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Hysterectomy

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121. Detailed Morphologic and Immunohistochemical Characterization of Myomectomy and Hysterectomy Specimens From Women With Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome (HLRCC). (PubMed)

Detailed Morphologic and Immunohistochemical Characterization of Myomectomy and Hysterectomy Specimens From Women With Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome (HLRCC). Hereditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC), caused by a germline mutation in the fumarate hydratase (FH) gene, predisposes patients to uterine and cutaneous smooth muscle tumors and an aggressive type of renal cell carcinoma. Almost all women with HLRCC develop symptomatic uterine (...) presented with symptomatic uterine fibroids and underwent myomectomy (age 24 to 36 y), followed by hysterectomy in 2 patients (age 31 and 40 y). Specimens showed conventional leiomyomas, cellular leiomyomas and leiomyomas with bizarre nuclei. FH-d morphology was present in leiomyomas from all patients and was typically observed as a diffuse finding in the majority of slides across different leiomyoma types. FH-d morphology was absent in some leiomyoma sections from one patient and the morphologic

2019 American Journal of Surgical Pathology

122. Hysterectomy Practice Patterns in the Postmorcellation Era. (PubMed)

Hysterectomy Practice Patterns in the Postmorcellation Era. To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal.This was a descriptive study using data from the American College of Surgeons National Surgical Quality Improvement Program from 2012 to 2016. We identified hysterectomies using Current Procedural Terminology codes. We used an interrupted (...) time-series analysis to evaluate abdominal and supracervical hysterectomy trends surrounding The Wall Street Journal article first reporting morcellation safety concerns and the FDA safety communication. We compared categorical and continuous variables using χ, t, and Wilcoxon rank sum tests.We identified 179,950 hysterectomies; laparoscopy was the most common mode of hysterectomy in every quarter. Before The Wall Street Journal article, there was no significant change in proportion of abdominal

2019 Obstetrics and Gynecology

123. Association of Radical Hysterectomy Surgical Volume and Survival for Early-Stage Cervical Cancer. (PubMed)

Association of Radical Hysterectomy Surgical Volume and Survival for Early-Stage Cervical Cancer. To examine the association between surgical volume and survival of women with early-stage cervical cancer who underwent radical hysterectomy.This is a nationwide multicenter retrospective study examining consecutive women with clinical stage IB1-IIB cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy from 2004 to 2008 (N=5,964). The surgical volume per site over the 5-year (...) an independent prognostic factor for decreased recurrence (adjusted HR 0.69, 95% CI 0.57-0.84, P<.001) and all-cause mortality (adjusted HR 0.75, 95% CI 0.59-0.95, P=.016) compared with surgery at mid- and low-volume centers on multivariable analysis.Hospital volume for radical hysterectomy may be a prognostic factor for early-stage cervical cancer. Surgery at high-volume centers is associated with decreased local recurrence risk and improved survival.

2019 Obstetrics and Gynecology

124. What Is New in Hysterectomy for Benign Gynecologic Disorders?: Best Articles From the Past Year. (PubMed)

What Is New in Hysterectomy for Benign Gynecologic Disorders?: Best Articles From the Past Year. This month we focus on current research in hysterectomy for benign gynecologic disorders. Dr. Famuyide discusses four recent publications, which are concluded with a "bottom-line" that is the take-home message. A complete reference for each can be found on Box 1 on this page along with direct links to abstracts.

2019 Obstetrics and Gynecology

125. Association of Radical Hysterectomy Surgical Volume and Survival for Early-Stage Cervical Cancer. (PubMed)

Association of Radical Hysterectomy Surgical Volume and Survival for Early-Stage Cervical Cancer. To examine the association between surgical volume and survival of women with early-stage cervical cancer who underwent radical hysterectomy.This is a nationwide multicenter retrospective study examining consecutive women with clinical stage IB1-IIB cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy from 2004 to 2008 (N=5,964). The surgical volume per site over the 5-year (...) an independent prognostic factor for decreased recurrence (adjusted HR 0.69, 95% CI 0.57-0.84, P<.001) and all-cause mortality (adjusted HR 0.75, 95% CI 0.59-0.95, P=.016) compared with surgery at mid- and low-volume centers on multivariable analysis.Hospital volume for radical hysterectomy may be a prognostic factor for early-stage cervical cancer. Surgery at high-volume centers is associated with decreased local recurrence risk and improved survival.

