196,121 research outputs found
Vaginal versus abdominal hysterectomy in endometrial cancer: a retrospective study in a selective population
No full textInt J Gynecol Cancer. 2008 Jul-Aug;18(4):797-802. Epub 2007 Oct 18.
Vaginal versus abdominal hysterectomy in endometrial cancer: a retrospective study in a selective population.
Berretta R, Merisio C, Melpignano M, Rolla M, Ceccaroni M, DE Ioris A, Patrelli TS, Nardelli GB.
SourceDepartment of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. [email protected]
Abstract
The purpose of this study was to analyze the outcome of vaginal and abdominal hysterectomy for the treatment of early-stage endometrial cancer in a selected group of elder patients. This retrospective study analyzed a total of 154 patients: 113 (group I) underwent vaginal surgery and 41 (group II) underwent laparotomy. In both groups, we investigated the following parameters: intra- and postoperative complications, mean operative time, mean hospital stay, disease-free survival (DFS), overall survival (OS), and time of local or retroperitoneal recurrence. Medically compromised patients were significantly more frequent in the vaginal surgery group (P = 0.005), and the operative duration in this group was significantly shorter (P = 0.01). Intra- and postoperative complications, along with local and distant recurrence, did not show a statistically significant difference in the two groups. Total survival in the two populations, 85% at 5 years, did not reach statistically significant difference either in terms of DFS or in terms of OS. Vaginal surgery compared to traditional abdominal approach is feasible also in patients with high surgical risk; it does not require general anesthesia, abolishes abdominal trauma correlated to laparotomy, and allows a quicker reprise of the bladder and rectal function; therefore, it achieves high eradication rates and low intra- and postoperative morbidity rates
Randomised prospective study of abdominal wall closure in patients with gynaecological cancer.
No full textAust N Z J Obstet Gynaecol. 2010 Aug;50(4):391-6.
Randomised prospective study of abdominal wall closure in patients with gynaecological cancer.
Berretta R, Rolla M, Patrelli TS, Piantelli G, Merisio C, Melpignano M, Nardelli GB, Modena AB.
SourceDepartment of Obstetrics and Gynecology, University of Parma, Italy. [email protected]
Abstract
BACKGROUND: Median laparotomy is the most common approach to the abdominopelvic cavity in patients with gynaecological tumours.
AIMS: The primary endpoint of the study was to evaluate the onset of incisional hernia. The secondary endpoint was to evaluate the onset of infection, wound dehiscence, wound infection, and scar pain during the post-operative period.
METHODS: A total of 191 patients were eligible for the study. They were divided into three groups. Group A underwent en bloc closure of the peritoneum and fascia with Premilene suture, Group B en bloc closure of the peritoneum and fascia with Polydioxanone suture, and Group C separate closure of the peritoneum and fascia with single stitches of Ethibond suture. Statistical analysis was performed using the Statistical Software Package for Social Sciences 12.0.
RESULTS: Group A and Group B comprised 63 patients, and Group C included 65 patients. The three groups proved homogeneous on statistical analysis (P > 0.05). The statistical analysis did not reveal significant differences between the different suture types and techniques with respect to the incidence of incisional hernia (P > 0.05).
CONCLUSION: In our study, the incidence of incisional hernia was 8%. Randomised patients were homogeneous for sample size and risk factors. No significant differences were found between suture types or techniques. Currently, there is no suture material or technique that can be considered superior to others. When possible, we believe that the best way to prevent incisional hernia is to preserve the integrity of the abdominal wall using minimally invasive techniques
Endometrial carcinoma metastatic to the vulva: A case report and review of the literature
No full textPreoperative transvaginal ultrasonography and intraoperative gross examination for assessing myometrial invasion by endometrial cancer
No full textJ Ultrasound Med. 2008 Mar;27(3):349-55.
Preoperative transvaginal ultrasonography and intraoperative gross examination for assessing myometrial invasion by endometrial cancer.
Berretta R, Merisio C, Piantelli G, Rolla M, Giordano G, Melpignano M, Nardelli GB.
