INTRODUCTION

Hysteroscopy is the gold standard procedure for the evaluation and diagnosis of intrauterine pathologies. The optimal time to do hysteroscopy is during the proliferative phase. However, for women with irregular bleeding, the optimal time is unpredictable. Besides pharmacological means, mechanical endometrial preparation could be done.

OBJECTIVE

The objective of this study was to determine the effect of suction curettage on visualization, operative time, fluid deficit, and histopathologic diagnosis among perimenopausal women with abnormal uterine bleeding (AUB) and unprepared endometrium prior to operative hysteroscopy.

METHODOLOGY

Thirty-four (34) perimenopausal women admitted for AUB with unprepared endometrium for operative hysteroscopy who consented to participate were recruited and randomly divided into two groups: 18 women had suction curettage done prior to operative hysteroscopy and 16 women had operative hysteroscopy done alone. The following data were obtained for each group: (1) improvement in clarity (i.e., visualization of fundus and both tubal ostia), (2) operative time from entry to withdrawal of the resectoscope (measured in minutes), (3) fluid deficit, and (4) final histopathological diagnosis. P 

RESULTS

Women who underwent suction curettage prior to operative hysteroscopy had improved visualization (72.2%, P < 0.001), shorter operative time (29.06 ± 7.06 min vs. 35.5 ± 7.2 min, P = 0.013), no difference in fluid deficit (P = 0.276), and the histopathologic diagnosis (P = 0.470).

CONCLUSION

Suction curettage prior to operative hysteroscopy among perimenopausal women with AUB and unprepared endometrium improved visualization and shortened operative time without affecting fluid deficit and histopathologic diagnosis.

Hysteroscopy ; Suction Curettage ; Vacuum Curettage

Surgical excision of keloids is generally not accepted as a first treatment option, but many reports have described specialized surgical methods, such as intralesional and intramarginal excision. This operation preserves the active peripheral portion of the keloid and excises the central bulky lesion. The suprakeloidal flap technique and keloid core excision involve intralesional excision. These methods are known to be associated with a low probability of recurrence or lesion exacerbation because the remaining keloidal lesion acts as a barrier. However, several complications, such as partial necrosis and flap congestion, have been reported, especially in large lesions. We describe cases of four patients with keloids on the chest or abdomen. All patients complained of pain or itching due to the keloids. Patient age ranged from 20 years to 54 years, and the number of lesions ranged from one to seven. The largest lesion measured 10x8 cm. We treated the lesions by the dermal shaving method using a suction-assisted cartilage shaver, and the lesions were markedly flattened in all cases. Because this surgery is performed through an incision for a cannula, it allows more rapid healing and causes less postoperative pain with fewer severe complications. It also has the advantage of requiring less effort and time due to the use of motorized curettage with suction. The suction-assisted cartilage shaver using dermal shaving method seems to be an effective alternative treatment modality for reducing the lesional size of keloids.
Abdomen ; Cartilage ; Catheters ; Curettage ; Estrogens, Conjugated (USP) ; Humans ; Imidazoles ; Keloid ; Necrosis ; Nitro Compounds ; Pain, Postoperative ; Pruritus ; Recurrence ; Suction ; Thorax

For more than 20 years, many cytologic techniques have been developed for endometrial sampling such as Gravlee jet aspirator, Isaacs cell sampler, Vabra aspirator, Pipelle, etc. But none of the techniques received general acceptanee as a replacement for dilatation and curettage. Hence dilatation and curettage is still used to evaluate women at high risk for endometrial cancer and infertility, to manage abnormal uterine bleeding and to follow womeh on hormone replacement therapy, But biopsy methods produce enough pain to lower patients acceptance, Z-sarnpler is a new simple plastic endornetrial suction curette that provides a histologic diagnosis like Pippelle, This study compared the clinical usability of the Z-sampler to that of endometrial biopsy by dilatation and eurettage. The Z-sampler obtained sufficient tissues for histologic diagnosis in 45 cases(45/50, 90.0%), it was lower than that of end.ometrial biopsy(49/50, 98,0%), But the accuracy of tissue diagnosis was almost equal to that of endometrial biopsy. In addition. Z-sempler cau less pain(94.1%) and the duration of this procdure was shorter than that of endometrial biopsy by dilatation and curettage. These results suggest that the Z-sampler may be efficieot technique in endometrial tissue diagnosi, like dilatation and curettage and it has greater patient acceptability due to less pain, less bleeding and shorter duration of procedure.
Biopsy ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Endometrial Neoplasms ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Infertility ; Plastics ; Suction ; Uterine Hemorrhage

BACKGROUNDLaparoscopic surgery is advantageous for minimal invasiveness and rapid postoperative recovery. Since the use of laparoscopic hepatectomy in liver resection in the 1990s, it has been performed in a few institutions worldwide. Lack of efficient and safe techniques for liver transaction is the major obstacle preventing from its further development. We developed a new technique for laparoscopic hepatectomy by curettage and aspiration in 1998. In this paper we analyze the clinical outcomes of this technique after 7 years of practice.

METHODSAltogether 59 consecutive patients underwent laparoscopic hepatectomy by curettage and aspiration from August 1998 to January 2005 at our institution. These patients included 33 males and 26 females, with a mean age of 47 years. For liver transection laparoscopic Peng's multifunctional operative dissector (LPMOD) was used. Lesions included malignant liver tumors in 19 patients, benign liver tumors in 17, intrahepatic calculus in 18, and other liver lesions in 5. Procedures included local resections in 30 patients, left lateral segmentectomy in 28, and right hemihepatectomy in 1.

