Scar Endometrioma: An Uncommon Yet Easily Treated Condition.

OBJECTIVE: To illustrate and emphasize the need for keeping scar endometrioma in mind in order to facilitate an early diagnosis in cases of a mass detected on the abdominal wall in women who have undergone a cesarean section. STUDY DESIGN: Records of 21 patients were reviewed retrospectively. All the patients complained of a mass on the abdominal wall and had undergone cesarean section in the past. Endometrioma was confirmed histopathologically for each patient. Information about the characteristics of the patients are retrieved from the patient records and analyzed. RESULTS: The average age of patients was 31 years. The average duration before onset of the complaints in the postcesarean section period was 32.9 months, and the average duration of the complaints was 25.3 months. In most cases (62%) the scar endometrioma was located at the right end of the Pfannenstiel incision. The average size of the endometrioma masses was 30 mm. Recurrence was not observed in any of the patients during an average follow-up of 31.3 months after total excision. CONCLUSION: Scar endometrioma is a rare disease which can be treated easily. If a mass on a cesarean section scar which becomes sensitive during menstruation is detected in a patient with history of cesarean section, the diagnosis of scar endometrioma should be suspected.

Effect of the intraperitoneal paclitaxel on the healing of colonic anastomoses.

The effect of the antiangiogenic agent paclitaxel on the healing of colonic anastomoses was studied in a rat model. Ninety-six rats underwent end-to-end colonic anastomoses, and healing was evaluated by measuring bursting pressure, hydroxyproline content, and number of newly formed vessels. The rats with end-to-end anastomoses were randomized into control and study groups (n = 48). The rats in the control group were administrated 5 ml physiologic saline intraperitoneally, and those in the study group were given 4.5 mg/kg paclitaxel in 5 ml physiologic saline intraperitoneally. One-half of the rats in both groups were killed on day 4, and the other half were killed on day 7 after surgery with high doses of ether anesthesia. There were no deaths. No detectable improvement in anastomoses bursting pressure was observed in the paclitaxel group on day 4 after surgery. On postoperative day 7, a statistically significant difference was found between the groups (P < 0.05). On day 4 after surgery, there was no statistically significant difference in hydroxyproline levels and vessel density between the two groups (P > 0.05; hydroxyproline: 26.25 versus 16 microg/mg tissue; vessel contents: 110.8 versus 118.2 vessels/x 100 fields for control and study groups, respectively). On postoperative day 7, a significant difference was detected between the two groups (P < 0.0001; hydroxyproline: 40.5 versus 9.6 microg/mg tissue; P < 0.05; vessel contents: 105 versus 85.3 vessels/x 100 fields for control and study groups, respectively). Neovascularization and hydroxyproline levels in rats receiving paclitaxel were significantly reduced on postoperative day 7 (P < 0.05 and P < 0.0001, respectively). These findings suggest that the antiangiogenic efficiency of paclitaxel, and thus, negative impact on wound healing, is more prominent on postoperative day 7. Experimentally, paclitaxel may inhibit and delay healing of colonic anastomoses.