2019 Obstetrics and Gynecology

126. What Is New in Hysterectomy for Benign Gynecologic Disorders?: Best Articles From the Past Year. (PubMed)

What Is New in Hysterectomy for Benign Gynecologic Disorders?: Best Articles From the Past Year. This month we focus on current research in hysterectomy for benign gynecologic disorders. Dr. Famuyide discusses four recent publications, which are concluded with a "bottom-line" that is the take-home message. A complete reference for each can be found on on this page along with direct links to abstracts.

2019 Obstetrics and Gynecology

127. Assessing Endometrial Cancer Risk Among US Women: Long-Term Trends using Hysterectomy-Adjusted Analysis. (PubMed)

Assessing Endometrial Cancer Risk Among US Women: Long-Term Trends using Hysterectomy-Adjusted Analysis. Commonly reported incidence rates for endometrial cancer (EC) fail to take into account both the large number of hysterectomies performed each year and the dynamic change in hysterectomy rate over the past decade. Large racial differences in pre-menopausal hysterectomy rates between Black and White women in the US likely affect calculation of race-based risk.To determine how the long-term (...) trends in Black-White differences in EC incidence and histology type have changed over time for women at risk.Using longitudinal Surveillance, Epidemiology, and End Results data from 1997 to 2014 and state-level hysterectomy prevalence from the Behavioral Risk Factor Surveillance System, we calculated hysterectomy-adjusted incidence rates of endometrial cancer and the proportion of high vs. low-risk EC, by race, over time.In women over 50 who have not had a hysterectomy, EC incidence is 87/100,000

2019 American Journal of Obstetrics and Gynecology

128. Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy: Protocol for a systematic review of randomized controlled trials. (PubMed)

Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy: Protocol for a systematic review of randomized controlled trials. Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while (...) seated at a console in the operating room. This differs from laparoscopic hysterectomy because a "robot" performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery.We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review

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2019 Medicine

129. Treatment of urinary incontinence after total hysterectomy with acupuncture: A case report. (PubMed)

Treatment of urinary incontinence after total hysterectomy with acupuncture: A case report. Acupuncture is a significant feature of traditional Chinese medicine, which can dredge the channels, harmonize qi and blood, replenish deficiency and relieve excess, strengthen the body and remove pathogens to treat urinary incontinence after hysterectomy, and improve the quality of life, which is simple, convenient, inexpensive, and practical.After a total hysterectomy, the catheter was retained every (...) were normal.acupuncture is safe and effective mode for the treatment of urinary incontinence issues after total hysterectomy. It greatly improves the quality of life and daily wellbeing.

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2019 Medicine

130. Comparing benign laparoscopic and abdominal hysterectomy outcomes by time. (PubMed)

Comparing benign laparoscopic and abdominal hysterectomy outcomes by time. While laparoscopic hysterectomy has benefits compared to abdominal hysterectomy, the operative times are longer. Longer operative times have been associated with negative outcomes. This study's purpose was to elucidate if there is an operative time at which 30-day outcomes for laparoscopic hysterectomy become inferior to a more expeditiously completed abdominal hysterectomy.This was a retrospective cohort study (Canadian (...) Task Force classification II-2) using the American College of Surgeons National Surgical Quality Improvement Program database to identify women undergoing hysterectomy for benign indications from 2010 to 2016 by current procedural terminology code. Hysterectomy cases were stratified by approach and 60-min intervals. 30-day post-operative outcomes were analyzed by operative time and approach.109,821 hysterectomies were included in our analysis, of which 66,560 (61%) were laparoscopic, and 43,261 (39

2019 Surgical endoscopy

131. No survival difference between robotic and open radical hysterectomy for women with early-stage cervical cancer: results from a nationwide population-based cohort study. (PubMed)

No survival difference between robotic and open radical hysterectomy for women with early-stage cervical cancer: results from a nationwide population-based cohort study. The aim of the study was to compare overall survival (OS) and disease-free survival (DFS) after open and robotic radical hysterectomy for early-stage cervical cancer.This was a nationwide population-based cohort study on all women with cervical cancer stage IA1-IB of squamous, adenocarcinoma or adenosquamous histological (...) subtypes, from January 2011 to December 2017, for whom radical hysterectomy was performed. The Swedish Quality Register of Gynaecologic Cancer was used for identification. To ensure quality and conformity of data and to disclose patients not yet registered, hospital registries were reviewed and validated. Cox and propensity score regression analysis and univariable and multivariable regression analysis were performed in regard to OS and DFS.There were 864 women (236 open and 628 robotic) included

