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Endometriosis is associated with increased risk of epithelial ovarian cancers (EOCs). Using data from large endometriosis and EOC genome-wide association meta-analyses, we estimate the genetic correlation and evaluate the causal relationship between genetic liability to endometriosis and EOC histotypes, and identify shared susceptibility loci. We estimate a significant genetic correlation (rg) between endometriosis and clear cell (rg = 0.71), endometrioid (rg = 0.48), and high-grade serous (rg = 0.19) ovarian cancer, associations supported by Mendelian randomization analyses. Bivariate meta-analysis identified 28 loci associated with both endometriosis and EOC, including 19 with evidence for a shared underlying association signal. Differences in the shared risk suggest different underlying pathways may contribute to the relationship between endometriosis and the different histotypes. Functional annotation using transcriptomic and epigenomic profiles of relevant tissues/cells highlights several target genes. This comprehensive analysis reveals profound genetic overlap between endometriosis and EOC histotypes with valuable genomic targets for understanding the biological mechanisms linking the diseases.

Objective: The objective of this study was to evaluate the effect of an Enhanced Recovery After Surgery (ERAS) protocol on patient experience after discharge from laparoscopic hysterectomy. Materials and Methods: Patients having laparoscopic hysterectomies by high-volume surgeons (>10 hysterectomies per year) at an urban tertiary-care hospital were divided into 2 cohorts: (1) a perioperative ERAS protocol adopted by the institution or (2) standard perioperative care according to the patient's surgeon. At the postoperative visit, each patient completed a validated questionnaire of self-reported recovery scores in domains of daily functional activities Results: There were 40 patients in the ERAS group and 44 in the standard perioperative care group, and 100% follow-up through the 2-week postoperative visits. Patients in both groups had similar rates of same-day discharges (88% versus 73%; p = 0.09). Both groups reported similar physical activity scores (1.38 versus 1.33; p = 0.79), days of first bowel movements (2.69 versus 2.71; p = 0.94), and days of opioid use after surgery (3.13 versus 2.64; p = 0.48). ERAS patients had fewer unplanned patient contacts than the standard care group (15% versus 50%; p < 0.01). There were no readmissions. Patients took few opioids, with 90% of all patients using <10 opioid tablets post surgery (5-mg oxycodone equivalents). Conclusions: Same-day discharge, patient-reported recovery experience, and opioid requirements did not differ between the ERAS protocol versus standard perioperative care. The ERAS protocol decreased unplanned patient contacts. [ABSTRACT FROM AUTHOR]

This article examines the costs and carbon emissions associated with virtual preoperative visits in a gynecologic surgery practice. The study found that virtual visits significantly reduced driving costs, CO2 emissions, and driving time compared to in-person visits, with no negative impact on surgical outcomes. The authors emphasize the potential environmental benefits of telemedicine in reducing carbon footprints in healthcare. However, the study has limitations, including its retrospective design and single-center setting. The article provides additional supporting information online and is relevant for library patrons researching the environmental impact and financial implications of virtual healthcare practices. [Extracted from the article]

We aimed to study whether separating the vaginal and abdominal surgical fields during total laparoscopic hysterectomy (TLH) is associated with surgical site infection rates. This was a retrospective cohort study of all patients who underwent TLH and any concomitant procedures with two minimally invasive gynecologic surgery subspecialists between January 2016 and May 2023. Among 680 included patients, the rate of infection was 0.8% with surgical field separation and 1.3% without (3/377 vs 4/303; odds ratio 0.60, 95% CI, 0.13-2.70). There was no statistical difference between groups; however, the difference in infection rates between groups was extremely small, which led to inadequate power. Our findings suggest that rates of infection after TLH are low, with or without surgical field separation. Treating the vagina, perineum, and abdomen as a single, continuous operative field during TLH may be an acceptable practice., Competing Interests: Financial Disclosure Rebecca Schneyer reports money was paid to her institution by Ethicon for her efforts in this study. Matthew Siedhoff reports receiving payment from Applied Medical. The other authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)