• Title/Summary/Keyword: Gynecological Surgery

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THE EFFECT OF GINSENOSIDE-TRIOL ON THE POSTOPERATIVE RECOVERY IN GYNECOLOGICAL PATIENTS

  • Chang Yoon Seok;Lee Jin Yong;Kim Chong Woo
    • Proceedings of the Ginseng society Conference
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    • 1978.09a
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    • pp.79-84
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    • 1978
  • Ginseng has been widely used in the Oriental world for more than 2,000 years. Its chemical and pharmacological studies have been published by many investigators of many countries. But its clinical studies have not been performed in satsifactory amount. This study was carried out to evaluate the effect of ginsenoside-triol on the postoperative recovery in 120 cases of gynecological laparotomies. Daily dose of 0.23 gram of ginsenoside-triol was administered orally for three weeks after surgery to 60 cases, and placebo to 60 cases as control. Hemoglobin, hematocrit, leukocyte count, serum total protein, albumin, cholesterol and glucose were studied at pre- and postadministration. At the same time, body weight, blood pressure and subjective symptoms such as appetite, bowel movement and digestion were checked. The results obtained were summarized as follows: 1) The side effect was nil. 2) Hemoglobin and hematocrit Were more increased in treated group than in control group, but the changes were not significant. 3) Serum total protein was more significantly increased in treated group than in control group. 4) Serum cholesterol was significantly less increased in treated group than in control group. 5) Serum glucose level was significantly decreased in both groups, more significantly in control group. 6) Body weight was significantly increased in treated group.

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Lymphological Liposculpture for Secondary Lymphedema after Breast Cancer and Gynecological Tumors: Long-Term Results after 15 Years

  • Manuel E. Cornely
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.288-304
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    • 2023
  • Background Untreated lymphedema of an extremity leads to an increase in volume. The therapy of this condition can be conservative or surgical. Methods "Lymphological liposculpture" is a two-part procedure consisting of resection and conservative follow-up treatment to achieve curative volume adjustment of the extremities in secondary lymphedema. This treatment significantly reduces the need for complex decongestive therapy (CDT). From 2005 to 2020, 3,184 patients with secondary lymphedema after breast cancer and gynecological tumors were treated in our practice and clinic. "Lymphological liposculpture" was applied to 65 patients, and the data were recorded and evaluated by means of perometry and questionnaires. Results The alignment of the sick to the healthy side was achieved in all patients. In 58.42% (n = 38), the CDT treatment could be completely stopped postoperatively; in another 33.82% (n = 22) of the patients, a permanent reduction of the CDT was achieved. In 7.69% (n = 5) patients, the postoperative CDT could not be reduced. A total of 92.30% (n = 60) of the patients described a lasting significant improvement in their quality of life. Conclusion "Lymphological liposculpture" is a standardized curative sustainable procedure for secondary lymphedema for volume adjustment of the extremities and reduction of postoperative CDT with eminent improvement of the quality of life.

Effects of Provision of Concrete Information about Patient-controlled Analgesia in Hysterectomy Patients (자궁 적출 수술 환자를 대상으로 한 통증 자가 조절기 관련 구체적 정보 제공의 효과)

  • Lee, Bo Gyeong;Lee, Young Whee
    • Women's Health Nursing
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    • v.20 no.3
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    • pp.204-214
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    • 2014
  • Purpose: This study was to investigate the effects of the provision of concrete information about patient-controlled analgesia (PCA) in hysterectomy patients. Methods: Study design was a nonequivalent control group non-synchronized pre- and post-test design. Sixty subjects participated were assigned to experimental group (30 patients) or control group (30 patients) at one university hospital. Concrete information about PCA was composed of three sections: explanation with a leaflet, practice of using PCA, and question and answer session. Results: The experimental group who received concrete information about PCA before surgery had statistically higher knowledge level about PCA, more positive attitude toward pain control analgesia, a lower pain score, and a higher satisfaction level of the use of PCA post-surgery compared to the control group who received general information before surgery. Conclusion: Provision of concrete information about PCA was an effective nursing intervention that reduced post-operative pain for patients and increased their satisfaction with using PCA. It is recommended that concrete information about PCA be provided by nurses to promote the use of PCA and consequently reduce patient's pain post-surgery.