RESULTSLaparoscopic operation was completed in 57 patients. Two patients (3.4%) had the operation converted to laparotomy. The mean operating time was 143 minutes and the mean intraoperative blood loss was 456 ml. The mean length of postoperative hospital stay was 7 days. Complications occurred in 2 patients (3.4%), and there was no perioperative death.

CONCLUSIONLaparoscopic hepatectomy by curettage and aspiration is efficient and safe for liver resection.

Adult ; Aged ; Curettage ; methods ; Female ; Hepatectomy ; adverse effects ; instrumentation ; methods ; Humans ; Laparoscopy ; methods ; Length of Stay ; Male ; Middle Aged ; Suction

Axillary osmidrosis, also referred to as bromhidrosis, is a condition of excess, abnormal, or strong acrid body odor that typically manifests itself after puberty with the enlargement of apocrine glands. This condition often causes the affected to avoid social settings and personal relationships particularly throughout puberty and into adult life. The surgical objectives for treating axillary osmidrosis are to eliminate malodor and postoperative recurrence, to reduce significant complications such as hematoma and skin flap necrosis causing scarring, to decrease the recovery time, and to reduce the surgical scars. In order to meet the objectives, I recommend to use three surgical methods such as subdermal shaving method with scissors, liposuction and curettage method, and curettage and dermal shaving with manual and electric bone rasp. The subdermal shaving method demands the surgeon to execute meticulous hemostasis in the central axilla. Quilting sutures should be placed to fixate the skin flap to the axillary base to further prevent hematoma and to shorten recovery time. A relatively simple pressure dressing is removed after a couple of days, which will allow the patients to resume their routine daily life. Liposuction and curettage method is used to remove the apocrine glands in the subcutaneous layer. Apocrine and eccrine glands in the lower dermis are removed by dermal shaving with a manual or electric bone rasp or by a suction assisted cartilage shaver.
Adolescent ; Adult ; Apocrine Glands ; Axilla ; Bandages ; Cartilage ; Cicatrix ; Curettage ; Dermis ; Eccrine Glands ; Hematoma ; Hemostasis ; Humans ; Lipectomy ; Necrosis ; Odors ; Puberty ; Recurrence ; Skin ; Suction ; Sutures

OBJECTIVE: Some vaginal procedures may be safer, easier and more successful if they could be done under direct sonographic vision of the object. METHODS: All the procedures were done under the guidance of transrectal sonography. Suction curettage, after using curved plastic Karman's cannula, additional curettage was done only when there was probable remaining conceptal tissue seen on sonography. If additional curettage was needed curved metal cannula made in the same form as plastic Karman's cannula is used first and then usual metal curette if the former did not work. A high frequency cautery unit was used for myolysis. Insertion of the flexible curved cautery tip into the myoma mass was done through the uterine cavity and coagulation of the myoma tissue was performed. Myoma biopsies were done with thin loop high frequency cautery tip through laparoscopy and the vagina. RESULTS: Suction curettage in 156 cases of early pregnancy and 2 cases of previous cesarean incision site pregnancy, D&C in 11 cases, chorionic villus sampling in 13 cases, polypectomy in 1 case, myolysis in 1 case and myoma biopsy in 2 cases were done. CONCLUSION: Performing some vaginal procedures under the guidance of transrectal sonography may be better.
Biopsy ; Catheters ; Cautery ; Chorionic Villi Sampling ; Curettage ; Dilatation and Curettage ; Female ; Laparoscopy ; Myoma ; Plastics ; Pregnancy ; Ultrasonography* ; Vacuum Curettage ; Vagina

Cervical pregnancy is a rare life-threatening form of ectopic pregnancy. The exact etiology of cervical pregnancy is not known, but several contributing factors have been considered. Probably a combination of factors leads to cervical pregnancy. The first case was required hysterectomy. The second case was successfully treated with a unique combination of precurettage cerclage, suction curettage and postcurettage balloon tamponade. Conservative treatment has evolved in recent years, with a considerable reduction in the number of hysterectomies. We present two cases of cervical pregnancy associated with multiple risk factors in elderly gravida, with brief reviews.
Aged* ; Balloon Occlusion ; Female ; Humans ; Hysterectomy ; Pregnancy* ; Pregnancy, Ectopic ; Risk Factors* ; Vacuum Curettage

Cervical pregnancy is an uncommon life threatening form of ectopic pregnancy. It is associated with the unexpected occurrence of uncontrollable hemorrhage from the cervix. This condition is usually treated with hysterectomy. And thus the patient loses her fertility potential. To avoid hysterectomy and to maintain fertility, several conservative methods of termination have been used. We report a case of cervical pregnancy treated conservatively without hysterectomy. Hemorrhage from the implantation site was controlled with an inflated Foley catheter balloon positioned within the cervical canal. Foley catheter ballooning after endocervical suction curettage seems to be a simple and effective treatment of cervical pregnancy as conservative treatment to maintain fertility.
Catheters ; Cervix Uteri ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Pregnancy* ; Pregnancy, Ectopic ; Vacuum Curettage

Suction curettage is a relatively safe procedure to induce abortion of first trimester pregnancy with a very low complication rate. But, in order to do that, cervix should be dilated enough to pass operating devices. We experienced a case of first trimester pregnancy terminated successfully using transvaginal misoprostol when suction curettage was failed due to severely cervical stenosis after LEEP conization.
Cervix Uteri ; Conization ; Constriction, Pathologic ; Female ; Humans ; Misoprostol* ; Pregnancy ; Pregnancy Trimester, First ; Vacuum Curettage

Acute Disease ; Child ; Child, Preschool ; Empyema, Pleural ; therapy ; Female ; Humans ; Infant ; Male ; Therapeutic Irrigation ; Vacuum Curettage