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2019 European Journal of Cancer

132. Laparoscopic and robotic hysterectomy in endometrial cancer patients with obesity: A systematic review and meta-analysis of conversions and complications. (PubMed)

Laparoscopic and robotic hysterectomy in endometrial cancer patients with obesity: A systematic review and meta-analysis of conversions and complications. Robotic assistance may facilitate completion of minimally invasive hysterectomy, which is the standard of care for the treatment of early-stage endometrial cancer, in patients for whom conventional laparoscopy is challenging. The aim of this systematic review was to assess conversion to laparotomy and perioperative complications after (...) laparoscopic and robotic hysterectomy in patients with endometrial cancer and obesity (body mass index, ≥30 kg/m2).We systematically searched MEDLINE, EMBASE, and Evidence-Based Medicine Reviews (January 1, 2000, to July 18, 2018) for studies of patients with endometrial cancer and obesity (body mass index, ≥30 kg/m2) who underwent primary hysterectomy.We determined the pooled proportions of conversion, organ/vessel injury, venous thromboembolism, and blood transfusion. We assessed risk of bias

2019 American Journal of Obstetrics and Gynecology

133. Genetic polymorphisms and prediction of chronic post-surgical pain after hysterectomy-a subgroup analysis of a multicenter cohort study. (PubMed)

Genetic polymorphisms and prediction of chronic post-surgical pain after hysterectomy-a subgroup analysis of a multicenter cohort study. Chronic post-surgical pain (CPSP) is a serious problem. Clinical and psychological variables have not been able to explain all observed variance in prevalence and severity of CPSP. The first objective is to determine the association between genetic polymorphisms and the prevalence of CPSP after hysterectomy. The second objective is to analyze (...) if the implementation of genetic polymorphisms into a previously performed clinical and psychological predictor analysis on the development of CPSP after hysterectomy will improve its discriminatory power.A prospective multicenter cohort study was performed in patients undergoing hysterectomy for benign indication. Clinical and psychological variables were collected by questionnaires in the week before surgery, post-operatively up to day 4, 3 and 12 months after hysterectomy. Blood was collected and 16

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2019 Acta Anaesthesiologica Scandinavica

134. Peritoneal contamination with ICG stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination. A proof-of-principle study for laparoscopic hysterectomy. (PubMed)

Peritoneal contamination with ICG stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination. A proof-of-principle study for laparoscopic hysterectomy. Intracorporal colpotomy during radical hysterectomy for cervical cancer is discussed to be a risk factor for peritoneal dissemination of tumor cells. It might lead to increased recurrence rates after laparoscopic radical hysterectomy compared to abdominal hysterectomy as shown by the recent LACC study. Data (...) on the frequency or mechanisms of peritoneal contamination are missing. We aimed to analyze peritoneal contamination of cervical secretion during intracorporal colpotomy with a novel indocyaningreen (ICG) -based technique.In this prospective proof-of-principle study, patients undergoing routine laparoscopic or robot-assisted hysterectomy were included. ICG was specifically applied to the cervical surface and routine surgery was performed. During colpotomy pictures under white and fluorescence light were taken

2019 Acta Obstetricia et Gynecologica Scandinavica

135. Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations. (PubMed)

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations. Laparoscopic hysterectomy is increasingly performed because it is associated with less postoperative pain and earlier recovery as compared with open abdominal hysterectomy. The aim of this systematic review was to evaluate the available literature regarding the management of pain after laparoscopic hysterectomy.Randomized controlled trials evaluating postoperative pain after (...) laparoscopic hysterectomy published between January 1996 and May 2018 were retrieved, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the EMBASE and MEDLINE databases and the Cochrane Register of Controlled Trials. Efficacy and adverse effects of analgesic techniques were assessed.Of the 281 studies initially identified, 56 were included. Of these, 31 assessed analgesic or anesthetic interventions and 25 assessed surgical interventions. Acetaminophen

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2019 Regional Anesthesia and Pain Medicine

