RESUMEN
Two unusual cases of a 22- and a 28-year-old woman, respectively, who were found to have endometrial adenocarcinoma, are presented. The patients experienced abnormal vaginal bleeding and the diagnosis was made by dilatation and curettage. They declined treatment with progestagens, therefore, a total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy were performed in both cases. We emphasize the need of endometrial evaluation in young females with abnormal bleeding before starting any medical treatment. Specific problems of endometrial cancer at young age include delay in diagnosis, difficulty in pathologic interpretation of the curettings and the motivation of most patients to preserve their fertility.
Asunto(s)
Adenocarcinoma/diagnóstico , Neoplasias Endometriales/diagnóstico , Adenocarcinoma/cirugía , Adulto , Dilatación y Legrado Uterino , Neoplasias Endometriales/cirugía , Trompas Uterinas/cirugía , Femenino , Humanos , Histerectomía , Escisión del Ganglio Linfático , Ovariectomía , Pelvis , Hemorragia UterinaRESUMEN
This study was undertaken to assess the effectiveness in pregnancy rates of microsurgery and operative laparoscopy in adhesiolysis. Adhesions were found to be the sole infertility factor in 15% of our patients. One hundred and ninety infertile patients with periadnexal adhesions as the only cause of their infertility were treated by microsurgery (86) or operative laparoscopy (104) and were followed up for 24 months. Our results indicate that advanced laparoscopic surgery in general is as effective as microsurgery in healthy infertile patients with adhesions but offers some advantages in comparison to laparotomy. Factors that adversely affect the postoperative success rates are the age of the women, the duration of infertility, and the severity of the adhesions.