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1.
JBRA Assist Reprod ; 18(1): 24-26, 2014 Mar 27.
Article in English | MEDLINE | ID: mdl-35761720

ABSTRACT

Adnexal masses are relatively common, contributing to gynecologist office volume and surgical case load. The development of minimally invasive techniques and a greater focus on fertility preservation have led to the favoring of a laparoscopic approach with ovarian cystectomy, when possible. We report the case of a young woman presenting with two simultaneous, distinct ovarian masses who was successfully treated by laparoscopy with preservation of both gonads. A minimally invasive surgical approach by laparoscopy with preservation of both ovaries is feasible and crucial, even in rare and difficult cases such as the case presented.

2.
JBRA Assist Reprod ; 18(4): 139-143, 2014 Dec 27.
Article in English | MEDLINE | ID: mdl-35761742

ABSTRACT

OBJECTIVE: Evaluate the type and incidence of postoperative complications after surgery for deep infiltrative endometriosis at Biocor Hospital. METHODS: Our observational study involved a multidisciplinary surgical team that performed laparoscopy on 154 patients suffering from pelvic pain. Surgical complications occurring up to the 30th postoperative day were recorded. RESULTS: Mean age patient age was 34.1 years. Infertility was present in 69 (45%) although 31% had not attempted to get pregnant. Dysmenorrhea was the most frequent symptom (79.3%) followed by chronic pelvic pain (59.7%) and deep dyspareunia (48,7%). Most cases required extensive surgery as the majority (n=117; 76.9%) were classified as severe endometriosis (ASRM grade IV). The most frequent surgical procedures were: 136 adhesiolysis, 100 intestinal surgeries (85 retosigmoidectomies), 92 peritonal lesion excision, 39 vaginal resections, 19 myomectomies, 21 hysterectomies and 5 partial bladder resections. Postoperative complications were recorded in 14 (9.59%) patients: 8 (5.48%) major complications and 6 (4.11%) minor. Major complications included blood transfusion (n=2) retosigmoid anastomosis dehiscence (1), rectovaginal fistula (n=1), urinary fistula (n=1), deep vein thrombosis (n=1), lower limb compartment syndrome with motor deficit (n=1) and one intestinal obstruction (n=1). Minor complications were abdominal wall infection (n=3), peripheral neuropathy (n=3), bladder atony (n=1) and bladder perforation (n=1). No deaths were observed. All major complication cases underwent retosigmoidectomy associated with vaginal resection (n=6), uterosacral ligament excision (n=5) or hysterectomy (n=3). CONCLUSION: The surgical treatment of DIE is complex and subject to complications. The surgical expertise of a multidisciplinary team plays a vital role in this setting.

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