Eur J Gynaecol Oncol
June 2018
Background: Treatment of metastatic breast cancer experienced significant improvement in the past decades by introduction of highly effective therapies, but survival still remains poor. Nonetheless, in some patients, long-term survival can be achieved by sequent endocrine and chemotherapy treatment, although toxicity and resistance eventually occur, until no further suitable and approved therapies remain. If further therapy is needed, therapist may be forced to consider treatients which are promising but not approved, such as the alkylating agent treosulfan, which is approved for the treatment of ovarian cancer only.
View Article and Find Full Text PDFThe aim of reconstruction with expanders is to restore breast shape and volume as close as possible to the contralateral breast and to reconstruct the inframammary fold with adequate ptosis.
View Article and Find Full Text PDFUp to 15% of patients with cervical cancer and pN0-status develop recurrent-disease. This may be due to occult metastatic spread of tumor cells. We evaluated the use of human-papillomavirus-(HPV)-mRNA as a molecular marker for disseminated tumor cells to predict the risk of recurrence.
View Article and Find Full Text PDFEur J Gynaecol Oncol
April 2013
Unlabelled: In gynecologic oncology lymphadenectomy is of prognostic and therapeutic importance because recurrence-free time and survival depend on the metastatic involvement of lymph nodes. Lymphadenectomies are not performed to such an extent as they are indicated. This might be due to a laborious or problematic preparation.
View Article and Find Full Text PDFObjective: The objective of this research was to identify the rate of unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH) and describe the therapy regime.
Methods: The research is based on a retrospective chart analysis of patients undergoing a simple hysterectomy in the gynecological endoscopy department of a general hospital in Germany.
Results: 2,577 simple hysterectomies conducted between March 2005 and March 2010 were sub-classified in different types of hysterectomies (vaginal-, abdominal-, total-, abdominal supracervical hysterectomy, LAVH, and LASH).
Background: Diseases of the vulva often cause severe impairment and long-term problems for the affected women. Adequate treatment requires expert knowledge on the part of treating dermatologists and gynecologists. This was the reason for the initiation of an interdisciplinary consultation service for vulvar diseases at the University Hospital of Lübeck.
View Article and Find Full Text PDFObjective: The main interest of this study was to assess the rate of intraoperative and perioperative complications of laparoscopic supracervical hysterectomy (LASH) in a teaching hospital.
Methods: A retrospective analysis of 1,584 laparoscopic assisted hysterectomies between 2005 and 2010 by different surgeons.
Results: In 2,577 patients undergoing simple hysterectomy, an indication for LASH was present in 1,584 cases.
Purpose: Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are closely related malignant neoplasms, usually affecting the skeletal system. Extraosseous ES/PNETs are uncommon, with occasional reports of tumors affecting the genitourinary tract. Only few cases of primary vulvar Ewing's sarcoma/PNET have previously been reported.
View Article and Find Full Text PDFIntroduction: To evaluate the operative outcomes of patients managed by laparoscopic-assisted vaginal hysterectomy (LAVH) with and without laparoscopic transsection of the uterine artery for benign gynaecologic diseases.
Patients And Methods: A retrospective analysis of 1,255 women from two different centers undergoing hysterectomy between 1998 and 2009 with benign indications is presented. 856 patients were treated by LAVH type I (vaginal transsection of the uterine artery) and 399 patients by LAVH type II (laparoscopic transsection of the uterine artery).
Gynakol Geburtshilfliche Rundsch
August 2009
By now laparoscopy has become an established access route in gynaecological surgery. It took many years to get to this stage for various obstacles had to be overcome. In the end, it was the low intra- and postoperative complication rates together with the rapid reconvalescence of the patients and their wish to be quickly discharged from hospital which led to an unstoppable diffusion of the method.
View Article and Find Full Text PDFObjective: The purpose of this study was to examine the effect of immunohistochemical (IHC) staining of sentinel (SLN) and non sentinel lymph nodes (NSLN) on the detection of additional metastases in patients with endometrial cancer.
Patients And Methods: Between April 2004 and March 2006, 25 patients with endometrial cancer were operated on. A new method for labelling SLNs with Patent Blue(R) was used.
Purpose: Omphalocele is a rare congenital abdominal wall defect that has been attributed to environmental factors such as increased levels of herbicides in surface water. We wanted to verify a seasonal variation of the incidence of Omphalocele and thus to identify possible environmental factors in an area in Northern Germany that is characterized by a predominantly agricultural setting.
Materials And Methods: A retrospective analysis of all pregnancies (n = 28 935) screened by ultrasound at our University Hospital between January 1, 1993 and December 31, 2007 was carried out.
Purpose: Single-institution case series have demonstrated the feasibility of the sentinel concept in cervical cancer. However, the diagnostic accuracy remains to be validated. We evaluated detection rate and diagnostic accuracy to predict the histopathologic pelvic nodal status in patients with cervical cancer of all stages.
