1.Clinical implications of the superficial uterine vein pattern for the dissection of the anterior layer of the vesicouterine ligament in radical hysterectomy
Atsushi FUSEGI ; Hiroyuki KANAO ; Mayumi KAMATA ; Shogo NISHINO ; Akiko ABE ; Makiko OMI ; Hidetaka NOMURA
Journal of Gynecologic Oncology 2024;35(4):e50-
Objective:
To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos.
Methods:
We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection.
Results:
Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4).
Conclusion
We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.
2.Cerebral infarction caused by Trousseau syndrome associated with cervical cancer
Motoko KANNO ; Mayu YUNOKAWA ; Atsushi FUSEGI ; Akiko ABE ; Hidetaka NOMURA ; Hiroyuki KANAO
Journal of Gynecologic Oncology 2024;35(4):e41-
Objective:
The combination of cancer and hypercoagulable states is often called Trousseau syndrome. In particular, cerebral infarction caused by Trousseau syndrome is reported to have a poor prognosis. In gynecology, there are many reports of ovarian cancer and a few of uterine cancer. Since there has been no comprehensive report of Trousseau syndrome in cervical cancer, we aimed to summarize Trousseau syndrome in cervical cancer.
Methods:
Cerebral infarction caused by cancer-related arterial thrombosis was defined as Trousseau syndrome. Patients with cervical cancer diagnosed at our hospital between January 2014 and December 2021 were retrospectively reviewed using the hospital’s medical records.
Results:
A total of 1,432 patients were included in the study. Trousseau syndrome occurred in 6 patients (0.4%). The mean age of patients with Trousseau syndrome was 63 years (range:53–78 years). Of the 6 patients who developed Trousseau’s syndrome, 4 patients had it before or during initial treatment, and 2 during recurrent/relapsed disease treatment. The 4 patients who developed the syndrome before or during initial treatment had advanced disease: 1 in stage IIIC and 3 in stage IVB. In all cases, the disease was associated with progressive distant metastasis. The median survival time from the onset of Trousseau syndrome was 1 month (range: 0–6 months).
Conclusion
Cervical cancer causes Trousseau syndrome in cases of advanced disease with a short time between the onset of the syndrome and mortality.
4.Pupillometer-Based Neurological Pupil Index Differential: A Potential Predictor of Post-Stroke Delirium
Kotaro NODA ; Tomotaka TANAKA ; Soichiro ABE ; Ryo USUI ; Misa MATSUMOTO ; Yoshito ARAKAKI ; Hiroyuki KIDA ; Ryoma INUI ; Kaoru KOHAMA ; Kazuo WASHIDA ; Sonu M. M. BHASKAR ; Masatoshi KOGA ; Kazunori TOYODA ; Masafumi IHARA
Journal of Stroke 2024;26(2):321-324
5.Clinical implications of the superficial uterine vein pattern for the dissection of the anterior layer of the vesicouterine ligament in radical hysterectomy
Atsushi FUSEGI ; Hiroyuki KANAO ; Mayumi KAMATA ; Shogo NISHINO ; Akiko ABE ; Makiko OMI ; Hidetaka NOMURA
Journal of Gynecologic Oncology 2024;35(4):e50-
Objective:
To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos.
Methods:
We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection.
Results:
Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4).
Conclusion
We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.
6.Cerebral infarction caused by Trousseau syndrome associated with cervical cancer
Motoko KANNO ; Mayu YUNOKAWA ; Atsushi FUSEGI ; Akiko ABE ; Hidetaka NOMURA ; Hiroyuki KANAO
Journal of Gynecologic Oncology 2024;35(4):e41-
Objective:
The combination of cancer and hypercoagulable states is often called Trousseau syndrome. In particular, cerebral infarction caused by Trousseau syndrome is reported to have a poor prognosis. In gynecology, there are many reports of ovarian cancer and a few of uterine cancer. Since there has been no comprehensive report of Trousseau syndrome in cervical cancer, we aimed to summarize Trousseau syndrome in cervical cancer.
Methods:
Cerebral infarction caused by cancer-related arterial thrombosis was defined as Trousseau syndrome. Patients with cervical cancer diagnosed at our hospital between January 2014 and December 2021 were retrospectively reviewed using the hospital’s medical records.
