Gynecologic oncology
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Gynecologic oncology · Oct 2007
Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy.
To clarify the anatomy necessary for the nerve sparing Okabayashi's radical hysterectomy, we meticulously separated the blood vessels and connective tissues to preserve the pelvic splanchnic nerve, the hypogastric nerve, and the bladder branch of the inferior hypogastric plexus under magnification (x2.5) during the Okabayashi radical hysterectomy. ⋯ In order to accomplish the nerve sparing Okabayashi's radical hysterectomy, it is necessary to meticulously divide the posterior leaf of the vesicouterine ligament. By the separation of the inferior vesical vein in the posterior leaf of the vesicouterine ligament, the bladder branch from the inferior hypogastric plexus can be identified and preserved. All patients recovered their urinary function completely by POD 21.
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Gynecologic oncology · Oct 2007
Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer.
To determine factors predicting post-cone residual disease in cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer. ⋯ Positive margin and pre-cone HR-HPV load >or=300 RLU/PC were the only significant factors predicting post-cone residual disease in multivariate analysis. Appropriate application of these predictive factors may avoid post-cone hysterectomy.
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Gynecologic oncology · Sep 2007
Cytoreductive surgery for patients with recurrent epithelial ovarian carcinoma.
This study aims to identify favorable preoperative characteristics and examine the impact of secondary cytoreductive surgery on survival for patients with recurrent epithelial ovarian carcinoma. ⋯ When selecting patients for secondary cytoreduction, the most significant preoperative factors are disease-free interval and success of a prior cytoreductive effort. Once secondary cytoreductive surgery is attempted, the most important factor for improved survival is optimal cytoreduction. Of equal importance is counseling regarding the significant risk for bowel surgery, colostomy, and complications.