View Article and Find Full Text PDFThe authors demonstrate expression of the vitamin D receptor (VDR) and its hydroxylases in the endometrium and ovaries of women with and without endometriosis and endometrial or ovarian cancer. Immunohistochemistry showed strong staining of the VDR in endometriosis and endometrial cancer, with the most intense staining in epithelial cells. The VDR mRNA was significantly increased in patients with endometrial and ovarian cancer compared to the control group.
View Article and Find Full Text PDFBackground: As part of the German healthcare modernization law implemented in 2004, infertile couples face a 50% co-payment of the total assisted reproduction technique (ART) treatment costs. This has led to a drastic reduction in ART treatment cycle numbers after January 2004. The hypothesis tested in the present study was that the number of ART treatment cycles in different German federal states changed differentially after implementation of the law, depending on the economical power of the individual state in terms of gross domestic product per capita (GDP pc).
View Article and Find Full Text PDFObjective: To describe the successful laparoscopic management of an omental pregnancy.
Design: Case report.
Setting: University of Schleswig-Holstein, Campus Luebeck, Department of Gynecology and Obstetrics.
Purpose: The objective of the study was to determine the feasibility of a new method of labeling sentinel lymph nodes in patients with endometrial cancer using blue dye.
Patients And Methods: 4 ml of blue dye was subserously administered in 25 patients with endometrial cancer at eight sites. After 8 min, sentinel lymph nodes were harvested.
About 10-15% of patients with cervical cancer suffer from recurrence despite histologically negative lymph nodes (pN0). Occult micrometastases or small tumour cell clusters may contribute to disease outcome. The aim of this study was to compare at the RNA level 2 known tumour-associated genes, HPV16-E6 and cytokeratin 19 (CK19), as molecular markers for the detection of disseminated tumour cells.
View Article and Find Full Text PDFObjective: Aim of this study to improve the detection rate of parametrial sentinel nodes in patients with early cervical cancer by using a new dosage of blue dye in a randomized trial.
Methods: Standard labelling volume of 4 ml Patent Blue was compared to 2 ml Patent Blue diluted with 8 ml NaCl 0.9% in 60 patients using a randomized protocol.
Background: Laparoscopic myomectomy offers a uterus-conserving alternative to hysterectomy for patients suffering from symptomatic myomas. The following study aimed to examine clinically relevant aspects of perceived satisfaction following laparoscopic myomectomy.
Method: 191 women completed a 17-item questionnaire on retrospective satisfaction with their choice for the operation and with the surgical outcome (e.
Fluorescence diagnosis and photodynamic therapy with 5-aminolevulinic acid induced protoporphyrin IX are promising new options in the diagnosis and therapy of diseases in a wide spectrum of medical disciplines such as urology, dermatology, gastroenterology, surgery, neurosurgery and gynecology. The techniques are based on the application of the heme biomolecule precursor 5-aminolevulinic acid which induces the endogenous accumulation of the photosensitizer protoporphyrin IX in designated tissues. After external excitation with blue light a strong red fluorescence can be initiated particularly in tumorous tissues.
View Article and Find Full Text PDFBackground: An increasing number of patients with fibroids wish to retain their uterus without improving fertility. We evaluated the rate of complications in our teaching hospital and its association with patients' age.
Methods: Chart records of 351 patients were evaluated according to patients' age.
Gonadotropin-releasing hormone (GnRH) stimulates the pituitary secretion of both luteinising hormone (LH) and follicle-stimulating hormone (FSH), and thus controls the hormonal and reproductive functions of the gonads. The blockade of the effects of GnRH may be sought for a variety of reasons; for example, to control premature LH surges and to reduce the cancellation rate with the aim of improving the pregnancy rate per treatment cycle or in the treatment of sex hormone-dependent disorders. Selective blockade of LH/FSH secretion and subsequent chemical castration have previously been achieved by desensitising the pituitary to continuously administered GnRH or by giving long-acting GnRH agonists.
View Article and Find Full Text PDFObjective: The aim of this study was to evaluate the factors considered for proficiency and to estimate the number of procedures needed to achieve competence in laparoscopic-assisted vaginal hysterectomy in a teaching hospital.
Methods: The length of the learning curve, duration of surgery, change of hemoglobin (in grams per liter), conversion rate, and intra- and postoperative complications were evaluated. Cases were analyzed according to the order for the individual surgeon.
Aim: The aim of this prospective study was to assess the role of uterine artery color Doppler waveform analysis in the prediction of adverse pregnancy outcome such as preeclampsia, intrauterine growth retardation, placental abruption or a combination of outcome parameters in risk pregnancies (n=52).
Methods: Various uterine artery Doppler ultrasound parameters (resistance index (RI)>0.58, RI>0.