Should we centralise care for the patient suspected of having ovarian malignancy?

Objectives: Outcome of ovarian cancer is better when surgery is provided by a gynaecological oncologist than by a general gynaecologist. However, when all patients with an adnexal mass have to be operated by gynaecological oncologists, this requires a change in the organisation of care, which generates additional costs. In this study, we assess the costs and effects of centralised and regular care for women with an ovarian malignancy in the Netherlands.

Women's preference for laparoscopic or abdominal hysterectomy.

In the present study, women's preferences on advantages and disadvantages of laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH) have been studied. Patients' preferences were evaluated in individual, structured interviews in women scheduled for hysterectomy and questionnaires in nurses. Forty-three patients and 39 nurses were included.

Patients' preferences in mode of surgery of an adnexal mass.

Objective: We assessed the preferences of women with an adnexal mass for the mode of surgery.

Methods: A structured interview was designed in which women, scheduled for surgery for an adnexal mass, were confronted with fictive scenarios of the different approaches. Women were asked at what probability of a false negative test result of frozen section diagnosis they would prefer frozen section diagnosis over primary radical surgery.

The accuracy of risk scores in predicting ovarian malignancy: a systematic review.

Objective: To perform a systematic review of the literature on the accuracy of prediction models in the preoperative assessment of adnexal masses.

Data Sources: Studies were identified through the MEDLINE and EMBASE databases from inception to March 2008. The MEDLINE search was performed using the keywords ["ovarian neoplasms"[MeSH] NOT "therapeutics"[MeSH] AND "model"] and ["ovarian neoplasms"[MeSH] NOT "therapeutics"[MeSH] AND "prediction"].

Pelvic organ function in randomized patients undergoing laparoscopic or abdominal hysterectomy.

Study Objective: To assess the incidence of urinary incontinence, bowel dysfunction, and sexual problems after laparoscopic hysterectomy as compared with abdominal hysterectomy.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Single-center teaching hospital in the Netherlands, experienced in gynecologic minimal access surgery.

Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: a randomized, controlled trial.

Study Objective: Minimally invasive surgery aims to achieve at least a similar clinical effectiveness with a quicker recovery than traditional open techniques. Although there have been numerous randomized clinical trials comparing laparoscopic hysterectomy with hysterectomy by laparotomy, only a few studies have compared quality of life after different types of hysterectomy. None of these studies evaluated total laparoscopic hysterectomy.

Evaluation of adnexal masses with three-dimensional ultrasonography.

Objective: To estimate whether three-dimensional ultrasonography and three-dimensional power Doppler investigation can contribute to the differentiation between benign and malignant ovarian masses.

Methods: Women scheduled for surgical treatment of an adnexal mass were included in a multicenter prospective study. All women underwent two-dimensional and three-dimensional ultrasonographic examination in the week before surgery.

The impact of size of the adnexal mass on the accuracy of frozen section diagnosis.

Objective: We recently showed that frozen section diagnosis has an almost perfect specificity for the diagnosis of malignancy in an adnexal mass, whereas the sensitivity was, though good, not perfect. The aim of the present study was to examine whether the accuracy of frozen section diagnosis is affected by the size of the adnexal masses.

Methods: We included women that underwent frozen section diagnosis for adnexal mass surgery.