Laparoscopic photodynamic diagnosis of ovarian cancer peritoneal micro metastasis: an experimental study.

The goal of this study was to assess the interest of photodynamic diagnosis (PDD) for laparoscopic detection of peritoneal micro metastasis in ovarian carcinoma. Using an experimental animal model, intraperitoneal injection of aminolevulinic acid (ALA) and hexylester of aminolevulinic acid (He-ALA) were compared in order to improve laparoscopic detection of ovarian peritoneal carcinomatosis. Twenty-one 344 Fischer female rats received an intra peritoneal injection of 106 NuTu-19 cells.

[Management of in situ cervical adenocarcinoma].

The management of adenocarcinoma in situ of the cervix (ACIS) is difficult because it is often diagnosed in younger women who may wish to preserve their potential of fertility. Conservative treatment has been accepted as an appropriate strategy but interrogations persist as to carcinological safety. We report a complete review of the literature on this subject where conservative attitude appears possible but is associated with recurrence risk (5 to 10%) and invasive disease (2%).

[Transvaginal surgery for genital prolapse in women aged over 80 years: Results in 48 procedures].

Objectives: The aim of this study was to assess the morbidity and the effectiveness of the vaginal surgical treatment for women over 80 years of age with genital prolapse.

Materials And Methods: All the women over 80 years operated in our institution between 1996 and 2003 were reviewed retrospectively. We examined the risk and the effectiveness of this surgery.

[Intra-uterine arteriovenous malformations].

Intra-uterine arteriovenous malformations are a possible etiology of persistent metrorrhagia especially in the event of a history of miscarriages, cornuale pregnancy, molar pregnancy or gravidic trophoblastic diseases. We report 4 cases of patients having an intra-uterine arteriovenous malformation. The diagnosis of such lesions calls upon first intention Doppler echography.

In vivo expression and antitumor activity of p53 gene transfer with naked plasmid DNA in an ovarian cancer xenograft model in nude mice.

Introduction: Abnormalities in the p53 and p16 tumor suppressor genes are one of the most common occurrences associated with human neoplasia. Consequently, restoration of wild-type p53 or p16 functions is seen as a particularly promising approach for cancer gene therapy. In vitro and in vivo data have demonstrated that virus-mediated p53 gene transfer can induce active cell death and ovarian tumor regression.

[Synthetic meshes for transvaginal surgical cure of genital prolapse: evaluation in 2005].

Since 1996, prosthetic meshes have become increasingly popular for transvaginal surgical cure of genital prolapse. In light of the growing number of proposed techniques and materials we reviewed the experience of the pioneers in order to provide surgeons with the most objective information available. We reviewed the literature indexed in Meline/PubMed and Current Contents retaining all work concerning resorbable and non-resorbable meshes.

Management of multicentric lesions of the lower genital tract.

Objectives: To report management and outcome of multicentric lesions of the lower genital tract. To define risk factors of recurrence.

Study Design: Retrospective review of multicentric dysplasias treated in our colposcopic clinic between 1996 and 2003.

[Endometriosis and infertility].

Relationship between infertility and endometriosis is still controversial. Many mechanisms have been reported such as anatomical disorders, biologic and cytological modifications of peritoneal liquid, functional ovarian and endometrial disorders, reduced embryo quality. Management of infertility related to endometriosis is difficult and no consensus has been published yet.

[Management of endometriosis of the urinary tract].

Endometriosis of the urinary tract (bladder and/or ureter) is rare and concerns 1-2% of cases of endometriosis. Surgical management is usually mandatory. Rate of peri operative morbidity is low.

[Ovarian cancers and CA 125 in 2006].

The authors propose to report progress on the use of the CA 125 serum assay. It affects three situations: screening, diagnosis and the follow-up of the patients dealt with ovarian tumour either of benign or malignant nature. For each situation the interest and the relevance of CA 125 assay will be approached.

[The HELLP syndrome: diagnosis and therapeutic burden].

Management of HELLP syndrome is still controversial. In order to improve maternal and foetal prognosis, 2 approaches are usually considered: immediate termination of pregnancy (risk of foetal complications related to prematurity) or conservative treatment (maternal risk of complications related to hematologic disorders). Choice of treatment needs to be taken after evaluation of the maternal and fetal risk/benefit ratio.

[Risk factors for prosthesis exposure in treatment of genital prolapse via the vaginal approach].

