RESUMEN
BACKGROUND AND AIMS: To evaluate diagnostic laparoscopy (DL) and laparoscopic ultrasonography (LUS) in the diagnostic workout of patients with colorectal liver metastases, who were considered to have resectable disease after multi detector computed tomography (MDCT). MATERIAL AND METHODS: The medical records of 45 patients, 22M/23F, mean age 62.0 (+/-10.6), who were considered to have resectable liver metastases after CT-scan, were analysed. RESULTS: DL and LUS could not be performed in 7 patients (16%) because of adhesions. Unresectable disease was detected by DL in 3 patients (7%), in all cases due to carcinosis. Additional lesions in the liver were detected by DL in 2 cases (4%), none of these making the patient unresectable. LUS showed additional lesions in 3 patients (7%), which in one case (2%) made the patient unresectable. None of the patients in the present study experienced adverse effects to DL or LUS. CONCLUSION: DL and LUS, due to the low efficacy with regard to avoid unnecessary laparotomies and the relative high failure rate because of adhesions, should not be a routine part of the diagnostic work out in patients with colo-rectal liver metastases.
Asunto(s)
Neoplasias Colorrectales/patología , Endosonografía/métodos , Laparoscopía/métodos , Neoplasias Hepáticas/secundario , Neoplasias Colorrectales/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Hysterosalpingography (HSG) with lipiodol ultra fluid was performed in 294 infertile women with a normal ovulatory temperature curve and at least two years of infertility and a partner with normal sperm. In 21 per cent, pregnancy occurred within 6 months after the examination, and about one third of the women with a normal finding or with intraperitoneal adhesions at HSG conceived. The pregnancy rate was especially high in the first two cycles after HSG. The spontaneous pregnancy rate was 8 per cent, and the difference between this and the total number of pregnancies must be attributed to a therapeutic effect of the procedure. Previous pelvic inflammatory disease was present in 40 per cent of those who did not become pregnant, while only 11 per cent of those who conceived had previous inflammation. Of the women without previous gynecologic disease 30 per cent conceived.