Results:
A total of 1,432 patients were included in the study. Trousseau syndrome occurred in 6 patients (0.4%). The mean age of patients with Trousseau syndrome was 63 years (range:53–78 years). Of the 6 patients who developed Trousseau’s syndrome, 4 patients had it before or during initial treatment, and 2 during recurrent/relapsed disease treatment. The 4 patients who developed the syndrome before or during initial treatment had advanced disease: 1 in stage IIIC and 3 in stage IVB. In all cases, the disease was associated with progressive distant metastasis. The median survival time from the onset of Trousseau syndrome was 1 month (range: 0–6 months).
Conclusion
Cervical cancer causes Trousseau syndrome in cases of advanced disease with a short time between the onset of the syndrome and mortality.
8.Clinical implications of the superficial uterine vein pattern for the dissection of the anterior layer of the vesicouterine ligament in radical hysterectomy
Atsushi FUSEGI ; Hiroyuki KANAO ; Mayumi KAMATA ; Shogo NISHINO ; Akiko ABE ; Makiko OMI ; Hidetaka NOMURA
Journal of Gynecologic Oncology 2024;35(4):e50-
Objective:
To describe anatomic patterns of the superficial uterine vein (sUV) and assess their association with aspects of the dissection procedure of the anterior layer of the vesicouterine ligament (aVUL) by retrospectively reviewing surgical videos.
Methods:
We analyzed patients who underwent laparoscopic radical hysterectomy for early-stage cervical cancer from 2014 to 2019. The primary endpoint was the time required for aVUL dissection. Multiple linear regression analyses were performed to identify factors influencing the time required for aVUL dissection.
Results:
Fifty-three Japanese patients were included. Two sUV configurations were observed:type 1 (the vein ran ventral to the ureter along the uterine artery) and type 2 (the vein did not run along the usual ventral course; it ran dorsal to the ureter or was absent). Approximately 30% of the sUVs were type 2. The total time for dissection of both sides of the aVUL was significantly shorter for type 2 sUVs than for type 1 sUVs. The number of hemostatic interventions during dissection of each side of the aVUL was significantly lower for type 2 sUVs than for type 1 sUVs. In the multivariate analysis, the sUV configuration was the factor significantly influencing the duration of aVUL dissection on each side (right side: β=−143.4;left side, β=−160.4).
Conclusion
We demonstrated that the sUV had 2 types of courses, ventral and others, and its course affected the time required for dissection and the number of hemostatic interventions.Our results provide information supportive of improved radical hysterectomy outcomes.
9.Cerebral infarction caused by Trousseau syndrome associated with cervical cancer
Motoko KANNO ; Mayu YUNOKAWA ; Atsushi FUSEGI ; Akiko ABE ; Hidetaka NOMURA ; Hiroyuki KANAO
Journal of Gynecologic Oncology 2024;35(4):e41-
Objective:
The combination of cancer and hypercoagulable states is often called Trousseau syndrome. In particular, cerebral infarction caused by Trousseau syndrome is reported to have a poor prognosis. In gynecology, there are many reports of ovarian cancer and a few of uterine cancer. Since there has been no comprehensive report of Trousseau syndrome in cervical cancer, we aimed to summarize Trousseau syndrome in cervical cancer.
Methods:
Cerebral infarction caused by cancer-related arterial thrombosis was defined as Trousseau syndrome. Patients with cervical cancer diagnosed at our hospital between January 2014 and December 2021 were retrospectively reviewed using the hospital’s medical records.
Results:
A total of 1,432 patients were included in the study. Trousseau syndrome occurred in 6 patients (0.4%). The mean age of patients with Trousseau syndrome was 63 years (range:53–78 years). Of the 6 patients who developed Trousseau’s syndrome, 4 patients had it before or during initial treatment, and 2 during recurrent/relapsed disease treatment. The 4 patients who developed the syndrome before or during initial treatment had advanced disease: 1 in stage IIIC and 3 in stage IVB. In all cases, the disease was associated with progressive distant metastasis. The median survival time from the onset of Trousseau syndrome was 1 month (range: 0–6 months).
Conclusion
Cervical cancer causes Trousseau syndrome in cases of advanced disease with a short time between the onset of the syndrome and mortality.

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