• Title/Summary/Keyword: Cystectomy

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Efficacy of ablation and sclerotherapy for the management of ovarian endometrioma: A narrative review

  • Jee, Byung Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.2
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    • pp.76-86
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    • 2022
  • Ovarian cystectomy is the preferred technique for the surgical management of ovarian endometrioma. However, other techniques such as ablation or sclerotherapy are also commonly used. The aim of this review is to summarize information regarding the efficacy of ablation and sclerotherapy compared to cystectomy in terms of ovarian reserve, the recurrence rate, and the pregnancy rate. Several studies comparing ablation versus cystectomy or sclerotherapy versus cystectomy in terms of the serum anti-Müllerian hormone (AMH) decrement, endometrioma recurrence, or the pregnancy rate were identified and summarized. Both ablation and cystectomy have a negative impact on ovarian reserve, but ablation results in a smaller serum AMH decrement than cystectomy. Nonetheless, the recurrence rate is higher after ablation than after cystectomy. More studies are needed to demonstrate whether the pregnancy rate is different according to whether patients undergo ablation or cystectomy. The evidence remains inconclusive regarding whether sclerotherapy is better than cystectomy in terms of ovarian reserve. The recurrence rates appear to be similar between sclerotherapy and cystectomy. There is not yet concrete evidence that sclerotherapy helps to improve the pregnancy rate via in vitro fertilization in comparison to cystectomy or no sclerotherapy.

Clinical experience with single-port access laparoscopic cystectomy and myomectomy

  • Jeong, Jae-Hyeok;Kim, Yu-Ri;Hong, Kil-Pyo;Ha, Jae-Eun;Kim, Eun-Jeong;Hong, Da-Kyo;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.44-50
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    • 2016
  • Objective: This study was performed to assess our clinical experience with single-port access (SPA) laparoscopic cystectomy and myomectomy and the surgical outcomes of those procedures at our institution. Methods: The authors evaluated the surgical outcomes of SPA laparoscopic cystectomy in 293 patients and SPA laparoscopic myomectomy in 246 patients. The surgical outcomes comprised operation time, the amount of blood loss during the operation, the change in hemoglobin (before and after the operation), the change in hematocrit (before and after the operation), switching to the multi-port access method, complications, transfusions, and the duration of the postoperative hospital stay. Results: The Pearson correlation coefficient and the Spearman correlation coefficient between the operation time and the amount of blood loss were 0.312 and 0.321 for SPA laparoscopic cystectomy, respectively, and 0.706 and 0.674 for SPA laparoscopic myomectomy, respectively. The drops in hemoglobin and hematocrit were $1.33{\pm}0.78g/dL$ and $4.14%{\pm}2.45%$, respectively, in SPA laparoscopic cystectomy, while the corresponding figures were $1.34{\pm}1.13g/dL$ and $4.17%{\pm}3.24%$ in SPA laparoscopic myomectomy, respectively. Conclusion: This study reported the surgical outcomes of SPA laparoscopic cystectomy and myomectomy and compared them to previously published findings on traditional laparoscopic cystectomy and myomectomy. No significant differences were found in the surgical outcomes between SPA and traditional laparoscopic cystectomy and myomectomy.

Treatment of the chronic pelvic pain and complications of post-ovarian cystectomy with laparoscopy : a case report (난소낭종제거수술 후 내원한 만성골반통 환자 1례에 대한 증례보고)

  • Yang, Seoung-In;Han, In-Sun;Park, Hyun-Jae;Bae, Sang-Jin;Lee, Dong-Nyung;Yi, Youn-Ju
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.4
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    • pp.287-297
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    • 2006
  • Purpose : Chronic pelvic pain(CPP) is a common gynecologic symptoms. Recent research has been directed towards understanding the pathology of CPP, but many questions have existed. And the study for treating CPP has been tried by various manners. A Korean medicine(KM) also try to treat a various methods for treatment of CPP. It is often that a pelvic pain is continue a post-hysterectomy or a operating of gynecology. We have a case of CPP treatment by KM that is a patient continue pain after post-ovarian cystectomy with laparoscopy. So we report a case on pelvic pain and complication of post-ovarian cystectomy with laparoscopy. Methods : A 44 years old woman, who suffered from chronic pelvic pain, dizziness, nausea, dyspepsia, general weakness, insomnia after ovarian cystectomy, was enrolled in this study. She received KM therapies such as herbal medicine, moxibustion, acupuncture for 4 weeks. Results : CPP and symptoms after ovarian cystectomy were reduced by KM therapies. Conclusion : 'The present study suggests that KM therapies have a significant effect on CPP and complications of post-ovarian cystectomy with laparoscopy.

