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1.
J Laparoendosc Adv Surg Tech A ; 29(1): 24-28, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30198831

ABSTRACT

OBJECTIVES: The aim was to study technique, complications, and outcomes of transvaginal ultrasound-guided radiofrequency myolysis (TRFAM) of uterine myomas. MATERIALS AND METHODS: A prospective observational study of 205 patients with metrorrhagia secondary to type II/III submucosal or intramural cavity-distorting myomas undergoing outpatient TRFAM under sedation between September 2015 and February 2017. MAIN OUTCOME MEASURES: Intraoperative and postoperative complications, correction of metrorrhagia, patient satisfaction, mean volume of myoma, and hemoglobin level at 1, 3, 6, and 12 months after the procedure. RESULTS: The mean age of the patients was 38.7 years (range 26-49). The mean operating time was 17 minutes (range 11-44). The mean postoperative time to discharge home was 2.3 hours (range 1.6-3.2). There were 2 (1.46%) patients with type III-b complications (Clavien-Dindo classification). The mean (standard deviation [SD]) preoperative myoma volume was 122.4 [182.5] cm3. There was a significant reduction in the mean volume at 1 (85.2 [147.9] cm3; P = .001), 3 (67.3 [138.0] cm3; P = .001), 6 (59.3 [135.3] cm3; P = .001), and 12 months (49.6 [121.4] cm3; P = .001). The mean volume reduction at 12 months was 60% when compared with preoperative volume. All patients had normal menstruation at a mean follow-up of 3 months (range 1.5-6). CONCLUSION: TRFAM is an effective and safe technique in selected patients for the treatment of metrorrhagia secondary to myomas.


Subject(s)
Leiomyoma/surgery , Natural Orifice Endoscopic Surgery/methods , Radiofrequency Ablation/methods , Uterine Neoplasms/surgery , Adult , Female , Hemoglobins/analysis , Humans , Leiomyoma/complications , Metrorrhagia/etiology , Metrorrhagia/surgery , Middle Aged , Patient Satisfaction/statistics & numerical data , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prospective Studies , Radiofrequency Ablation/adverse effects , Ultrasonography, Interventional/adverse effects , Ultrasonography, Interventional/methods , Uterine Neoplasms/complications
2.
Gynecol Oncol ; 105(3): 604-8, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17321572

ABSTRACT

OBJECTIVE: The appropriate management of advanced ovarian cancer has been controversial in recent years. There are no adequate data about the importance of lymphadenectomy and the appropriate sites for lymph node assessment. We sought to evaluate the distribution, size, and number of pelvic and aortic lymph node metastases in patients with epithelial ovarian carcinoma. METHODS: Retrospective chart review of 116 patients with stage IIIC or IV epithelial ovarian carcinoma treated at Mayo Clinic who underwent systematic bilateral pelvic and aortic lymphadenectomy between 1996 and 2000. RESULTS: Eighty-six (78%) of 110 patients who underwent pelvic lymphadenectomy were found to have nodal metastases in 422 (16%) of 2705 pelvic nodes that were removed. Eighty-four (84%) of 100 patients had documented aortic lymph node metastases in 456 (35%) of 1313 aortic nodes that were removed. Fifty-five (59%) of 94 patients had bilateral metastatic pelvic and aortic lymph nodes and bilateral aortic lymphadenectomy was conducted in 53 (72%) of 74 patients. The most representative group for detection of nodal metastases was the aortic group (83%) followed by the external iliac group (59%) and the obturator nodes (53%). There was no significant difference between the mean size of positive (1.8 cm) and negative nodes (1.6 cm). Thirty-seven patients had unilateral tumor, and 1 patient (7%) had contralateral node metastasis. CONCLUSION: The incidence of positive nodes bilaterally and positive high aortic nodes indicates the need for bilateral pelvic and aortic node dissection (extending above the inferior mesenteric artery) in all patients regardless of laterality of the primary tumor.


Subject(s)
Lymph Nodes/pathology , Ovarian Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Aorta , Epithelial Cells/pathology , Female , Humans , Lymph Node Excision , Lymph Nodes/surgery , Lymphatic Metastasis , Middle Aged , Ovarian Neoplasms/surgery , Pelvis
3.
Gynecol Oncol ; 90(2): 458-61, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12893219

ABSTRACT

BACKGROUND: Malignant lesions derived from mesonephric (Wolffian) remnants are uncommon. The course of these tumors is usually indolent, and the recurrence has only been documented in nine cases. Because of the small number of cases, no current recommendations exist regarding treatment, and little is known about the response to chemotherapeutic agents. CASE: A 33-year-old woman was diagnosed with a mesonephric adenocarcinoma arising in the uterine corpus. Ten months after initial surgery and radiotherapy she presented with local and pulmonary relapse. Salvage chemotherapy with carboplatin plus paclitaxel was administered with a good response. CONCLUSIONS: Mesonephric adenocarcinomas are uncommon neoplasms. Their treatment remains elusive. We report a case of a recurrent uterine mesonephric adenocarcinoma that presented a good response to therapy with carboplatin plus paclitaxel. A review of the previous literature is also presented.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Mesonephroma/drug therapy , Neoplasm Recurrence, Local/drug therapy , Uterine Neoplasms/drug therapy , Adult , Carboplatin/administration & dosage , Female , Humans , Paclitaxel/administration & dosage
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