Methotrexate provides significant cost savings for the treatment of unruptured ectopic pregnancy.

The aim of this study was to compare direct and indirect costs of single-dose methotrexate and laparoscopy in the treatment of unruptured ectopic pregnancy. We conducted a prospective study between 1 January 1995 and 31 May 1997 and recorded costs accrued from outpatient and inpatient treatment with methotrexate (group I) and laparoscopy (group II). We used the French National Social Security nomenclature as reference for the different costs.

[Sentinel lymph node biopsy in cervical and endometrial cancers: a feasibility study].

The sentinel lymph node (SLN) biopsy has been proposed for the cancers of the uterus in order to optimize the diagnosis of lymphatic metastases and micrometastases in early stage tumors. Patients with early invasive cervical (n = 8) or endometrial (n = 15) cancers were enrolled. A lymphoscintigraphy was carried out before the intervention.

[Use of Misoprostol for medical abortion: a trial of the acceptability for home use].

Objective: The object of this trial was to appreciate the acceptability of Misoprostol home use in medical abortion.

Patients And Method: From 1 January 2001 to 28 February 2002, 120 voluntary patients were included in the study of medical voluntary pregnancy interruption with Misoprostol at home, and 289 patients were using the protocol "Misoprostol at hospital".

Results: The method was well tolerated by all patients.

Comparison between bisection/morcellation and myometrial coring for reducing large uteri during vaginal hysterectomy or laparoscopically assisted vaginal hysterectomy: results of a randomized prospective study.

Background: Vaginal hysterectomy (VH) is being performed increasingly by gynecologic surgeons. Thus, enlarged uteri are more frequently removed vaginally, requiring reducing techniques to allow vaginal extraction.

Material And Methods: We designed a randomized prospective study to compare bisection-morcellation and myometrial coring.

[Hysterosonography].

Hysterosonography, which consists in the injection of some cc of saline in the uterine cavity during sonography, allows an exploration of the uterine cavity and of the endometrium. Accuracy of hysterosonography is similar to that of office hysteroscopy. Hysterosonography distinguishes normal cavities from pathologic ones, endometrial atrophy from mucosal anomalies, polyps from myomas.

Impact of pneumoperitoneum on tumor growth.

Aim Of The Study: To compare intraperitoneal tumor growth after CO2 laparoscopy (L), gasless laparoscopy (GL), midline laparotomy (ML), and general anesthesia (GA) as a control.

Materials And Methods: A prospective randomized trial was carried out in nude rats. A carcinomatosis was obtained by intraperitoneal injection of either one of the two human ovarian cancer cell lines IGR-OV1 or NIH:OVCAR-3.

Description of two new human ovarian carcinoma models in nude rats suitable for laparoscopic experimentation.

Background: Experimental laparoscopic trials require relevant models of ovarian carcinomatosis.

Methods: Female nude rats were inoculated intraperitoneally either with the IGR-OV1 or the NIH:OVCAR-3 human adenocarcinoma cell lines. Serial clinical checks and sacrifices were used to evaluate the rates of tumor take, survival, and patterns of tumor spread.

Impact of pneumoperitoneum on visceral metastasis rate and survival. Results in two ovarian cancer models in rats.

Objective: To compare the impact of CO2 laparoscopy, gasless laparoscopy, and midline laparotomy on the development of distant metastases and on survival in two ovarian carcinoma models.

Design: A prospective randomised study in rats.

Material: and methods Two ovarian cancer xenografts were obtained by intraperitoneal injection of IGR-OV1 or NIH-OVCAR-3 cells.

Hospital resources used for ectopic pregnancy treatment by laparoscopy and methotrexate.

Objective: To compare resources used in the medical and laparoscopic treatment of unruptured ectopic pregnancy.

Methods: We prospectively recorded all the medical resources required in the treatment of unruptured ectopic pregnancy. The study period ranged from January 1, 1995 to June 30, 1998.

Laparoscopy in patients with prior surgery: results of the blind approach.

Background And Objectives: To compare the complication rate due to blind access laparoscopy between patients with or without a prior history of laparotomy.

