Laparoscopic surgery of dermoid cysts--intraoperative spillage and complications.

Objective: To assess the risks of complications including intraoperative spillage following laparoscopic dermoid cyst enucleation.

Study Design: A retrospective case series comparison of 390 patients who had surgery at our hospital from 1992 to 1998 for teratomas of the ovary.

Results: 43 patients were treated with laparotomy.

[Carcinosarcoma of the urinary bladder].

A female patient is presented who had a large carcinosarcoma of the urinary bladder that became clinically manifest only 2 months before treatment. The initial treatment by transurethral resection was followed by radical cystectomy; 7 months postoperatively the patient died of local tumour recurrence with widespread metastases. Carcinosarcoma of the urinary bladder is a rare tumour with a poor prognosis.

[Spectrum of morphologic findings in cystectomy specimens].

A report of 64 cystectomy specimens is presented with emphasis on the macroscopic tumor pattern of the urinary bladder carcinoma. From gross observations bladder cancer gives a wide spectrum: unifocal or multiple papillary, mostly superficial carcinomas, nodular tumors more or less deeply invading the bladder muscle, flat carcinomas, widespread diffuse carcinomas with infiltration of the whole bladder wall, flat ulcers with or without tumor rest after TUR, and tumors almost filling the whole bladder and destroying the bladder wall; miscellaneous tumours were also observed. In 3 cases bladder cancer arose from the lumen of one or more diverticula.

[Pathophysiology and classification of adhesions].

The central issue in the pathophysiology of adhesions is the shift of the dynamic balance between fibrinolysis and fibrinogenesis to the side of fibrinogenesis. Permanent adhesions with the most varied morphology are formed by invasion of the fibrin network by fibroblasts and fibroid organization. Their classification by four degrees of severity is based on histological and morphological criteria.