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Conservative surgery for borderline ovarian tumors: a review
No full textGynecol Oncol. 2006 Jan;100(1):185-91. Epub 2005 Oct 10.
Conservative surgery for borderline ovarian tumors: a review.
Tinelli R, Tinelli A, Tinelli FG, Cicinelli E, Malvasi A.
Source
I Department of Obstetrics and Gynecology, University Medical School of Bari, Piazza Giulio Cesare, Bari, Italy. [email protected]
Abstract
OBJECTIVE:
Borderline tumor of the ovary is an epithelial tumor with a low rate of growth and a low potential to invade or metastasize. This review will outline the most recent information regarding the molecular pathogenesis, pathology, fertility and tumor recurrence rate after conservative management of young women with early-stage borderline ovarian tumors.
METHODS:
We performed a MEDLINE literature search of relevant clinical trials for the scope of this review that evaluated conservative treatment of borderline ovarian tumors for young women with low-stage disease who wish to preserve their fertility.
RESULTS:
Recently, investigators have begun to identify subsets of patients with a worse prognosis, such as patients with aneuploid tumors. A number of oncogenes are under investigation to determine their role in the pathogenesis of borderline ovarian tumors. Previous studies have suggested the safety of conservative surgery with unilateral salpingo-oophorectomy or cystectomy for patients with stage I borderline ovarian tumors. Laparoscopic treatment of adnexal masses has proved to be a safe and effective diagnostic and therapeutic tool in the hands of experienced laparoscopists. For women who are treated conservatively, follow-up is important. Surgery remains the most effective therapy for later stage lesions. Adjuvant therapy for advanced stage of borderline ovarian tumors remains controversial.
CONCLUSION:
Conservative management of borderline ovarian tumors is an appropriate therapeutic option for young women with early-stage lesions who wish to preserve their childbearing potential. Available data indicate that in these patients fertility, pregnancy outcome and survival remain excellent.
PMID: 16216320 [PubMed - indexed for MEDLINE
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No full textThe bladder-flap hematoma (BFH) is an unusual complication of the cesarean section (CS) performed by Misgaw Ladach method or Stark CS (performed without peritoneal closure) and it is an usual event after the visceral peritoneal closure performed during the traditional method. A BFH is generally thought of as a blood collection located in a space placed between the bladder and lower uterine segment (LUS), called vescico-uterine space. If, during a Stark CS, pathological fluid collections arise in this space by uterine suture bleeding, these decant into the large peritoneal cavity causing a hemoperitoneum. This last complication can be easily and accurately detectable by ultrasonography, which can be utilised by non-invasive monitoring as a guide for the clinical follow-up. In the authors' experience, the CS by Stark method is associated with a lower febrile and infective morbidity and it is possible also to perform a successful conservative laparoscopy for the BFH management. Laparoscopical treatment of BFH offers to patients the potential clinical benefits of the minimally invasive endoscopical treatments, but it should be reserved for surgeons trained in extensive laparoscopic procedure
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