Second-look laparoscopy in ovarian cancer.

Forty-six patients with epithelial ovarian cancer previously treated with surgery, chemotherapy or external radiation underwent second-look laparoscopy to evaluate management. Twenty of the patients had positive laparoscopic findings and were not subjected to further laparotomy. The frequency of positive findings was related to the stage of the disease. Laparoscopic examination revealed no evidence of cancer in the remaining 26 patients. Three of the patients in this group were found to have additional disease at subsequent laparotomy. The laparoscopic procedures were not associated with major complications. Although second-look laparoscopy cannot replace repeat laparotomy, it does have a role in the follow-up of patients with ovarian cancer.

Bacteriologic aspects of pelvic inflammatory disease in gynecologic patients.

The bacteriology of acute pelvic inflammatory disease (PID) was studied in 65 women. Endometrial, endocervical and vaginal cuff cultures were taken. In some cases blood cultures and cultures from the cul-de-sac or pelvic abscess were also obtained. Mixed organisms (aerobes and anaerobes) were the most common isolates from the endometrial, endocervical or vaginal cuff cultures, present in 40%. Neiseria gonorrhoeae was isolated in 8 (12.30%) endocervical specimens. Anaerobes were the most common bacteria recovered from cul-de-sac aspirates, pelvic abscesses and blood cultures. The combination of gentamicin, penicillin and metronidazole was the most common antibiotic scheme used. However, other antibiotics as cefoxitin and clindamycin were also used according to the sensitivity test. These data support the polymicrobial etiology of the disease and suggest: (1) the high incidence of anaerobic or mixed infections, and (2) the relatively low incidence of gonococcus in the studied cases.

Bacteriology of amniotic fluid.

The incidence of aerobic and anaerobic bacteria in the amniotic fluid and the cervix of 101 healthy parturients, with intact membranes, was studied. Pharynx, urine and umbilical cord of the newborns were also examined for the same pathogens. Although positive cultures from the cervix were found in 41.58% of the cases, the contamination of the amniotic fluid was only 1.98%. Our results support the view of the antibacterial activity of amniotic fluid.