This report discusses a pregnancy case following a series of two consecutive magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) procedures for the treatment of two different myomas in an individual patient. Both procedures were completed without adverse events, and the patient conceived naturally four months after treatment. At 39 weeks, she gave birth to a healthy baby girl, via a vaginal delivery. There were no complications in the pregnancy or during labor.
Adult ; Female ; Humans ; Magnetic Resonance Imaging, Interventional/*methods ; Myoma/*surgery ; Pregnancy ; Pregnancy Outcome ; Surgery, Computer-Assisted/*methods ; Uterine Neoplasms/*surgery

OBJECTIVETo compare the clinical characteristics of three subcategories of laparoscopic hysterectomy: total laparoscopic hysterectomy (TLH) and two subcategories of laparoscopic-assisted vaginal hysterectomy (LAVH): LAVHs and LAVHb.

METHODSWe retrospectively analyzed the clinical data of 393 patients underwent laparoscopic hysterectomy, including TLH (n=178), LAVHa (n=177), and LAVHb (n=38), in our hospital from September 2002 to September 2005.

RESULTSMyoma and adenomyosis of uterus were the most common diseases in this study, accounting for 66.9%, 38.4%, and 52.6% in TLH group, LAVHa group, and LAVHb group, respectively. The mean surgery duration and blood loss were not significantly different between TLH group and LAVHa group (P > 0.05), but were significantly less in TLH group than in LAVHb group (P < 0.05). The bulk of uterus in TLH group was significantly bigger than in other two groups (P < 0.05). The incidence of major complications in the TLH group (9. 0%) was lower than in LAVHa group (14.1%) and in LAVHb group (18.4%), but without statistical significance. Conclusion Compared with LAVH, TLH is feasible to deal with bigger uterus with less blood loss and shorter surgery duration and without more frequent complications.

Endometriosis ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Hysterectomy, Vaginal ; adverse effects ; methods ; Laparoscopy ; adverse effects ; methods ; Myoma ; surgery ; Retrospective Studies ; Uterine Neoplasms ; surgery

BACKGROUNDHysterectomy is a very common surgery in gynecology. Ideal surgery for hysterectomy is microinvasive with few complications. There are three major routes of hysterectomy that are currently used. The aim of this study was to identify the differences of peri-operative outcome among the patients who underwent the three different approaches.

METHODSOne hundred and one women undergoing hysterectomy for myoma had the procedure performed by laparoscopic assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (TVH) or total abdominal hysterectomy (TAH) in a randomized study. We compared the course of peri-operative and post-operative outcome for the three different approaches.

RESULTSwere evaluated by linear regression analysis, Fisher's exact test and Student's t test for independent samples.

RESULTSThe operation time among the three procedures was not significantly different (P > 0.05). The amount of blood loss in the TVH group was less than in the LAVH and TAH groups (P < 0.05). The pain score 3 hours after operation in the LAVH group was significantly lower than in the TAH and TVH groups (P < 0.001). The pain scores in the LAVH and TVH groups were lower than in the TAH group at 24 and 48 hours after operation (P < 0.01). The women who underwent LAVH and TVH had a shorter hospitalization stay (P < 0.001). The highest body temperature after operation in the TAH group was higher than that in LAVH and TVH groups (P < 0.001).

CONCLUSIONSLAVH and TVH are better procedures for women requiring hysterectomy. The peri-operative and post-operative courses of TVH are better than LAVH, excluding the pain score 3 hours after operation. Vaginal hysterectomy is the most cost-effective approach but the final choice for the route of hysterectomy can depend on many factors such as gynecological disease, patients' health status and experiences of the gynecologist.

Blood Loss, Surgical ; Female ; Humans ; Hysterectomy ; methods ; standards ; Hysterectomy, Vaginal ; methods ; Laparoscopy ; methods ; Length of Stay ; Myoma ; surgery ; Pain, Postoperative ; Regression Analysis ; Treatment Outcome

OBJECTIVETo study the effect of Simotang oral liquid and glycerin enema on the patients' bowel sound (BS) restoration and anal exhaust after abdominal gynecological operation.

METHODNinety patients with benign tumor who had undergone gynecological operation were randomly divided into the Simotang group, treated after operation with Simotang oral liquid; the enema group, treated with glycerin enema, and the control group, non-treated. The restoration time of BS and anal exhaust were observed.

RESULTSCompared with the control group, the restoration time of BS and anus exhaust were both significantly shorter in the Simotang group and the enema group, showing statistical significance (P < 0.05); but the difference between the two treated groups was insignificant (P > 0.05).

CONCLUSIONSimotang oral liquid and glycerine enema both could benefit the restoration of anal exhaust and BS after abdominal operation.

Abdomen ; Administration, Oral ; Adolescent ; Adult ; Aged ; Constipation ; drug therapy ; etiology ; Drugs, Chinese Herbal ; administration & dosage ; Enema ; Female ; Gastrointestinal Motility ; drug effects ; Glycerol ; administration & dosage ; Humans ; Middle Aged ; Myoma ; surgery ; Postoperative Complications ; drug therapy ; Pregnancy ; Pregnancy, Ectopic ; surgery ; Uterine Neoplasms ; surgery

PURPOSE: Venous air embolism (VAE) is characterized by the entrainment of air or exogenous gases from broken venous vasculature into the central venous system. No study exists regarding the effect of patient positioning on the incidence of VAE during abdominal myomectomy. The purpose of this study was to assess the incidence and grade of VAE during abdominal myomectomy in the supine position in comparison to those in the head-up tilt position using transesophageal echocardiography. MATERIALS AND METHODS: In this study, 84 female patients of American Society of Anesthesiologist physical status I or II who were scheduled for myomectomy under general anesthesia were included. Patients were randomly divided into two groups: supine group and head-up tilt group. Transesophageal echocardiography images were videotaped throughout the surgery. The tapes were then reviewed for VAE grading. RESULTS: In the supine group, 10% of the patients showed no VAE. Moreover, 10% of the patients were classified as grade I VAE, while 50% were categorized as grade II, 22.5% as grade III, and 7.5% as grade IV. In the head-up tilt group, no VAE was detected in 43.2% of the patients. In addition, 18.2% of the patients were classified as grade I VAE, 31.8% as grade II, and 6.8% as grade III; no patients showed grade IV. VAE grade in the head-up tilt group was significantly lower than that in the supine group (p<0.001). CONCLUSION: The incidence and grade of VAE in the head-up tilt group were significantly lower than those in the supine group during abdominal myomectomy.
Abdomen/pathology ; Adult ; Echocardiography, Transesophageal ; Embolism, Air/epidemiology/*etiology ; Female ; Humans ; Incidence ; Middle Aged ; Myoma/pathology/*surgery ; *Posture ; Supine Position ; Uterine Myomectomy/adverse effects/*methods ; Uterus/pathology/ultrasonography ; Veins/*ultrasonography