A Study on Distress and State Anxiety Level in Gynecological Postoperative Patients under PCA Management (통증자가조절기 사용 중인 부인과수술환자의 불편감과 불안 연구)

  • Suh, Young-Sook;Hong, Mi-Soon
    • Women's Health Nursing
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    • v.10 no.4
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    • pp.351-359
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    • 2004
  • Purpose: A descriptive study was conducted to examine the levels of distress, state anxiety, and physiologic responses in postoperative patients under patient controlled analgesia (PCA), and to determine correlations among the variables. Method: The study sample included women who underwent an elective hysterectomy procedure or other gynecologic surgeries(N=100). Subjective distress was assessed by visual analog scales around 8 hours postoperatively. Trained nurses collected objective distress data through observation of subject's behavior and vital signs. Data were analyzed with frequencies, percentages, means, Pearson correlation coefficients, ANOVA, and the Scheffe post test using SPSS/PC 11.0. Result: Subjective distress, objective distress, and state anxiety scores were relatively low, except pain scores(5.31 out of 10.0) among sub-scales of subjective distress. Women who had a total abdominal hysterectomy showed significantly higher levels of both subjective distress and state anxiety than those after a minor gynecologic surgery. In relationships among variables, subjective distress correlated positively with postoperative state anxiety, but not with the amount of analgesic medication, verified by further analysis on sub-scales of subjective and objective distress. The higher the levels of state anxiety, the higher the levels of tension, dyspnea, facial change, and systolic blood pressure observed. Conclusion: Regardless of effective pain management, most postoperatively experienced distress in gynecological patients was derived from surgery associated anxiety and pain. Specific psychological strategies should be established as well for those with high levels of state anxiety to facilitate prompt recovery.

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Patient-Controlled Analgesia(PCA) for Pain Management after Gynecological Surgery (Baxter $Infusor^{(R)}$를 이용한 부인과 수술후의 통증 자가 조절)

  • Lee, Jung-Koo;Kim, Jin-Mo;Chung, Jung-Kil
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.49-54
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    • 1993
  • The use of intravenous patient-controlled analgesia is an effective and increasingly used means of providing postoperative pain relief. Recently a non-electric, disposable and portable infusor, the Baxter $Infusor^{(R)}$, has developed. This delivers not only a continuous drug infusion but can also deliver extradoses of medication on demand. The present study examined the benefits of two kinds of analgesics for pain management in 28 patients undergoing gynecological surgery. One group, 14 patients, received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA with meperidine 3 mg/kg/day for 3 days only(M group). In the other group, 14 patients, also received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA meperidine 3 mg/kg/day for 3 days and droperidol 5 mg(MD group). The PCA device used was the Baxter $Infusor^{(R)}$. This unit was fitted with patient control module which had a flow rate 0.5 ml/hr and the lockout time was 15 min. Resulting from the study, the MD patients in the first and second days post-operatively, reported less pain compared with the M group. VAPS(Visual Analogue Pain Scales) values were $3.52{\pm}l.61$ vs. $2.22{\pm}0.69$, $2.38{\pm}1.12$ vs. $1.45{\pm}0.48$ and $1.93{\pm}1.65$ vs. $0.98{\pm}0.36$, respectively pertaining to M and MD groups. In conclusion, the MD group with meperidine and droperidol(mixed regimen) provided more effective postoperative analgesia than M group(meperidine only).

