. METHODS: A cohort study was performed by identifying patients who underwent laparoscopic pelvic exenteration, and retrospectively comparing data with open cases from the same period of time, from 2000 to 2008. RESULTS: Fourteen patients underwent laparoscopic PE and 29 patients underwent an open exenterative procedure. All patients except one (97.6%) had received prior radiotherapy. Eighteen patients (41.9%) underwent total PE, 17 anterior PE (39.5%), and 8 posterior PE (18.6%). Urinary diversion (UD) technique consisted of 24 Miami pouch (68.6%), 9 Bricker diversion (25.7%), 1 Kock pouch (2.9%), and 1 ureterostomy (2.9%). Most frequent postoperative complications were related to the urinary diversion (45%) and bowel reconstruction (27.9%). Median estimated blood loss for the laparoscopy and laparotomy group was 400 ml (range 200-700 ml) and 875 ml (range 200-1600 ml), respectively. Transfusion rate was also significantly higher in the laparotomy group. Operative time, margin status, length of hospital stay, operative and postoperative morbidity, and disease and overall survival were not significantly different between both groups. CONCLUSIONS: Laparoscopic PE is feasible with curative intent to selected patients. Potential postoperative advantages of laparoscopic approach when compared to classical approach, oncological safety of the procedure, and QOL considerations need to be further investigated.

Achievement goals in sport: the development and validation of the Perception of Success Questionnaire.

Recent research into motivation and achievement behaviour in sport has focused on achievement goal theory. This theory states that two goal orientations manifest themselves in achievement contexts and impact on the motivation process. These two goals have been defined as 'task' and 'ego' goal orientations. This paper traces the development of the Perception of Success Questionnaire as a measure of achievement goals developed specifically for the sport context. The early development of the questionnaire is documented, in which the scale was shortened from the initial 29 to the current 12 question format. We demonstrate that task and ego goals are orthogonal, internal reliabilities for the orientations are high, with strong construct and concurrent validity. We conclude by reporting results from two recent confirmatory factor analyses that were conducted on the Children's and Adult versions of the questionnaire; these results show the Perception of Success Questionnaire to be a reliable and valid instrument to measure achievement goal orientations in sport.