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Follow-up of Sexual Activity in Bladder Tumor Patients Following Total Cystectomy (방광암 환자에서 방광전적출술 후의 성기능에 대한 추적관찰)

  • Oh, Kil-Hyun;Choi, Hyung-Ki;Lee, Jin-Moo
    • Clinical and Experimental Reproductive Medicine
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    • v.11 no.1
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    • pp.9-16
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    • 1984
  • This study was conducted to determine whether patients could engage in sexual activity following total cystectomy with ileal conduit. Sixteen male bladder cancer patients treated by total cystectomy with or without preoperative irradiation. Patients ranged in age from 48 to 70 years (mean 59.6 years). The interval from therapy ranged from 7 to 82 months (mean 33.8 months).Prior to therapy 11 /16 patients (68.8 %) reported they were engaging some form of sexual activity at least once per month. All were able to achieve an erection and were orgasmic. Following total cystectomy, 6 patients (37.5%) continued to engage in sexual activity at least once per month and were experiencing orgasm. 3 patients (18.8%) reported they were able to achieve an erection. The spontaneous resumptiom of sexual activity by almost one third of the patients in this study refutes the assumption that sexual activity would be impossible following total cystectomy.

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Comorbidity Relationship to Outcome of Radical Cystectomy in Chinese: a Single Institution Study with the ACE-27 Comorbidity Index

  • Xuan, Zhu;Zhong, Zhao-Hui;Zhang, Xuan-Zhi;Zhang, Lei;Zhao, Xiao-Kun;Lv, Chen;Xu, Ran;Ren, Wei-Gang;Li, Song-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.827-831
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    • 2012
  • To determine the relationship between comorbidity and outcome after radical cystectomy in Chinese patients by using the Adult Comorbidity Evaluation (ACE)-27 index. Two-hundred-and-forty-six patients treated with radical cystectomy at the Second Xiangya Hospital of Central South University, Hunan Province, China between 2000 and 2010 were retrospectively analyzed. Medical records were reviewed for age, gender, delayed time of radical cystectomy, urinary diversion type, pelvic lymphadenectomy status, TNM stage, and pathological grade. Comorbidity information was assessed by the ACE-27 index. The outcome measurement was overall survival. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the association between comorbidity and outcome. The study population consisted of 215 (87.40%) males and 31 (12.60%) females with a mean age of $62{\pm}11$ years. Median duration of follow-up was $47{\pm}31$ months. A total of 151 (61.38%) patents died during follow-up. Of those, 118 (47.97%) had at least one comorbidity. According to the ACE-27 scores, 128 (52.03%) patients had no comorbidity, 79 (32.11%) had mild, 33 (13.41%) had moderate, and 6 (2.45%) had severe comorbidities. Multivariate analysis indicated that moderate (p=0.002) and severe (p<0.001) comorbidity was significantly associated with decreased overall survival. In addition, age ${\geq}70$ years (p=0.002), delayed time of radical cystectomy >12 weeks (p=0.044), pelvic lymphadenectomy status (p=0.014), and TNM stage >T3 (p<0.001) were determined to be independent risk factors of overall survival. Increasing severity of comorbidity statistically correlated with decreased overall survival after radical cystectomy.

