• Women's Health Nursing
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• v.21 no.4
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• pp.321-331
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• 2015

Purpose: Purpose of this study was to identify the effect of structured information on immediate preoperative anxiety and uncertainty for women undergoing total laparoscopic hysterectomy. Methods: Sixty women who were admitted for total laparoscopic hysterectomy were recruited at a university hospital in Gyeonggi-do from June to October 2014. Thirty women were assigned to either the experimental or the control group. Women in the experimental group were provided structured information, which consisted of visual and auditory materials about surgical preparation and process, practical experience on devices such as IV-PCA pump and Inspiro-meter and actual experience on route to go to the operating room. State-anxiety, uncertainty, and blood pressure and pulse rate as biological indicators were measured before and after the intervention to examine the effect. Results: Significant group differences were found on state anxiety, uncertainty, including ambiguity, inconsistency, and unpredictability at the holding area. There was a significant difference on pulse rate in the operating room between the two groups. Conclusion: Findings demonstrated that the structured information provided for women undergoing laparoscopic hysterectomy preoperatively was effective on immediate preoperative anxiety and uncertainty. Nurses may contribute to decreasing patients' anxiety and uncertainty by utilizing this structured information preoperatively.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2515-2519
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• 2013

The standard surgery for early-stage endometrial cancer is total abdominal hysterectomy (TAH), while total laparoscopic hysterectomy (TLH) is less invasive and assumed to be associated with lower morbidity. This meta-analysis was performed to investigate the effects of TLH versus TAH in women with early-stage endometrial cancer. We searched the PubMed, EMBASE, CBM and Cochrane Review databases for randomized trials assessing the effects of TLH versus TAH in women with early-stage endometrial cancer. The relative risks (RR) with 95% confidence intervals (CIs) from each study were pooled using meta-analysis. In our study, 9 randomized trials with a total of 1,263 patients were included. Meta-analyses showed that TLH was associated with lower risks of major complications (RR = 0.53, 95%CI 0.29-0.98, P = 0.042), total complications (RR = 0.59, 95%CI 0.42-0.82, P = 0.002) and postoperative complications (RR = 0.57, 95%CI 0.40-0.83, P = 0.003). However, there were no obvious differences in risks of intra-operative complications (RR = 0.98, 95%CI 0.62-1.55, P = 0.919) and mortality (RR = 0.96, 95%CI 0.66-1.40, P = 0.835). In conclusion, our results provide new evidence of a benefit for TLH over TAH in terms of major complications, total complications and postoperative complications in endometrial cancer patients.

• Journal of Yeungnam Medical Science
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• v.37 no.4
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• pp.308-313
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• 2020

Background: Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital. Methods: We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients' demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes. Results: A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%-38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%). Conclusion: Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

• Journal of Medicine and Life Science
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• v.20 no.1
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• pp.48-52
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• 2023

High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

• The Journal of Korean Obstetrics and Gynecology
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• v.22 no.4
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• pp.122-134
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• 2009

Purpose: The purpose of this study is to know the blood stasis pattern for the patients who had hysterectomy. Methods: Among the patients who had hysterectomy in the department of obstetrics and gynecology, OO medical center from March 3rd 2009 to October 21st 2009, subjects who met inclusion criteria and submitted appropriate questionnaire. We compared blood stasis score and operational method, age, BMI, past operation history of abdominal and pelvic site, parity, whether adhesiolysis, oriental medicine intervention was done. For statistics, we used independent samples t-test, oneway analysis of variances(ANOVA) and SPSS version 13.0 for windows. Results: Blood stasis score of the subtotal hysterectomy group ($44.43{\pm}15.01$) is higher than that of the total hysterectomy group($39.04{\pm}12.46$). Blood stasis score under the age 40($51.88{\pm}12.68$) is higher than 40-49 age patients($40.34{\pm}14.24$) and over the age 50 patients($41.62{\pm}13.46$). There is no statistically significant difference between laparoscopic and abdominal trial, whether adhesiolysis, oriental medicine intervention was done, BMI, past operation history abdominal and pelvic site, parity, chief complaint before hysterectomy, oriental medicine intervention. Conclusion: Through the results showed, when traditional Korean medical doctors use static blood medication, history of hysterectomy and age should be considered as the history of subtotal hysterectomy and younger age tend to have a higher rate of a blood stasis pattern. We need a further study to develop blood stasis indicators with a validated questionnaire, and more subjects involved at multiple institutions.

• Clinical and Experimental Reproductive Medicine
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• v.10 no.2
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• pp.13-23
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• 1983

In recent days, family planning is not only a problem limitted to our country but an important problem for the while world to solve. Up to present, various methods of sterilization have been developed for population control. When a patient with a previous tubal sterilization by operative method develops any symptoms and signs of pregnancy, we strongly consider it ectopic pregnancy and intrauterine pregnancy. As the cause of sterilization failure, we think that the tubal loop sloughs away and tubal ends either unite and recanalization results or heal and failure of union results in fistula. This present study considered of the 34 cases of ectopic pregnancies and 2 cases of intrauterine pregnancies after tubal sterilization by laparoscopy and Pomeroy's method, at the Dept. of Gynecol. in Kyung Hee University Hospital, during 6 years from Jan. 1977 to Dec. 1982. Authors take result in this study retrospectively. 1. Mean age was 33.7 years for the laparoscopic tubal sterilization group, 31.5 years for the Pomeroy tubal sterilization group. 2. The number of mean gravida and parity at the sterilization was 4.9, 2.8 for the laparoscopic tubal sterilization group, 4.2, 2.2 for the Pomeroy tubal sterilization group, :respectively. 3. The number of mean artificial abortion at the sterilization was all 2.2 for the laparoscopic and Pomeroy tubal sterilization groups. 4. Mean intervals from the tubal surgery to the incidental pregnancy was 3.2 years for the laparoscopic tubal sterilization group, and 3.8 years for the Pomeroy tubal sterilization group. 5. 63.3% of the laparoscopic tubal sterilization group had problem of inadequate tubal ligation, in comparison to having no inadequate problem in the Pomeroy tubal sterilization group. 6. The previous tubal sterilized scar was found to be 6 cases (17.6%) of inner portion, 15 cases (44.4%) of midportion, 13 cases (38.2%) of outer portion at the time of operation. The tubal site of ectopic pregnancy was found to be 23 cases (67.6%) of ampullary portion,S cases ( 4.7%) of isthmic and fimbrial portion, respectively. 7. The causes of table sterilization failure were, in order of frequency, technical error (19 cases), fistula formation (6 cases) and recanalization (5 cases) for the laparoscopic tubal sterilization group and fistula formation (2 cases), technical error (l case), recanalization (l case) fo the Pomeroy tubal sterilization group. 8. As the new applicated contraceptive method in incidental pregnant patient, Authors used 2 gravigard insertion for the two intrauterine pregnancy and 34 Pomeroys' tubal ligation, 2 total abdominal hysterectomy (due to associated pelvic inflammatory disease) for the 36 tubal pregnancy.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.110-118
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• 2016

Background: Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient controlled analgesia (PCA). Methods: Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl $1,000{\mu}g$; Group B, fentanyl $500{\mu}g$ + nefopam 200 mg; and Group C, fentanyl $500{\mu}g$ + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. Results: Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. Conclusions: The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.