SourceDepartment of Obstetrics and Gynecology, University of Parma, Via A. Gramsci 14, 43100 Parma, Italy. [email protected]
Abstract
OBJECTIVE: Endometrial cancer is the most common gynecologic malignancy. The cornerstone of treatment remains surgery according to International Federation of Gynecology and Obstetrics staging. The aim of this study was to evaluate the concordance between myometrial infiltration detected by ultrasonography and gross examination with respect to definitive histologic examination and to select a population in which lymphadenectomy could be excluded. We also evaluated the concordance for the degree of tumor differentiation between diagnostic biopsy and final histologic results.
METHODS: Our study included 75 patients with International Federation of Gynecology and Obstetrics stage I endometrial cancer. We evaluated preoperative and definitive grading and myometrial infiltration detected by ultrasonography and gross examination. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the procedures under study were determined with the Bayes theorem. To determine the predictive value of preoperative transvaginal ultrasonography and intraoperative gross examination for myometrial invasion, we used a multiple logistic regression model with a statistical software package.
RESULTS: Our study showed 60% concordance between biopsy and histologic results. In 80% of the cases with discordant results, the tumor was undergraded. Ultrasonography had diagnostic accuracy of 73%, whereas gross examination correctly determined myometrial invasion in 82.6% of the patients, with sensitivity of 62% and specificity of 79%.
CONCLUSIONS: Preoperative transvaginal ultrasonography and macroscopic gross examination appear to be simple, fast, and reliable methods to predict in myometrial invasion in patients with a low risk for lymph node metastasis, for which lymphadenectomy can reasonably be avoided
A Comparision of Back-Off and Ternary Tree Collision Resolution Algorithms in HFC Access Networks
No full textSydney, Australia
A large scale SHM system: A case study on pre-stressed bridge and cloud architecture
No full textIn recent decades, external prestressing is increasingly being used especially in motorway and railway bridge structures due to the substantial savings in terms of construction time and costs. In such systems, internal and external steel tendons work together with concrete elements to withstand external actions. This means that the deterioration or failure of these elements reduces structural safety in a meaningful way. Real time monitoring of prestressing tendons can provide useful information on the health of the bridge under service loads, detecting possible fatigue, corrosion and damage/deterioration processes. However, most of the currently used structural monitoring systems are rather expensive and time consuming to install. Although many papers address high density sensing as the proper solution thanks to the “internet of things” tool, both for hardware and software, there are not so many applications in which this approach is really put into service. This paper describes the application of MEMS accelerometers in a high performance and cost-effective SHM system for bridge structures. In particular, data from a real time monitoring system installed in a box section composite highway bridge are presented. The external tendons of this bridge have been instrumented with a total number of 88 triaxial accelerometers. Changes in the dynamic characteristics of the monitored elements have been analyzed by detecting the shift in tendons’ dynamic behavior. The main challenge was collecting a huge amount of data and find a way to properly process them, not requiring the operator’s direct action, unless the observed situation is out of the “normal” scenario. For this purpose, simple but easy-to-implement specific data processing algorithms have been tested in order to check the real feasibility of such a SHM system first, and then to analyze the collected sensor data and provide an efficient real time damage detection
Metastatic extragenital neoplasms to the uterus: A clinicopathological study of four cases.
No full textThe aim of this study was to elucidate the clinicopathologic features, the
differential diagnostic problems, and the prognostic consequences of patients
with metastatic extragenital malignancies to uterus. The patients with metastatic
extragenital malignancies to the uterus were evaluated. We considered the
metastases in non-genital tract organs at diagnosis of primary neoplasm, the
distribution of the metastases in the uterus, and the presence of concomitant
metastases in other genital and non-genital tract organs. There were four cases
of metastatic extragenital malignancies to the uterus. The breast was the most
frequent primary site (two cases: 50%). The other two primary tumors were
adenocarcinoma of the cecum and malignant melanoma of the skin. The diagnosis was
facilitated by clinical history, revealing the previous primary neoplasm, and by
specific immunohistochemical study. Almost all the patients died from
disseminated disease. Thus, the prognosis of metastatic extragenital malignancies
to the uterus alone or simultaneously to the uterus and other organs of the
genital tract is poor. Thus, the metastases to the uterus and to other organs of
the genital tract can be considered a preterminal event
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