Arthroscopic Shaving Cystectomy of Popliteal Cyst by using Posteromedial Portal (관절경적 후내측 도달법을 이용한 슬와 낭종의 절삭 절제술)

  • Kwak, Kyoung-Duck;Ahn, Sang-Min;Baek, Seung-Il;Jung, Chan-Jong;Roh, Jae-Su
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.153-158
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    • 2006
  • Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

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Effective Arthroscopic Treatment of Huge and Anteriorly Extended Spinoglenoid Cysts

  • Park, Jung-Ho;Lee, Yong-Seuk;Lee, Jun-Yong;Kim, Jae-Gyun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.5-5
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    • 2008
  • Spinoglenoid cyst of the shoulder is a rare clinical entity and several treatment modalities have been reported. Recently, arthroscopy is effectively used via communication hole or posterior capsulotomy through the glenohumeral joint. With this method, the complete cystectomy is impossible if the cyst is a large size or extended anteriorly and there are few reports about such cases. We present extra-articular complete cystectomy through bursal space in 3 cases of huge and anteriorly extended spinoglenoid cysts. All patients were able to return to work with no restrictions and 2 patients who performed the follow up MRI demonstrated complete resolution of the cyst and some recovery of the mass of infraspinatus muscle.

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Comparison of Radical Cystectomy and Chemoradiotherapy in Patients with Locally Advanced Bladder Cancer

  • Ikeda, Masaomi;Matsumoto, Kazumasa;Nishi, Morihiro;Tabata, Ken-Ichi;Fujita, Tetsuo;Ishiyama, Hiromichi;Hayakawa, Kazushige;Iwamura, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6519-6524
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    • 2014
  • The aim of this study was to evaluate the clinical outcomes of radical cystectomy (RC) and concurrent chemoradiotherapy (CRT) with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with locally advanced bladder cancer (BC). From December 2000 to February 2012, 72 patients with locally advanced BC (T3-4a, N0 or N+, M0) received either RC or CRT. RC with bilateral pelvic lymph node dissection including the common iliac region as the standard procedure. Patients in the CRT group received one cycle of MVAC followed by radiotherapy with a half dose of MVAC and then two more cycles of MVAC. Standard fractionation at a daily dose of 1.8-2.0 Gy was used, with a median total dose of 50 Gy (range, 45-60 Gy). The 3-year progression-free survival (PFS) rates in the RC and CRT groups were 56.2% and 25.6%, respectively (p=-0.015) and the 3-year overall survival (OS) rates were 63.5% and 48.1% (p=0.272). Multivariate Cox proportional hazards regression analysis with application of a propensity score indicated that RC was a significant predictor of PFS (p=0.033) but not of OS (p=0.291). Among patients with locally advanced BC, PFS was significantly prolonged in the RC group compared with the CRT group. However, RC was not a significant predictor of OS. Although the sample size in this study was small, the results suggest that patient background and postoperative quality of life should be considered when choosing treatment strategy for locally advanced BC.

Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis

  • Yasui, Takahiro;Tozawa, Keiichi;Ando, Ryosuke;Hamakawa, Takashi;Iwatsuki, Shoichiro;Taguchi, Kazumi;Kobayashi, Daichi;Naiki, Taku;Mizuno, Kentaro;Okada, Atsushi;Umemoto, Yukihiro;Kawai, Noriyasu;Sasaki, Shoichi;Hayashi, Yutaro;Kohri, Kenjiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6353-6358
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    • 2015
  • Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.

Early Detection and Gemcitabine/Cisplatin Combination Positively Effect Survival in Sarcomatoid Carcinoma of the Urinary Bladder

  • Baseskioglu, Barbaros;Duman, Berna Bozkurt;Kara, I. Oguz;Can, Cavit;Yildirim, Mustafa;Acikalin, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5729-5733
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    • 2012
  • Background and Objectives: This study aimed to present the clinicopathological characteristics and treatment of patients with bladder carcinoma with sarcomatoid differentiation at our institution. Methods: Between 1995-2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinoma were retrospectively reviewed, and their clinical, pathological features and treatment were recorded. Results: Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All the patients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solid in 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoid differentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomy with ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis, 12 of the patients died in mean 10.7 months (range: 1-48 months). Conclusion: Urothelial carcinomas with sarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomes of multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosis positively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.