Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Jul 2006
ReviewUterine polypectomy in the management of abnormal uterine bleeding: A systematic review.
In order to assess the efficacy of uterine polypectomy in the treatment of abnormal uterine bleeding (AUB), we conducted a systematic review of the published literature. Relevant papers were identified through electronic scanning of MEDLINE (1966-2004), EMBASE (1980-2004), and the Cochrane Library, and manual searching of bibliographies of known primary and review articles. Studies were selected if the efficacy of uterine polypectomy in treating women with AUB (menstrual dysfunction, postmenopausal bleeding with or without hormone replacement/tamoxifen therapy) was estimated. ⋯ In conclusion, there is a lack of high-quality evidence to reliably inform clinical practice regarding the efficacy of intrauterine polypectomy in women with AUB. The limited available evidence suggests that hysteroscopic polypectomy is a technically successful procedure that improves AUB symptoms. Further research in the form of a multicenter, randomized, controlled trial, stratified by technique, setting, and pattern of AUB, is required to assess the short- and long-term effects of this commonly practiced intervention.
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J Minim Invasive Gynecol · Jul 2006
Hysteroscopic view in atypical endometrial hyperplasias: A correlation with pathologic findings on hysterectomy specimens.
To evaluate whether hysteroscopic imaging can contribute to decrease the rate of undetected endometrial carcinomas concurrent with atypical hyperplasia diagnosed by endometrial biopsy. ⋯ Hysteroscopic view is a sensitive and specific method to identify among patients with a diagnosis of atypical hyperplasia on endometrial biopsy those with a coexisting infiltrating carcinoma.
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J Minim Invasive Gynecol · May 2006
Randomized Controlled Trial Comparative StudyTopical diclofenac patch for postoperative wound pain in laparoscopic gynecologic surgery: a randomized study.
To compare pain management of standard analgesic and standard analgesic plus diclofenac transdermal patch in patients who undergo laparoscopic gynecologic surgery. ⋯ Diclofenac transdermal administration seems a valid help to standard analgesic treatment in postoperative pain control and could also help reduce the period of hospitalization of patients who undergo laparoscopic benign gynecologic surgery.
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J Minim Invasive Gynecol · May 2006
Effect of body habitus and parity on insufflated CO2 volume at various intraabdominal pressures during laparoscopic access in women.
To determine height, weight, body mass index (BMI), parity, and age effect on the volume of CO2 pneumoperitoneum during laparoscopic access in women. ⋯ Higher CO2 volume is required to establish appropriate pneumoperitoneum in tall, overweight, and parous women at 20 to 30 mm Hg. Setting the IPIP at 20 to 30 mm Hg before primary trocar insertion eliminates the need to monitor CO2 insufflated volume regardless of women's age, parity, and body habitus.
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J Minim Invasive Gynecol · Mar 2006
Randomized Controlled Trial Comparative StudyLaparoscopic-assisted vaginal hysterectomy versus total laparoscopic hysterectomy for the management of endometrial cancer: a randomized clinical trial.
To compare laparoscopic-assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH) for the treatment of endometrial cancer. ⋯ Both LAVH and TLH can be performed successfully to manage endometrial cancer, with similar surgical outcomes. Obese patients benefit more from TLH than from LAVH in terms of shorter operating time.