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Current landscape and future perspective of sentinel node mapping in endometrial cancer

  • Bogani, Giorgio;Raspagliesi, Francesco;Maggiore, Umberto Leone Roberti;Mariani, Andrea
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.94.1-94.10
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    • 2018
  • Endometrial cancer (EC) represents the most common gynecological neoplasm in developed countries. Surgery is the mainstay of treatment for EC. Although EC is characterized by a high prevalence several features regarding its management are still unclear. In particular the execution of lymphadenectomy is controversial. The recent introduction of sentinel node mapping represents the mid-way between the execution and omission of node dissection in EC patients. In the present review we discuss the emerging role of sentinel node mapping in EC. In addition, we discussed how type of tracers utilized and site of injection impacted on sentinel node detection rates. Future perspective regarding EC management are also discussed.

Effects of Preoperative Dehydration on Postoperative Nausea and Vomiting in Gynecological Surgery Patients (부인과 수술 환자의 수술 전 금식기간 탈수량이 수술 후 오심.구토에 미치는 영향)

  • Hwang, Yunjeong;Park, SoMi
    • Women's Health Nursing
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    • v.21 no.1
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    • pp.23-31
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    • 2015
  • Purpose: The purpose of this study was to investigate the effect of dehydration from preoperative fasting on postoperative nausea and vomiting in patients who underwent gynecologic surgeries. Methods: Study design was a prospective descriptive study. A total of 75 patients in a university hospital were selected. Data were collected from March 17 to May 16, 2014 using self-report questionnaires and clinical electronic chart. Results: Factors influencing the development of postoperative nausea and vomiting were type of surgery (t=3.44, p=.001), use of PCA (t=-2.16, p=.034), and preoperative dehydration level (t=5.93, p<.001), and these variables accounted for 51.7% of postoperative nausea and vomiting. Among these variables, preoperative dehydration amount (${\beta}=.56$) showed the largest influence in the difference in postoperative nausea and vomiting. Conclusion: Reducing dehydration during preoperative fasting can prevent occurrence of postoperative nausea and vomiting. Development of a clinical guideline is necessary to give directions for the prevention of dehydration during preoperative fasting and to ensure the proper duration of fasting according to patient characteristics, type of surgery and time of surgery.

Fertility-Preserving Treatments in Patients with Gynecological Cancers: Chinese Experience and Literature Review

  • Liu, Chun-Yan;Li, Hua-Jun;Lin, Hua;Ling, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4839-4841
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    • 2015
  • We conducted a retrospectively reviewed of the literature published of patients underwent fertility-preserving treatments for cervical, endometrial and ovarian cancers using the WANFANG database in Chinese. A majority were retrospective studies and case reports. With cervical cancer, radical trachelectomy(RT) in combination with pelvic lymphadenectomy could preserve the fertility of patients with early stage IA1-IB1 cancers, Tumor size ${\leq}2cm$ should be emphasized as the indication of RT in considering of the higher recurrent rate in patients with tumor size >2cm. For endometrial cancers, there is much experience on it. Given accurate pretreatment assessment, hormonal therapy is feasible management option to preserve fertility in young patients with early stage lesions that limited to the endometrium and well differentiated. High dose progestin have been applied, oral medroxyprogesterone acetate (MPA), 250-500mg/day, megestrol acetate 160-480mg/day. Other therapies that have been used in a limited number of cases include GnRH analog, intrauterine devices (IUDS) containing progestogen, usually combination of these therapies. All patients should be followed up by ultrasound and/or MRI evaluation, and endometrial curettage at intervals of 3 months. With ovarian cancer, in China, fertilitypreserving surgery in patients with stage IA (grade G1) of epithelial ovarian tumor and patients with germ cell tumor and borderline ovarian tumor have been successfully performed.

Classification of endometriosis

  • Lee, Soo-Young;Koo, Yu-Jin;Lee, Dae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.10-18
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    • 2021
  • Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

Risk for Malignant and Borderline Ovarian Neoplasms Following Basic Preoperative Evaluation by Ultrasonography, Ca125 Level and Age

  • Karadag, Burak;Kocak, M.;Kayikcioglu, F.;Ercan, F.;Dilbaz, B.;Kose, M.F.;Haberal, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8489-8493
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    • 2014
  • Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.