Female ; Humans ; Laparoscopy ; Ovarian Cysts/surgery* ; Pregnancy ; Pregnancy Trimester, Third ; Torsion Abnormality/surgery*

Abscess ; surgery ; Adult ; Aged ; Aged, 80 and over ; Cysts ; surgery ; Drainage ; methods ; Endometriosis ; surgery ; Fallopian Tube Diseases ; surgery ; Female ; Humans ; Middle Aged ; Ovarian Cysts ; surgery ; Pelvis ; surgery ; Retrospective Studies ; Surgery, Computer-Assisted ; Tertiary Care Centers ; Treatment Outcome ; Ultrasonography ; Ultrasonography, Interventional ; methods ; Vagina ; Young Adult

Adult ; Female ; Humans ; Laparoscopy ; adverse effects ; Ovarian Cysts ; surgery ; Ovariectomy ; adverse effects ; Pregnancy ; Takotsubo Cardiomyopathy ; etiology

INTRODUCTIONThe purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.

MATERIALS AND METHODSSeven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.

RESULTSThe sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.

CONCLUSIONThe sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.

Female ; Humans ; Infant, Newborn ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovary ; diagnostic imaging ; pathology ; Postoperative Period ; Retrospective Studies ; Torsion Abnormality ; diagnostic imaging ; pathology ; surgery ; Ultrasonography, Doppler ; instrumentation

OBJECTIVETo evaluate the effect of epidural anesthesia and patient-controlled epidural analgesia (PCEA) on hemorheology and the incidence of deep venous thrombosis in patients undergoing gynecological laparoscopy.

METHODSOne hundred ASA I-II patients undergoing gynecological laparoscopy were randomly allocated into 2 groups to receive general-epidural anesthesia combined with PCEA (GE group) and general anesthesia (G group). Blood samples were taken before anesthesia (T(0)), before operation (T(1)), 30 min after pneumoperitoneum (T(2)), 30 min after pneumoperitoneum cease (T(3)), and 24 and 48 h after the operation (T(4), T(5)) for hemorheological tests.

RESULTSIn GE group, the blood viscosity, plasma viscosity and RBC aggregation decreased significantly at T(1) (P<0.05), but no significant variations were detected at the other time points. In G group, blood viscosity and plasma viscosity increased significantly from T(2) to T(5), and were significantly higher than those of GE group. The incidence of deep venous thrombosis of GE group (2%) was significantly lower than that of the G group (8%).

CONCLUSIONThe blood viscosity, plasma viscosity and RBC aggregation increase during gynecological laparoscopy, and can be reduced by epidural anesthesia and PCEA to lower the incidence of deep venous thrombosis.

Adolescent ; Adult ; Analgesia, Patient-Controlled ; methods ; Anesthesia, Epidural ; methods ; Female ; Gynecologic Surgical Procedures ; Hemorheology ; Humans ; Laparoscopy ; Middle Aged ; Ovarian Cysts ; blood ; surgery ; Pregnancy ; Uterine Neoplasms ; blood ; surgery ; Young Adult

Adnexa Uteri ; surgery ; Colectomy ; methods ; Colonic Diseases ; etiology ; pathology ; surgery ; Colostomy ; Endometriosis ; complications ; pathology ; surgery ; Female ; Fistula ; etiology ; pathology ; surgery ; Follow-Up Studies ; Humans ; Intestinal Fistula ; etiology ; pathology ; surgery ; Middle Aged ; Ovarian Cysts ; complications ; pathology ; surgery ; Ovarian Diseases ; etiology ; pathology ; surgery ; Ovariectomy

OBJECTIVETo investigate the effect and mechanism of E-leng Capsule (ELC) in preventing and treating post-operation recurrence of ovarian endometriotic cysts (OEC).

METHODSA total of 60 patients enrolled were the inpatients, who underwent cystectomy of OEC in the Gynecological Department of Guangdong Provincial Hospital of Traditional Chinese Medicine from 2002 to 2004. They were randomly assigned to two groups, the treatment group and the control group. Patients in the treatment group were administered with ELC before operation and after operation (starting from the 7th day post-operation), each for 3 months, while patients in the control group were untreated before operation and administered with Danazol from the 7th day post-operation for 3 months. Specimens of eutopic and ectopic endometrium in all patients of both groups were taken during the operation for detecting expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA by polymerase chain reaction (PCR), and the incidence of post-operation recurrence was observed 12 months later.

RESULTSThe 12-month follow-up showed that recurrence presented in 1 patient in the treatment group (3.3%), and 6 in the control group (20.0%), showing significant difference between them (P<0.05). The expressions of TIMP-1 mRNA in eutopic and ectopic endometrium were 0.85 +/- 0.36 and 0.76 +/- 0.57 in the treatment group, and 0.71 +/- 0.33 and 0.56 +/- 0.39 in the control group, while the expressions of MMP-9 mRNA were 0.36 +/- 0.40 and 0.35 +/- 0.35 vs 0.36 +/- 0.33 and 0.72 +/- 0.59, respectively. The expression of endometrial TIMP-1 mRNA, either eutopic or ectopic, was significantly higher, and the expression of ectopic endometrial MMP-9 mRNA was lower in the treatment group than that in the control group (P<0.01).

