Search

We conducted a systematic review and meta-analysis of relevant clinical trials from full-text, scientific journal archives to assess the efficacy of hyoscine for the management of pain during in-office hysteroscopy (OH) procedures. Cochrane CENTRAL, ClinicalTrials.Gov, MEDLINE, PubMed, SCOPUS and the Web of Science were searched for all clinical trials that matched our search criteria. A full assessment of bias was made using the Cochrane Group tool-set. The following outcomes were included: visual analogue scale (VAS) score for postoperative pain, postoperative need for analgesia, and procedure time. In the case of homogeneous data, the analysis was performed using a fixed effects system, and the random effects system was used with heterogeneous data. Inclusion criteria included only randomized clinical trials, and interventions that included patients receiving hyoscine-N-Butyl Bromide during OH, regardless of dose or mode of administration, and compared this with placebo. Three clinical trials were included. The actual mean difference (MD) of the VAS pain score showed no significant difference between hyoscine or placebo [MD: -0.28 (-1.08, 0.52), (p=0.49)]. For postoperative analgesia, the overall MD showed no significant difference between hyoscine or placebo [MD: 0.43 (0.16, 1.14), (p=0.09)]. For procedure time, the combined effect estimate failed to show any significant difference between hyoscine and placebo [MD: -0.66 (-2.77, 1.44) (p=0.54)]. Contrary to previously published data, our meta-analysis using the latest available RCTs fails to show hyoscine as being effective in reducing pain or the need for other forms of anesthesia in OH. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To assess the efficacy, safety, and tolerability of retosiban—a novel tocolytic unavailable in the US—in the management of preterm labor. We searched ClinicalTrials.Gov, MEDLINE, PubMed, SCOPUS, Web of Science, and the Cochrane Library for relevant clinical trials using the terms "retosiban" and "preterm labor" through 09/2020. We included all published randomized clinical trials (three) that compared retosiban to placebo for preterm labor, excluding conferences, books, reviews, posters, case reports, and animal studies. We analyzed homogeneous data under the fixed-effects model and heterogeneous data under the random-effects model. We included all randomized clinical trials addressing this topic, which ultimately resulted in three trials with a total of 116 patients. There were no significant differences between retosiban and placebo in births at term (RR = 0.41, p =.02), births ≤7 days from the first study treatment (RR = 0.59, p =.23), or administration of rescue tocolytic (RR = 0.36, p =.07); the maternal adverse events of headache, anemia, constipation, or urinary tract infection (p >.05); or neonatal outcomes of Apgar score at 1 min (p =.88) or 5 min (p =.69), weight (p =.23), head circumference (p =.55), malnutrition (p =.27), hyperbilirubinemia (RR = 0.56, p =.21), jaundice (RR = 1.21, p =.84), respiratory distress (RR = 0.53, p =.49), or tachypnea (RR = 0.40, p =.42). With the limited high quality evidence available, retosiban demonstrates no clear benefit over placebo in the management of preterm labor. Nevertheless, its favorable safety profile, oral bioavailability, and novel mechanism of action and the limited number of studies available for review warrant further analysis. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This meta-analysis aimed to compare the effect of laparoscopic supracervical hysterectomy (LSH) with endometrial ablation (EA) in terms of general and menstrual-related quality of life in women opting for surgical treatment for abnormal uterine bleeding. Material and Methods: Sources searched included PubMed, Cochrane library, Scopus, and Web of Science for relevant clinical trials. Main outcomes of interest included: quality of life assessed using medical outcomes survey short form-36 (SF-36), (SF-12), operation time, time from operation to discharge, pain, fever, and hemoglobin level. Screening and data extraction were performed independently and the analysis was conducted using Review Manager Software v5.4.1. Results: Four clinical trials were included. Results of SF-12 score showed that there was no significant difference between the LSH and EA groups for either mental or physical component score overall mean difference (MD): -4.15 (-16.01, 7.71; p=0.49) and MD: 2.67 (-0.37, 5.71; p=0.08), respectively. Subgroup analysis of the SF-36 showed that only two components, general health and social function, were significantly improved in the LSH group (p<0.01) while the other six sub-scores did not differ between groups. The overall MD significantly favored the EA group for: operation time [MD: 72.65 (35.48, 109.82; p=0.0001)], time from operation to discharge [MD: 13.61 (3.21, 24.01; p=0.01)], hemoglobin level outcome [MD: 0.57 (0.40, 0.74); p<0.01], and pain score [standardized MD: 0.46 (0.32, 0.60; p<0.01)]. Conclusion: LSH has better outcomes for quality of life. This includes patient indicated responses to social health, general health, and superior hemoglobin levels at all measured points postoperatively. EA, however, was consistently associated with less operative time, a shorter hospital stay and is also considered by the authors to be a more minimally invasive technique which can also result in satisfying outcomes. [ABSTRACT FROM AUTHOR]

Objective: Rare co-existance of disease or pathology Background: Advances in minimally invasive surgery are essential for the improvement of patient care, overall health care efficiency, and total cost reductions. Morcellation, the technique used in the present case, is often used to aid minimally invasive laparoscopic procedures, whereby larger tissue specimens are broken down and divided to be removed via smaller incisions. Morcellation has become controversial in the medical community owing to the risk of the procedure spreading an occult malignancy. Case Report: A 47-year-old woman with obesity presented with right-sided pelvic pain and suspicion of ovarian torsion. The patient experienced severe acute pain and was taken to the operating room for laparoscopy to remove the left-sided adnexal mass seen on imaging. During surgery, there was no evidence of torsion, and the mass was perfused. During removal of the entire tumor, blunt instruments were utilized for in-bag manual morcellation to avoid spillage of the contents of the bag, which were then sent for frozen section analysis, and a diagnosis of adenocarcinoma of the ovary was made. Once the tumor was removed, a board-certified gynecologic oncologist was consulted to assist with the remainder of the procedure. Following this, the ovarian cancer staging procedure was able to be completed laparoscopically. Conclusions: This technique of in-bag manual morcellation using blunt instruments allows laparoscopic procedures to be per formed on large tissue specimens with potential malignancies without spreading cancerous tissue, overcoming the associated risks of dissemination of malignancy. This technique is therefore more beneficial to patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the field of minimally invasive surgery, there is a constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish with several ports of a given size will invariably be studied and attempted with fewer ports and with ports of smaller sizes. After researching the literature, we were not able to find any single port hysterectomies performed through a port size of smaller than 15 mm. We were able to perform, described here, a technique for performing laparoscopic hysterectomy through a single port of only 11 mm in diameter. We illustrate the technique in the accompanying video and believe the technique to be safe and reproducible. [ABSTRACT FROM AUTHOR]

Trachelectomy is a notoriously difficult laparoscopic procedure, often because of remaining scar tissue from a prior supracervical hysterectomy, as well as the necessity to clear vital organs, including the bladder and the rectum, out of the plane of dissection in order to remove the cervix. Many authors have suggested techniques involving ureteral stents to minimize the chance of ureteral injury. Our institute presents this two-port laparoscopic technique without the use of stents, which we believe safely accomplishes the trachelectomy through very minimally invasive means. [ABSTRACT FROM AUTHOR]