Objectives: Prosthetic reinforcement in the surgical repair of pelvic prolapse by the vaginal approach is currently on the increase. However, this technique is not without tolerance-related problems. The most frequently described complication is prosthesis exposure, including erosion and delayed healing.

[Prosthetic reinforcement by the vaginal approach after surgical repair of pelvic prolapse].

Introduction: Prosthetic reinforcement by the vaginal approach for surgical repair of pelvic prolapse is experiencing increasing popularity despite problems with tolerance. The most frequently described complication is prosthesis exposure, also known as erosion or granuloma. The mechanism is associated with defective vaginal healing and is independent of major infection such as pelvic cellulitis.

Efficacy and complications in the surgical treatment of stress urinary incontinence by insertion of a silicone-coated polyester tape (Lift).

Objectives: To evaluate the efficacy and safety of a surgical treatment for stress urinary incontinence by implantation of a silicone-coated polyester tape (Lift).

Materials And Methods: This retrospective study included 72 female patients having had a suburethral silicone-coated polyester tape inserted as treatment for stress urinary incontinence, combined or not with pelvic surgery. We recorded the patient's characteristics, the surgical procedure, the short and long-term results and complications.

Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors.

Prosthetic reinforcement in the surgical repair of pelvic prolapse by the vaginal approach is not devoid of tolerability-related problems such as vaginal erosion. The purposes of our study are to define the risk factors for exposure of the mesh material, to describe advances and to recommend a therapeutic strategy. Two hundred and seventy-seven patients undergoing surgery due to pelvic prolapse with transvaginal mesh technique were included in a continuous, retrospective study between January 2002 and December 2003.

[Strategy for management of ovarian immature teratoma. About three cases and review].

Ovarian immature teratoma is a malignant germ cell tumor and represents less than 1% of ovarian malignant tumors. Tissues are derived from the three germ layers (endo-, meso- and ectoderm). Tumor grading is based on the amount of immature neuroepithelium present.

Objective analysis of mechanical resistance of tension-free devices.

Introduction: The "tension-free" procedures are widely used by surgeons for the treatment of urinary incontinence and prolapse. The clinical results are largely in favour of these procedures. The aim of our study is to determine objectively the mechanical tissue resistance when using these techniques, before healing begins.

[Clinical study and prognosis of 56 cases of vulvar intraepithelial neoplasia].

Objective: To study main clinical characteristics of patients with vulvar intraepithelial neoplasia 3 (VIN3). To investigate the long-term outcome and risk factors associated with recurrence or progression to invasive carcinoma.

Patients And Methods: Retrospective study of 56 patients with VIN3 from January 1st 1995 to December 31st 2003.

[Phyllodes tumor of the breast: analysis of 8 patients].

Introduction: Phyllodes tumors of breast are rare and usually benign. These are histologically fibro-epithelial tumors similar to fibroadenomas. Histological confirmation on the operative specimen is required to establish the diagnosis and histological pronostic of phyllode tumors.

[Fluorescence imaging technique: diagnostic and therapeutic interest in gynecology].

Fluorescence techniques are presently used by several medical and surgical disciplines (dermatology, pneumology, urology, gastrointestinal surgery) for the diagnosis of pre-cancerous and cancerous lesions. The technique is based on the application of 5-aminolevulinic acid (5-ALA) which induces the production of an endogen photosensitizer: protoporphyrin IX (PpIX). Fluorescence detection of the infraclinical dysplasia lesion is based on the contrast between fluorescent pathological tissue and non-fluorescent healthy tissue.

[Management of type III female genital mutilation].

Female genital mutilation (FGM) consists in a non-therapeutic removal of part or all of the external genitalia and /or injury to the external genitalia. This practice in common in a few African countries and in Middle East. Mass immigration of African women to Europe in the past decade has brought the problems of FGM to these countries.

Perineal cellulitis following trans-obturator sub-urethral tape Uratape.

Objective: We report two cases of perineal cellulitis due to the surgical treatment of female stress urinary incontinence with a trans-obturator sub-urethral tape of Uratape (Porgés).

Methods: Treatment and follow up of their complication were performed at the CHRU of Lille.

Results: In both cases, this complication is related to prolonged vaginal exposition of the tape.

[Mechanical resistance of pelvic ligaments used for incontinence or prolapse surgery].

Objective: Underline the objective strength of the pelvic ligaments.

Patients And Methods: Twenty nine human female pelvis cadavers, whose storage conditions differed, were used in our study. In each cadaver we dissected all the ligaments used in pelvic surgery.