Programmed Death Ligand 1: Unveiling its Impact on Endometrial Carcinogenesis.

Endometrial cancer is a commonly diagnosed gynecological malignancy presenting an increasing incidence worldwide. The immune response plays a crucial role in the mechanisms underlying carcinogenesis and the progression of tumors. In recent times, there has been a discernible surge in the acknowledgment of the importance of programmed death ligand 1 (PDL1) in evading the immunological response of the host and promoting the growth of malignancies. The primary aim of this review is to consolidate the existing corpus of evidence pertaining to the role of PDL1 in the etiology and progression of endometrial cancer and investigate the molecular mechanisms involved in the expression of PDL1 in cells impacted by endometrial cancer. Finally, the association between PDL1 expression and clinical outcomes, as well as the potential therapeutic uses of targeting the PDL1 pathway are being analyzed.

Application of J-Plasma in the excision of diaphragmatic lesions as part of complete cytoreduction in patients with advanced ovarian cancer.

For the resection of diaphragmatic disease in patients with advanced ovarian cancer (OC), a plethora of ablative methods have been utilized. The present study aimed to present preliminary data on the use of J-Plasma in OC with diaphragmatic involvement via a retrospective review of patients who had diaphragmatic stripping with of J-Plasma® from January 2016 to September 2020. A total of 12 patients (median age, 65 years) were analyzed. Median operative time was 240 min while median estimated blood loss was 400 ml. Median operative time for diaphragmatic resection was 25 min. During a median follow-up of 12 months, two recurrences were noted while none of the patients died of the disease. Median disease free survival was 12 months. Overall, the preliminary outcomes of the present study indicated that J-Plasma could be safely used in diaphragmatic resection and it was associated with low rates of short-term morbidity. However, further studies are warranted to reach to safe conclusions.

Surgery for ureteral repair after gynaecological procedures: a single tertiary centre experience.

PURPOSE: This study evaluates the frequency of ureteral repair and its management in patients with a history of gynaecologic surgery. MATERIALS AND METHODS: After retrospective review of the medical records of all major gynaecologic operations performed over a six-year period (2004-2010), 17 cases of ureteral repair were identified. The indication and the type of gynaecological surgery, the anatomic site, the indication, the type of ureteral repair and the associated morbidity were analyzed. RESULTS: Ureteral repair was necessary in 17 (0.26 %) out of 6,422 patients who had undergone a gynaecological operation. The indication for surgery was fibroma in 6 cases (0.11 %) out of 5,481 and malignancy in 11 cases (1.17 %) out of 941. Ureteral damage was recognized intraoperatively in eight patients and postoperatively in nine with a mean delay of 13.1 days (range 1-29). Indications for ureteral repair were ligation (11.8 %), laceration (11.8 %), partial or total accidental transection (29.5 %), metastasectomy due to tumor infiltration (17.4 %) and fistula formation (29.5 %). Ureteral repair was accomplished by ureteroneocystostomy (70.6 %), ureteroureterostomy (5.9 %), insertion of a double-j stent (17.6 %) and Boari-Ockerblad flap (5.9 %). Febrile morbidity was the most common postoperative symptom (29.0 %), followed by wound infection (18 %) and ileus (1 %). One patient (5.9 %) developed hydronephrosis due to ureteric stenosis as a late complication. CONCLUSIONS: Although the need for ureteral repair is relatively infrequent during gynaecological operations, prompt recognition and treatment within accepted guidelines result in successful outcome.

Primary retroperitoneal echinococcal cyst.

A 74-year-old man was admitted with right flank pain and discomfort lasting for 2 months. CT scanning revealed a large retroperitoneal cystic mass. There were no cysts elsewhere. Serological testing revealed hydatid disease. Preoperatively he was treated by Albendazole 400 mg for 1 month and then underwent laparotomy. The entire mass was excised en bloc and intact and right hemicolectomy was simultaneously performed for excision of the adhered ascending colon. He recovered uneventfully and was discharged on the eighth day, Albendazole was given and follow-up visits were arranged for every 6 months. Total cystectomy in case of active echinococcal cysts remains the treatment of choice.