Methods: We examined a prospective record of data on laparoscopic surgeries performed from 1992 to 1998. Only cases in which the Veress needle and the first trocar were inserted through the umbilicus were included in this study.

Saline contrast sonohysterography in the preoperative assessment of benign intrauterine disorders.

Objectives: To assess the value of saline contrast sonohysterography (SCSH) in the preoperative evaluation of benign intrauterine lesions.

Design: Patients presenting with abnormal bleeding related to benign uterine pathologies and scheduled for surgical treatment were prospectively enrolled in a study conducted between 1 January 1996 and 31 December 1997. SCSH was first carried out with the intention of establishing further surgical management (hysterectomy or hysteroscopy).

Perioperative morbidity of gynecological laparoscopy. A prospective monocenter observational study.

Background: To study the morbidity rate of gynecological laparoscopy and to the most influential variables.

Methods: We conducted a prospective observational study from January 1st 1992 to December 31st 1998 in a single tertiary care center. It concerned patients who underwent gynecological laparoscopic surgery performed by seniors and residents.

The long-term tolerability and efficacy of OESCLIM: results of a 1-year study.

Objectives: A 1-year, open-label, non-comparative study evaluated the long-term tolerability and acceptability of a new generation matrix patch in post menopausal women with estrogen deficiency.

Methods: Menopausal women (224) from 37 centres in five European countries received OESCLIM 50 microg/d (17-beta estradiol) for 3 months, titrated if necessary to either 25 or 100 microg/d for a further 9 months. Patients received either a continuous or discontinuous estradiol regimen with concomitant sequential progestogen (except hysterectomised patients).

Direct cost of single dose methotrexate for unruptured ectopic pregnancy. Prospective comparison with laparoscopy.

Objectives: to compare the direct cost of single dose methotrexate (MTX) and laparoscopy in the treatment of unruptured ectopic pregnancy (unruptured EP).

Study Design: A prospective nonrandomized study. Thirty-two women received intramuscular MTX (1 mg/kg) on an out-patient basis when they fulfilled the following requirements: human chorionic gonadotropin (hCG) level <5000 IU/l, hematosalpinx diameter <3 cm and peritoneal fluid <100 cc.

[Complications of gynecological laparoscopy. Results of a prospective single center study].

Gynaecological laparoscopy is associated with a patient morbidity rate. Half of the complications occur during the installation stage.

Anticoagulant therapy in pregnancy.

Anticoagulation during pregnancy should derive benefit from recent advances in anticoagulant therapy. Unfractionated heparin is at present the drug of choice for most of the indications of thromboprophylaxis as well as for acute venous thrombosis during pregnancy but it is likely that, in the near future, low molecular weight heparins will supercede this anticoagulant in many indications. One particular indication is mechanical heart valves that needs a high degree of anticoagulation.

Effect of methotrexate on tubal epithelium. A report of three cases.

Background: Tubal effects of methotrexate injections have been poorly reported.

Cases: Three fallopian tubes were examined with light microscopy 9-13 months after tubal methotrexate injection (one case) and intramuscular methotrexate injection (two cases) given for the treatment of unruptured ectopic pregnancies. No evidence of tubal damage was found.

Morbidity in laparoscopic gynecological surgery: results of a prospective single-center study.

Background: We set out to investigate prospectively the morbidity rate for gynecological laparoscopy patients at a tertiary care center.

Methods: We prospectively recorded data on 743 laparoscopic procedures performed between January 1, 1992 and December 31, 1996. The procedures included 36 diagnostic laparoscopies (4.

[Microinvasive carcinoma uterine cervix. Which approach in 1998?].

Numerous definitions of microinvasive carcinoma (MIC) have been proposed. The SGO takes into account the depth of stromal invasion and presence of capillary like space involvement (LVI). The Figo uses the lesion width and describes different substages according to the depth of stromal invasion.

Use of hysterosalpingosonography for early diagnosis of ectopic pregnancy.

Diagnosis of unruptured ectopic pregnancy was performed using hysterosonography in a patient with no adnexial mass visible on transvaginal sonography and low hCG level (440 UI l(-1)). This avoided a laparoscopy and allowed treatment by single injection of methotrexate. Hysterosonography may be useful for the diagnosis of small ectopic pregnancies.