Gynecologic oncology
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Gynecologic oncology · Sep 2015
Lean methodology improves efficiency in outpatient academic Gynecologic Oncology clinics.
Patient satisfaction scores may be used as a measure of quality of care, but outpatient scores are significantly and negatively affected by long clinic wait times. Patients in academic Gynecologic Oncology clinic at UVA for chemotherapy visits experience multiple wait times during a complex multipurpose visit. The purpose of this study was to utilize Lean methodology to identify variability in patient flow in order to guide solutions for improvement. ⋯ Analyzing patient flow through an academic Gynecologic Oncology clinic can elucidate inefficiencies and guide improvements. Change in process can meaningfully affect overall waiting time. Next steps include instituting a more global change in process, as well as linking results to patient satisfaction scores.
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Gynecologic oncology · Sep 2015
Randomized Controlled TrialUltrasound guided subcostal transversus abdominis plane (TAP) infiltration with liposomal bupivacaine for patients undergoing robotic assisted hysterectomy: A prospective randomized controlled study.
Optimal pain control after major surgery contributes to a patient's recovery and satisfaction. The use of liposomal bupivacaine in subcostal transversus abdominis plane (TAP) blocks for postoperative pain control after robot assisted abdominal surgery has yet to be studied. ⋯ Subcostal TAP blocks with liposomal bupivacaine decreased the total opioid requirement for the first 72h after robot assisted hysterectomy when compared to subcostal TAP blocks with bupivacaine.
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Gynecologic oncology · Sep 2015
Effectiveness and safety of expanded perioperative thromboprophylaxis in complex gynecologic surgery.
To determine the effectiveness and safety of an expanded perioperative venous thromboembolism (VTE) prophylaxis strategy in women undergoing complex gynecologic surgery. ⋯ Implementation of a perioperative VTE prophylaxis protocol was safe, feasible and resulted in a clinically significant reduction in symptomatic VTE. Preoperative single-dose unfractionated heparin for all patients, combined with two weeks of thromboprophylaxis in gynecologic cancer patients, may decrease VTE events without increasing bleeding or infection.
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Gynecologic oncology · Sep 2015
Radical trachelectomy in early-stage cervical cancer: A comparison of laparotomy and minimally invasive surgery.
Radical trachelectomy is considered standard of care in patients with early-stage cervical cancer interested in future fertility. The goal of this study was to compare operative, oncologic, and fertility outcomes in patients with early-stage cervical cancer undergoing open vs. minimally invasive radical trachelectomy. ⋯ Our results suggest that radical trachelectomy via MIS results in less blood loss and a shorter hospital stay. Fertility rates appear higher in patients undergoing open radical trachelectomy.