CONCLUSIONELC can reduce the invasive ability of endometrium tissue probably by regulating the balance of MMP/TIMP, namely, increase the expression of eutopic and ectopic endometrial TIMP-1 and decrease the expression of ectopic endometrial MMP-9, and thus to achieve its preventive and therapeutic effect on recurrence of OEC.

Adult ; Capsules ; pharmacology ; therapeutic use ; Endometriosis ; complications ; drug therapy ; prevention & control ; surgery ; Endometrium ; drug effects ; metabolism ; Female ; Gene Expression Regulation ; drug effects ; Humans ; Matrix Metalloproteinase 9 ; genetics ; Ovarian Cysts ; complications ; drug therapy ; prevention & control ; surgery ; Postoperative Complications ; drug therapy ; metabolism ; prevention & control ; Secondary Prevention ; Time Factors ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; Young Adult

Laparoscopy is a surgical procedure used both for diagnosis and for various treatments. A rare but sometimes fatal complication of laparoscopy is pulmonary embolism with CO2 resulting in pulmonary edema. During laparoscopic gynecological surgery in a 29-year-old woman who had previously undergone lower abdominal surgery, the end-tidal CO2 suddenly increased from 40mmHg to 85mmHg and then decreased to 13mmHg with hemodynamic deterioration. These events are characteristic of a CO2 embolism. When this occurred, CO2 insufflation was immediately stopped and the patient was resuscitated. The patient's condition gradually improved with aggressive treatment, but the clinical course was complicated by bilateral pulmonary edema. This case of pulmonary edema was soon resolved with supportive management. The formation of a CO2 embolism during laparoscopy must be suspected whenever there is a sudden change in the end-tidal CO2. In addition, the possibility of pulmonary edema should be considered when a CO2 embolism occurs.
Adult ; Carbon Dioxide/*metabolism ; *Cystectomy ; Female ; Humans ; *Laparoscopy ; Ovarian Cysts/*surgery ; Pulmonary Edema/*complications/metabolism/radiography ; Pulmonary Embolism/*complications/metabolism/radiography

OBJECTIVETo evaluate the efficacy of improved laparoscopic enucleation of benign ovarian cysts.

METHODSA total of 234 cases of ovarian cysts with 271 cysts were analyzed retrospectively. 152 patients with 177 ovarian cysts (Group A) underwent the improved laparoscopic enucleation and 82 patients with 94 ovarian cysts (Group B) underwent the classic laparoscopic enucleation. The data of operative process and postoperative follow-up were compared between two groups.

RESULTSThe rate of spillage of the Group A and Group B was 1.7% and 18.1% (P<0.01), respectively. The operating time was (40 +/-14)min and (47 +/- 16)min (P<0.01), respectively. The blood loss was (25 +/-17)ml and (27 +/- 19)ml (P>0.05), respectively. The bowel deflation recovery time was (18 +/- 8)h and (19 +/- 8)h (P>0.05), respectively. The length of hospital stay was (2.0 +/- 0.5)d and (2.2 +/- 0.8)d (P>0.05), respectively.

CONCLUSIONCompared with classic laparoscopic procedure, the improved laparoscopic ovarian enucleation seems to be safer and more effective with shorter operating time.

Adolescent ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Middle Aged ; Ovarian Cysts ; surgery ; Retrospective Studies

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Fetal ovarian cyst often presents complication such as torsion and seems to be an indication for surgical intervention. In this study, we reviewed pre- and post-natal medical records and ultrasonography of 17 fetuses that were diagnosed with ovarian cysts. In a total of 17 cases, postnatal surgery was performed in 7 infants. Of these cases, four cases of ovarian cyst torsion were confirmed. In the remaining 10 fetuses, one case regressed completely during pregnancy, and the other nine cases including two complex cysts resolve spontaneously after birth. Postnatal symptomatic cysts or cysts with a diameter greater than 5 cm that do not regress or enlarge should be treated, but uncomplicated asymptomatic cysts less than 5 cm in diameter should only be observed and reassessed by serial ultrasonography. If they regress spon-taneously, no surgical intervention is necessary independent of their sonographic findings.
Ultrasonography, Prenatal/*methods ; Remission, Spontaneous ; Pregnancy ; Ovariectomy/methods ; Ovarian Cysts/*diagnosis/surgery ; Infant, Newborn ; Infant ; Humans ; Gestational Age ; Fetal Diseases/*diagnosis/surgery ; Female