ABSTRACT
Mature cystic teratomas (MCTs) are some of the most common ovarian neoplasms in women of reproductive age. However, familial teratomas are exceedingly rare. We present 4 cases of dermoid cysts seen in a mother and her 3 daughters with left MCTs. None of the patients had symptoms at the time of diagnosis, but all of them were diagnosed in their twenties during an annual gynecologic examination. In this report, we elaborate on MCTs familial incidence, genetic linkage, theories of pathogenesis, diagnosis, complications, and surgical management. To our knowledge, after extensive review of the literature, there have been only 2 cases, in addition to the present case, of unilateral MCTs across generations reported.
Subject(s)
Dermoid Cyst/genetics , Genetic Predisposition to Disease , Ovarian Neoplasms/genetics , Teratoma/genetics , Adult , Female , Humans , Middle AgedABSTRACT
OBJECTIVE: To compare robot assisted laparoscopic platform to standard laparoscopy for the treatment of endometriosis. DESIGN: A retrospective cohort controlled study. SETTING: Tertiary referral center. PATIENT(S): Seventy-eight reproductive aged women. INTERVENTION(S): Robot assisted or standard laparoscopy for the treatment of endometriosis between January 2008 and January 2009. MAIN OUTCOME MEASURE(S): Operative time, estimated blood loss, hospitalization time, intraoperative and postoperative complications. RESULT(S): Seventy-eight patients underwent treatment of endometriosis, 40 by robot assisted laparoscopy and 38 by standard laparoscopy. The two groups were matched for age, body mass index (BMI), stage of endometriosis, and previous abdominal surgery. Mean operative time with the robot was 191 minutes (range 135-295 minutes) compared with 159 minutes (range 85-320 minutes) during standard laparoscopy. There were no significant differences in blood loss, hospitalization, intraoperative or postoperative complications. There were no conversions to laparotomy. CONCLUSION(S): Both robot assisted laparoscopic and standard laparoscopic treatment of endometriosis have excellent outcomes. The robotic technique required significantly longer surgical and anesthesia time, as well as larger trocars.
Subject(s)
Endometriosis/surgery , Laparoscopy/instrumentation , Laparoscopy/methods , Robotics/methods , Uterine Diseases/surgery , Adolescent , Adult , Case-Control Studies , Cohort Studies , Endometriosis/rehabilitation , Female , Gynecologic Surgical Procedures/adverse effects , Gynecologic Surgical Procedures/instrumentation , Gynecologic Surgical Procedures/methods , Gynecologic Surgical Procedures/rehabilitation , Humans , Laparoscopy/adverse effects , Laparoscopy/rehabilitation , Middle Aged , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/instrumentation , Minimally Invasive Surgical Procedures/methods , Minimally Invasive Surgical Procedures/rehabilitation , Pregnancy , Pregnancy Rate , Retrospective Studies , Uterine Diseases/rehabilitation , Young AdultABSTRACT
In recent years, there have been significant changes in many aspects of extragenital endometriosis ranging from the epidemiology to the management of the disease. Advances in minimally invasive surgery and expansion of the field have lead to further research in management of extragenital endometriosis. As a result, treatment has shifted from medical management toward a surgical, multidisciplinary approach. Surgery for extragenital endometriosis clearly improves outcome through relief of symptoms, improved quality-of-life, increased fertility rates, and reduced recurrences. Endoscopy has a pivotal role as both a diagnostic and therapeutic tool.
