RESUMEN
OBJECTIVE: The aim of this comparative study was to ascertain the efficacy of the Sulmycin® Implant E, an antiseptic sponge, on the incidence of peri- and postoperative morbidity in patients subjected to vaginal hysterectomy. MATERIAL AND METHODS: This eleven-year study included 228 patients undergoing vaginal hysterectomy. The patients were divided into two groups. Group A included 169 participants with benign diseases (fibroids, dysfunctional uterine bleeding and prolapse) and group B included 59 patients with early stage endometrial cancer or atypical hyperplasia. Women of both groups were further divided into three subgroups: (a) receiving a single dose of intravenous cefuroxime (2 gr) (group A: 55, group B: 19), (b) receiving three doses of intravenous cefuroxime (2 gr) (group A: 54, group B: 19), and (c) locally placed a collagen sponge containing gentamycin (Sulmycin® Implant E) (group A: 60, group B: 21). RESULTS: The number of postoperative infections (mainly urinary tract infections) did not differ between women of the three subgroups of patients in both groups. There were no important differences affecting the postoperative hospitalization, healing procedure and adhesion of the cuff between women of the three subgroups in both groups. CONCLUSION: The local chemoprophylaxis with Sulmycin® Implant E, a collagen sponge containing gentamycin and placed on the vaginal cuff, is well tolerated and equally effective as intravenous antibiotics.
Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Cefuroxima/uso terapéutico , Colágeno/administración & dosificación , Gentamicinas/administración & dosificación , Histerectomía Vaginal/métodos , Adulto , Anciano , Antibacterianos/administración & dosificación , Cefuroxima/administración & dosificación , Femenino , Humanos , Infusiones Intravenosas , Persona de Mediana Edad , Estudios Retrospectivos , Estadísticas no Paramétricas , Adulto JovenRESUMEN
AIM: The aim of this study was to investigate the impact of radical lymphadenectomy as a prognostic factor in the management of uterine sarcomas. METHODS: Sixty patients with histologically-proven uterine sarcomas were recruited for this study. The patients were evaluated retrospectively, during the time period from September 1990 to June 2008, in the Department of Obstetrics and Gynecology of Aschaffenburg Clinic in Germany. The normality of the quantitative variables was tested using the Kolmogorov-Smirnov test. RESULTS: Of 60 patients, 35 (58.3%) underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic or para-aortic lymphadenectomy. The excision of iliac nodes was the strongest and most independent factor (ß = 0.64, P = 0.000) associated with survival. Recurrence of disease developed in 14 out of 25 patients (56%) who did not receive lymphadenectomy, but in only 10 out of 35 patients (29%) who underwent lymphadenectomy. The mean survival in years after surgery plus lymphadenectomy was 5.28 years, while in patients who did not undergo lymphadenectomy it was 1.56 years. CONCLUSIONS: Removal of lymphatic tissue in patients with early-stage uterine sarcoma significantly decreases the recurrence rate of the disease and improves the postoperative survival. However, there is a need for further prospective randomized controlled trials to investigate the adequate surgical management of uterine sarcomas and to clarify the prognostic value of lymphadenectomy at the initial surgery.
Asunto(s)
Escisión del Ganglio Linfático , Ganglios Linfáticos/cirugía , Recurrencia Local de Neoplasia/prevención & control , Sarcoma/cirugía , Neoplasias Uterinas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Histerectomía , Ganglios Linfáticos/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Sarcoma/mortalidad , Sarcoma/patología , Tasa de Supervivencia , Resultado del Tratamiento , Neoplasias Uterinas/mortalidad , Neoplasias Uterinas/patologíaRESUMEN
AIM: The aim of our study was to investigate the relationship between the alpha2B-adrenoreceptor insertion/deletion (I/D) polymorphism and recurrent spontaneous abortions (RSA). METHODS: Genotyping was performed in 48 women with a history of at least three consecutive spontaneous abortions and 96 women with at least two live births and no history of pregnancy loss. Peripheral venous puncture, DNA extraction and PCR were used for the research of DD, ID and II genotype characters. RESULTS: The distribution of DD, ID and II genotypes of the alpha2B-adrenoreceptor gene was 2 (4.2%), 19 (39.6%) and 27 (56.2%) in the study group and 6 (6.5%), 28 (30.4%) and 58 (63%) in the control group, respectively. There was no significant difference between the groups. The presence of the D allele was not associated with RSA (P = 0.78, odds ratio = 0.88, 95% CI = 0.47-1.65). CONCLUSION: Our data fall short of showing any association between the presence of the alpha2B D allele and the occurrence of spontaneous abortions in the examined population.
Asunto(s)
Aborto Habitual/genética , Polimorfismo Genético , Receptores Adrenérgicos alfa 2/genética , Adulto , Secuencia de Aminoácidos , Femenino , Genotipo , Grecia , Humanos , Mutagénesis Insercional , Embarazo , Eliminación de SecuenciaRESUMEN
The major problem with myomectomy is excessive bleeding from increased uterine blood supply, and this can be a life-threatening condition and prolong postoperative stay. The aim of our study was to evaluate our experience in symptomatic myoma excision with bipolar electrode by mini-laparotomy; we compared 67 procedures with bipolar electrode, in normal saline as distension fluid, to 42 cases performed with unipolar electrode. All participants were pre-menopausal women who had symptomatic myomas Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control
, Electrocoagulación/métodos
, Laparotomía/métodos
, Leiomioma/cirugía
, Adulto
, Electrodos
, Estudios de Factibilidad
, Femenino
, Humanos
, Laparotomía/efectos adversos
, Persona de Mediana Edad
, Complicaciones Posoperatorias
, Periodo Posoperatorio
, Embarazo
, Índice de Embarazo
, Estudios Retrospectivos
, Prevención Secundaria
, Útero/irrigación sanguínea