136. Sexual-, bladder-, bowel and ovarian function one year after robot-assisted radical hysterectomy for early stage cervical cancer. (PubMed)

Sexual-, bladder-, bowel and ovarian function one year after robot-assisted radical hysterectomy for early stage cervical cancer. Surgery by open radical hysterectomy for cervical cancer is associated with sexual dysfunction as well as lymphedema and bladder problems. Our aim was to assess the impact of robot-assisted laparoscopic radical hysterectomy (RRH) with pelvic lymphadenectomy, for early stage cervical cancer on sexual-, bowel-, bladder- and lymphatic function and to measure ovarian

2019 Acta Obstetricia et Gynecologica Scandinavica

137. Long-term risk of de novo mental health conditions after hysterectomy with ovarian conservation: a cohort study. (PubMed)

Long-term risk of de novo mental health conditions after hysterectomy with ovarian conservation: a cohort study. The aim of this research was to study the long-term risk of de novo mental health conditions in women who underwent hysterectomy with bilateral ovarian conservation compared with age-matched referent women.Using the Rochester Epidemiology Project records-linkage system, we identified a historical cohort of 2,094 women who underwent hysterectomy with ovarian conservation for benign (...) indications at age ≥18 years and with an index date between 1980 and 2002 in Olmsted County, Minnesota. Each woman was age-matched (±1 y) to a referent woman residing in the same county who had not undergone hysterectomy or any oophorectomy before the index date. These two cohorts were followed historically to identify de novo mental health conditions. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) using Cox proportional hazards models adjusted for 20 preexisting chronic

2019 Menopause

138. Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning. (PubMed)

Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning. To examine changes in utilization of different types of laparoscopic hysterectomy, as well as their associated resource use and surgical outcomes, after the U.S. Food and Drug Administration (FDA) safety statement in April 2014 regarding power morcellation.We retrospectively analyzed data from the 2012-2016 American College of Surgeons National Surgical Quality Improvement Program (...) and identified 145,746 women undergoing hysterectomy for benign indications. We measured use of laparoscopic supracervical hysterectomy compared to total laparoscopic hysterectomy (including laparoscopic-assisted vaginal hysterectomy) in these patients, as well as operative time, surgical setting (inpatient vs outpatient), length of stay, and 30-day surgical outcomes (wound complication, medical complication, reoperation, and readmission). We used an interrupted time series analysis to examine

2019 Obstetrics and Gynecology

139. Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship. (PubMed)

Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship. Surgery is curative for the majority of early-stage endometrial cancers. Postoperatively, patients are actually at much higher risk of mortality from obesity-related comorbidities unless they have sustained weight loss.A 54-year-old woman with class III obesity, type II diabetes mellitus complicated by neuropathy and retinopathy, hypertension, sleep apnea, and fatty liver disease was diagnosed (...) with grade 1 endometrioid uterine cancer. She underwent dual surgery with laparoscopic bariatric surgery and robotic-assisted laparoscopic hysterectomy. The perioperative period was uncomplicated, and final pathology was consistent with a stage IA grade 1 endometrial cancer. In 12 months, the patient lost 41.3 kg and required less insulin, metformin, and antihypertensive medication.Combined minimally invasive hysterectomy and bariatric surgery for obese women with endometrial cancer can promote sustained

2019 Obstetrics and Gynecology

140. Vaginal Hysterectomy Suturing Skills Training Model and Curriculum. (PubMed)

Vaginal Hysterectomy Suturing Skills Training Model and Curriculum. Declining vaginal hysterectomy numbers in obstetrics and gynecology training programs highlights the need for innovative methods to teach vaginal surgical skills. We describe our experience with a vaginal hysterectomy skills simulation curriculum.A low-fidelity bench model was constructed to simulate four vaginal hysterectomy suturing tasks. A polyvinyl chloride downspout adapter and low-cost materials simulate the Heaney (...) the technical skills required for vaginal hysterectomy and agreed that vaginal skills laboratory training would improve their ability to perform procedures in the operating room. Ninety-two percent of residents felt that a vaginal surgery skills curriculum would be a useful addition to their simulation education.A proficiency-based vaginal hysterectomy skills simulation curriculum using a low-fidelity model may be an important training and evaluation tool for vaginal surgical skills training.

2019 Obstetrics and Gynecology

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