Serum interleukin-6 levels are elevated in women with minimal-mild endometriosis.

BACKGROUND: There is a need for a reliable marker of endometriosis, especially in early stages of peritoneal disease during which imaging is not effective. The use of serum interleukin (IL)-6 as a marker is controversial. To readdress the matter, patients undergoing laparoscopy were prospectively evaluated for serum IL-6 levels. MATERIALS AND METHODS: A total of 119 women 31 years old who underwent laparoscopy were divided into groups: control patients (n = 38) with no pathologic findings; endometriosis sufferers (n = 47) with minimal-mild (MM, n = 11) or moderate-severe (MS, n = 36) endometriosis; uterine myomas (n = 13) and benign ovarian pathologies (n = 21). Blood was drawn on cycles days 5-12 and stored for subsequent analysis of IL-6 and carbohydrate antigen (CA)-125 levels. RESULTS: Serum IL-6 levels were significantly (P = 0.002) higher in women with MM endometriosis (29.4 9.0 pg/ml) than in controls (15.7 9.3 pg/ml). When all the non-endometriosis patients were grouped together (n = 72) and serum IL-6 (17.8 12.1 pg/ml) compared with MS (n = 36; 17.6 10.3 pg/ml) and MM (n = 11; 29.4 9.0 pg/ml) endometriosis significantly (P < 0.01) higher levels in MM endometriosis were observed as compared to the other two groups. Serum Ca-125 levels were significantly (P < 0.01) elevated in MS endometriosis. A serum IL-6 threshold of 25.75 pg/ml afforded a sensitivity of 75% and specificity of 83% in the diagnosis of MM endometriosis. Sensitivity and specificity for CA-125 in the diagnosis of MS endometriosis, using 35 IU/ml as the cut-off value, were 47% and 97%, respectively. CONCLUSIONS: IL-6 is a reliable non-invasive marker of MM endometriosis, whereas Ca-125 is of use as a marker of severe cases.

Electrocoagulación tubárica laparoscópica. Idoneidad de su realización en una unidad de cirugía sin ingreso / Laparoscopic tubal electrocoagulation. Suitability in ambulatory surgery

OBJETIVO: Analizar la conveniencia de la realización de electrocoagulación tubárica bilateral en una unidad de cirugía sin ingreso. MARCO: Intervenciones de bloqueo tubárico por laparoscopia realizadas en la Unidad de Cirugía Sin Ingreso. MATERIAL Y MÉTODO: Estudio retrospectivo de 212 pacientes sometidas a esta técnica ambulatoriamente entre el año 2000 y 2004 en el Hospital Universitario Dr. Peset de Valencia. RESULTADOS: La edad media de las pacientes es de 36,04 años, el tiempo medio de anestesia al que son sometidas es de 60,3 minutos y el tiempo medio de recuperación posquirúrgica es de 251 minutos. En 4 años, únicamente se ha producido una complicación quirúrgica y dos ingresos hospitalarios. CONCLUSIONES: Esta técnica permite el paso del paciente desde el quirófano directamente a la sala de readaptación al medio (fast-track). Su realización precisa precisa de cuidados postoperatorios específicos sin requerir para tal fin de ingreso hospitalario (nivel II de Davis JE) (AU)

OBJECTIVE: To analyse the usefulness of laparoscopic bilateral tubal electrocoagulation in Outpatient Surgical Unit. FRAMEWORK: Laparoscopic bilateral tubal electrocoagulation in an Outpatient Surgical Unit. MATERIAL AND METHOD: A retrospective study of 212 patients who underwent this ambulatory surgical procedure between 2000 and 2004 at the Dr. Peset Universitary Hospital in Valencia. RESULTS: The study population´s average age was 36.04, the average anaesthetic time was 60.3 minutes and the average time for postsurgical recovery was 251 minutes. A single surgical complication and two hospital admissions ocurred during this period. CONCLUSIONS: This technique allows the patient to go directly from the surgical theatre to the readaptation ward (fast-track). Specific postsurgical care is needed in this procedure but hospital admissionis not necessary (2nd David JE stage) (AU)

Predicción del ingreso hospitalario en el tratamiento laparoscópico ambulatorio del endometrioma ovárico / Prediction of hospital admissions for laparoscopic ambulatory treatment of ovarian endometrioma

OBJETIVOS: Establecer el riesgo relativo de ingreso hospitalario en las intervenciones laparoscópicas por endometriosis en la Unidad de Cirugía Sin Ingreso. DISEÑO: Estudio retrospectivo. MARCO: Intervenciones realizadas en la Unidad de Cirugía Sin Ingreso (UCSI).PACIENTES: 36 intervenciones. Determinación del riesgo relativo de ingreso hospitalario según las siguientes variables:1) Tamaño del endometrioma mayor de 50 mm.2) Presencia de adherencias.3) Tiempo quirúrgico mayor de 100 minutos.4) Combinación de tamaño endometrioma mayor de 50 mm y presencia de adherencias.5) Combinación tamaño endometrioma mayor de50 mm, presencia de adherencias y tiempo quirúrgico mayor de 100 minutos. RESULTADOS: El riesgo relativo de ingreso hospitalario es 2.03 veces mayor cuando el tamaño del endometrioma supera los 50 mm. En presencia de adherencias este riesgo se incrementa en 1.28 veces. Con un tiempo quirúrgico superior a los 100 minutos el riesgo relativo de ingreso hospitalario pasa a ser 1.1 veces mayor. La combinación de la presencia de adherencias y un tamaño del endometrioma superior a 50 mm eleva este riesgo en 3.12 veces. Finalmente cuando a estos factores añadimos un tiempo quirúrgico superior a los 100 minutos, elevamos el riesgo de ingreso en2.85 veces. CONCLUSIONES: Aisladamente el factor que más incrementa el riesgo relativo de ingreso hospitalario es el tamaño del endometrioma, y el que menos el tiempo quirúrgico. El mayor riesgo de ingreso hospitalario se da cuando se combina un tamaño del (..) (AU)

OBJECTIVES: To establish the relative risk of hospital admission for laparoscopic surgery for endometriosis in the Outpatients’ Surgical Unit. DESIGN: A retrospective Study. FRAMEWORK: Surgery carried out in the Outpatients’ Surgical Unit. PATIENTS: 36 operations. To determine the relative risk of hospital admission according to the followingvariables.1) Size of endometrioma greater than 50 mm.2) Presence de adherences.3) Time needed for surgery exceeding 100 minutes.4) Combination of the size of endometrioma being greater than 50 mm and the presence of adherences.5) Combination of the size of the endometrioma being greater than 50 mm and the presence of adherences and time needed for surgery exceeding100 minutes. RESULTADOS: The relative risk of hospital admission is 2.03 times greater when the size of the endometrioma exceeds 50 mm. 1.28 times greater when there are adherences. 1.1 times greater when the time needed for surgery exceeds 100 minutes.3.12 times greater when the size of the (..) (AU)