Gynecology Oncology
Ganesalingam Murali; CheeMeng Yong; Nagandla Kavitha; Chew Hua Yeoh
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological ...
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Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological cancers over 8 years from January 2011 to 31 December 2019 that were identified through hospital databases. Patient demographic characteristics, indications, surgical characteristics and outcomes were retrospectively assessed. Overall survival (OS) was analysed with Kaplan-Meier method and log rank test. Cox proportional hazards regression was used to model survival outcomes. Twenty- one patients were identified with recurrent cervical, endometrial, ovarian and, or vaginal cancer underwent PE. Local disease recurrence was the most common indication in 80.9%. The primary tumor origin was the cervix in 80.9%, followed by endometrial origin 9.5%. PE was performed as curative intent in 62% and in 38% as palliative intent. The most common early complication was wound infections and late complications included deep vein thrombosis, lymphocyst and recurrent urinary tract infections. The median survival at 6 months is 85.7% and 12 months is 57.1 %. Our five-year OS was 54.3 % (95% CI 34.2, 74.6). Our case series illustrates pelvic exenteration provides about 54.3% of 5-year survival chance in a selected group of patients. The early-and late complications rate are similar to those described historically. Pelvic exenteration results in sustained survival in selected patients and continued efforts must focus on identifying those patients who could potentially benefit most from PE.
Obstetrics and Gynecology
Berikuly Duman; Ali Abdulhussain Fadhil; Samah Sajad Kadim; Ayad Abas Hasan; Naseer Mehdi Mohammed; Ebtihal Sattar Qasim; Tamara Muayad Abdullah
Volume 8, Issue 4 , July and August 2023, , Pages 389-395
Abstract
Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications ...
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Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications in pregnant patients with preeclampsia, the present study was conducted.Materials & Methods: In 2020, in Alwiyah Hospital for Obstetrics and Gynecology, Al-Jadiriah Private Hospital, Al-Karama Teaching Hospital, and Yarmouk Teaching Hospital in Baghdad, 87 pregnant women with preeclampsia and 160 healthy pregnant women participated in the present prospective study. The Doppler signal of the uterine arteries was evaluated during a supine abdominal Doppler ultrasound examination between 26 and 36 weeks of pregnancy. The survey form was updated with information about the birth of the children following the termination of the pregnancy. The data were evaluated using SPSS software (version 19) and independent t, Mann-Whitney, and chi-square tests.Results: The mean uterine artery pulsatility index of mothers with preeclampsia had the greatest sensitivity, specificity, and positive predictive amount of predicting a baby's low birth weight at 54.8%, 87.3%, and 91.6%, respectively. In addition, the sensitivity, specificity, and positive predictive amount of the mean uterine artery resistance index for predicting a baby's low birth weight were 65.2%, 96.4%, and 95.4%, respectively.Conclusion: Although uterine artery indices in Doppler ultrasound do not have a high sensitivity for predicting neonatal complications, abnormal indices can predict low birth weight with high confidence.
Obstetrics and Gynecology
Haleh Ayatollahi; Somayeh Ghasemzadeh; Sedigheh Ghasemiyan Dizaj Mehr
Volume 7, Issue 3 , January and February 2022, , Pages 192-199
Abstract
Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to ...
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Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to investigate the outcome of surgeries in patients with COVID-19 in Motahari Hospital in Urmia.Materials & Methods: This cross-sectional study was performed on 112 patients diagnosed with COVID-19 who underwent surgery. A Checklist including the following data was extracted from the patients' medical records, symptoms, laboratory tests, and any complications related to surgery up to one month after separate surgery.Results: A total of 6.3% of patients had limited complications due to the incision site after the surgery. The results did not show a significant relationship between age, type of anesthesia, and the type of operation with complications. However, the highest percentage of complications was seen in less than 40 years and emergency surgeries. It was found that patients with a history of diabetes had the highest rate of complications (57.1%), although there was no significant relationship between the underlying disease and complications (P = 0.40). In our study, none of the patients experienced complications such as vascular thrombosis or embolism, respiratory failure, and heart failure, or the need for cardiopulmonary resuscitation. Overall, 17.9% of patients needed ICU admission (mean 2.16 ± 1.50 days), indicating a higher ICU hospitalization demand. Also, in terms of in-ward hospitalization, patients with complications had a longer hospital stay than uncomplicated patients (7.85 ± 3.36 days) vs. (5.13 ± 1.66), which was not statistically significant (P = 0.88).Conclusion: The results show that surgery is not directly associated with an increased risk of mortality and complications in patients with COVID-19. On the other hand, Underlying diseases, age, and the urgency of surgery are associated with a higher risk for complications than COVID-19.