Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis.

BACKGROUND: Surgical site infection (SSI) is a common postoperative complication. We aimed to analyze the potential risk factors of SSI in patients with endometrial carcinoma. METHODS: Patients with endometrial carcinoma who underwent surgery treatment in our hospital from Sept 1, 2018 to August 31, 2020 were included. We retrospectively compared the characteristics of SSI and no SSI patients, and logistic regression analyses were performed to identify the risk factors of SSI in patients with endometrial carcinoma. RESULTS: A total of 318 postoperative patients with endometrial carcinoma were included. The incidence of SSI in patients with endometrial carcinoma was 14.47 %. There were significant differences on the FIGO stage, type of surgery, durations of drainage, postoperative serum albumin and postoperative blood sugar (all p < 0.05), and no significant differences on the age, BMI, hypertension, diabetes, hyperlipidemia, estimated blood loss, length of hospital stay were found (all p > 0.05). FIGO stage IV (HR3.405, 95 %CI 2.132-5.625), open surgery (HR2.692, 95 %CI 1.178-3.454), durations of drainage ≥ 7 d (HR2.414,95 %CI 1.125-2.392), postoperative serum albumin < 30 g/L (HR1.912,95 %CI 1.263-2.903), postoperative blood sugar ≥ 10 mmol/L (HR1.774,95 %CI 1.102-2.534) were the independent risk factors of SSI in patients with endometrial carcinoma (all p < 0.05). CONCLUSIONS: Measures including reasonable control of serum albumin and blood glucose levels, minimally invasive surgery as much as possible, timely assessment of drainage and early removal of the tube may be beneficial to reduce the postoperative SSI in in patients with endometrial carcinoma.

Efficacy of 5-Aminolevulinic Acid (ALA)-Photodynamic Therapy (PDT) in Refractory Vulvar Lichen Sclerosus: Preliminary Results.

BACKGROUND As a chronic inflammatory skin disease of unknown etiology, vulvar lichen sclerosus (VLS) mainly affects postmenopausal and perimenopausal women. The main clinical manifestations of VLS include itching, burning pain, and sexual dysfunction, which can lead to a decline in quality of life. The existing treatment options include topical corticosteroid ointment, estrogen, and traditional Chinese medicine; however, their therapeutic effects on VLS remain unsatisfactory. MATERIAL AND METHODS Thirty patients with VLS and routine treatment failure were treated with 5-aminolevulinic acid (ALA)-photodynamic therapy (PDT). A 20% ALA water-in-oil emulsion was applied to the vulvar lesions and sealed with plastic film for 3 h. Patients were irradiated at a power density of 60 to 90 mW/cm² with a red light at a wavelength of 635±15 nm for 20 min, delivering a total dose of 100 to 150 J/cm² per session. The treatment was repeated 3 times every 2 weeks. The objective parameters, female sexual function index (FSFI) and quality of life (QoL) scores, were used before and after treatment to evaluate the clinical curative effect. RESULTS All patients completed 3 treatment cycles of ALA-PDT and follow-up visits. The clinical symptoms of pruritus completely disappeared in 27 cases, and itching improved from severe to mild in 3 cases. The pathological changes of all patients were objectively improved. FSFI score decreased significantly after treatment (P<0.001). The main adverse effects of ALA-PDT were pain, erythema, and swelling. These adverse effects were temporary and tolerable. The QoL score was significantly improved after treatment (P<0.001). CONCLUSIONS ALA-PDT is an effective and safe approach for the treatment of VLS.

Treatment of HPV Infection-Associated Low Grade Cervical Intraepithelial Neoplasia with 5-Aminolevulinic Acid-Mediated Photodynamic Therapy.

OBJECTIVE: To investigate the efficacy of 5-aminoketovalic acid (5-ALA) photodynamic therapy (PDT) in the treatment of patients with low cervical intraepithelial neoplasia (CINI) combined with high-risk human papillomavirus ((HR-HPV), and the factors affecting the efficacy. METHODS: 80 patients with CINI and HR-HPV infection were selected for the study. They received once weekly 5-ALA-PDT for either three or six treatments. To evaluate the clinical efficacy of 5-ALA-PDT treatment, follow-up evaluations were conducted at 3, 6 and 12 months, utilizing thinPrep cytology test(TCT)and colposcopic histopathological biopsy for the detection of HPVDNA. RESULTS: Following PDT, HR-HPV remission rates at 3, 6 and 12 months were 75.32%, 80.52%, and 81.82%, respectively. Complete remission rate of CINI was 94.81% (73/77 patients). There was no statistically significant difference in the remission rate of HR-HPV between 3 and 6 treatments with PDT (P > 0.05). Likewise, there was no difference in the remission rate comparing patients ≤40 years old and those >40 years old (P > 0.05). However, the remission rate was statistically greater in patients with normal vaginal microecology compared to patients with vaginal microecologic imbalance (P = 0.004). CONCLUSIONS: Not only can 5-ALA-PDT effectively clear CINI, but it also can clear HR-HPV. Vaginal microecological imbalance can reduce the effect of PDT on HR-HPV, whereas differences in age or frequency of PDT do not affect the remission rate of PDT on HR-HPV.

5-ALA-photodynamic therapy in refractory vulvar lichen sclerosus et atrophicus.

OBJECTIVE: As a chronic inflammatory skin disease of unknown etiology, vulvar leukoplakia mainly affects postmenopausal and peri-menopausal females. The main clinical manifestations of vulvar lichen sclerosus et atrophicus (VLSA) include itching, burning pain, and sexual dysfunction, which can lead to a decline in the quality of life. The existing treatment options include topical corticosteroid ointment, estrogen, and traditional Chinese medicine. However, their therapeutic effects on VLSA remain unsatisfactory. In the present study, we aimed to investigate the clinical efficacy and safety of photodynamic therapy (PDT) in combination with 5-aminoketovaleric acid (ALA) for the treatment of vulvar leukoplakia. METHODS: A total of 30 patients with VLSA who failed routine treatment were treated with ALA-PDT. The patients were irradiated at a power density of 60-90 mW/cm2 with a red light at a wavelength of 635±15 nm for 20 min. Twenty percent of ALA water-in-oil emulsion was applied to the lesion and sealed with plastic film for 3 h. The treatment was repeated three times every 2 weeks. The objective and subjective symptoms and signs of vulvar lesions based on the horizontal visual analogue scale were recorded at 6 months after each treatment and the last treatment. RESULTS: All patients completed three cycles of ALA-PDT and follow-up. The clinical symptoms of pruritus completely disappeared in 27 cases. Itching changed from severe to mild in three cases. The pathological changes of all subjects were improved. The main side effects of ALA-PDT were pain, erythema, and swelling. The side effects were temporary and tolerable. All patients reported their results as "satisfied" or "very satisfied". CONCLUSIONS: ALA-PDT was an effective and safe approach for the treatment of VLSA.