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Objetivo. Describir el caso de una paciente sometida a histerectomía total abdominal por leiomiomatosis uterina con enfoque del Proceso de Atención de Enfermería (PAE) durante el perioperatorio. Materiales y método. Estudio de caso, observacional, prospectivo, longitudinal, descriptivo con aplicación del Proceso de Atención de Enfermería (PAE) en el perioperatorio de una mujer de 33 años, con monorrena, leiomiomatosis uterina que inició hace dos años con dismenorrea y menometrorragia en un hospital público de segundo nivel en Mérida, Yucatán. Resultados. Los cuidados realizados por los profesionales en enfermería quirúrgica durante el perioperatorio disminuyeron los problemas reales y potenciales logrando como resultado una estancia hospitalaria corta sin complicaciones. Discusión. El estudio re?eja la importancia de los cuidados del enfermero quirúrgico durante el perioperatorio, debido a la e?cacia de estos en la recuperación de la paciente. En el preoperatorio, se observó a la paciente con ansiedad, dudas, anemia, monorrena, con probables adherencias por cirugías anteriores, lo que permitió anticiparse a futuras complicaciones; la implementación del PAE permitió una atención de calidad que responde a las respuestas humanas de la paciente. Conclusiones. La miomatosis uterina es la principal causa por la cual se interviene quirúrgicamente con histerectomía abdominal.

INTRODUÇÃO:A histerectomia é o segundo procedimento operatório mais frequente em mulheres na idade reprodutiva, sendo superada apenas pela cesariana. É um tratamento cirúrgico de remoção parcial ou total do útero, indicado para diversas patologias do assoalho pélvico feminino. Trata-se de uma cirurgia irreversível, com alteração da integridade corporal e com implicações na identidade sexual feminina. OBJETIVO: descrever o perfil clínico-epidemiológico das pacientes que passaram pela histerectomia, a fim de avaliar a tendência de indicações cirúrgicas adotadas. MATERIAL E MÉTODOS: A presente pesquisa se trata de um estudo descritivo, comparativo e transversal, realizado com base em dados secundários, coletados de laudos histológicos e prontuários médicos de mulheres submetidas à histerectomia total no Hospital Universitário Professor Alberto Antunes (HUPAA), Maceió-AL, na série histórica de 2009 a 2018. RESULTADOS: A faixa etária de 41-50 anos correspondeu a 43,8% das pacientes que passaram pela histerectomia. A miomatose uterina, em conformidade com o que demonstra a literatura, representou 60,3% das indicações. Os sintomas relacionados a alterações menstruais foram os principais citados. A Ultrassonografia pélvica, considerada padrão ouro para diagnóstico dos miomas uterinos, foi o exame complementar mais utilizado. CONCLUSÃO: Os dados coletados, de maneira geral, entram em consonância com a literatura disponível. Contudo, ainda existem casos em que é preciso uma melhor investigação para a indicação correta da histerectomia.

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Objective: To analyze the humanized care in the immediate postoperative period of hysterectomized patients, from 25’s to 40’s, of the Olympus Clinic, during the period March-August 2017. Method: The study is carried out under a quantitative approach, with a descriptive level, supported by a field investigation. The information was based on a 11 items questionnaire, which was applied to 18 nurses in order to obtain the required data. Results: The application of humanized care is evidenced partially in the attention of biological needs in patients. It is noted that most of the respondents communicate effectively, however, a high level of indifference is manifested, on the part of nursing staff, in the pain attention as a basic need in the postoperative hysterectomy. Likewise, the absence of an instrument for evaluating user satisfaction is a weakness. Conclusions: Humanized care is a complex but essential process during post-operative care in hysterectomies. Within the health institution addressed, it is developed in a fragmented manner, however, there is an opening in nursing professionals for the humanization of care.

Foundation: Dexamethasone, long-acting corticosteroid, is a drug whose characteristics favor its use in the treatment of nausea and vomiting in certain circumstances, however, its usefulness to prevent postoperative nausea and vomiting in patients undergoing neuroaxial intrathecal anesthesia, performed an abdominal hysterectomy, is not determined. Objective: to demonstrate the effectiveness of dexamethasone in the prevention of postoperative nausea and vomiting in hysterectomized patients under intraaxial neuraxial anesthesia. Methods: a descriptive and prospective study was conducted in patients who underwent hysterectomy under regional intraaxial neuraxial anesthesia (N = 50), from December 2012 to February 2013, at the Ambrosio Grillo Hospital in Santiago de Cuba. Two groups of similar number of patients, randomly selected were used: one treated conventionally (diazepam and diphenhydramine), and another group which was also administered dexamethasone. Results: in general, 8 patients (32%) presented postoperative nausea, 8 from the group treated with the usual form, and 6 treated dexamethasone (24%). Conclusion: the use of dexamethasone in hysterectomized patients under intrathecal neuraxial anesthesia decreases the total incidence of postoperative nausea and vomiting, though not significantly.

Introducción: el cáncer de cuello uterino es el cuarto más frecuente a nivel mundial en mujeres. En estadios precoces la cirugía es el tratamiento de elección. El tratamiento quirúrgico estándar es la histerectomía radical tipo C1 y linfadenectomía pélvica. La vía de abordaje clásicamente utilizada en Uruguay es la laparotomía. Los resultados oncológicos por las diferentes vías de abordaje se consideran equiparables. Presentamos la primera serie de casos publicada en Uruguay de tratamiento quirúrgico de mínima invasión en cáncer de cuello uterino. Método: estudio descriptivo prospectivo de serie de casos. Se incluyen todas las pacientes operadas por cáncer de cuello uterino invasor como tratamiento primario con vía de abordaje de mínima invasión, desde enero de 2013 hasta diciembre de 2016 en la Clínica Ginecotocológica A del Centro Hospitalario Pereira Rossell. Resultados: se operaron 17 pacientes: 14 histerectomía radical laparoscópica + linfadenectomía pélvica laparoscópica y 3 histerectomía radical vaginal + linfadenectomía pélvica laparoscópica. Edad media: 44 años. Tiempo quirúrgico medio: 261 minutos. Tiempo medio de internación posoperatoria: cinco días. Conversión a laparotomía: dos casos. Se resecaron una media de 14,4 ganglios pélvicos. Ningún caso con márgenes comprometidos. Hubo dos lesiones vesicales. Ningún caso de sangrado severo, transfusión, lesión intestinal, vascular ni ureteral. No hubo ningún caso de infección, dehiscencia, trombosis, reintervención o readmisión. No hubo recurrencias, con media de seguimiento de 29 meses. Conclusiones: la cirugía de mínima invasión es factible para el tratamiento del cáncer de cuello uterino en estadios precoces en nuestro medio, obteniendo un buen resultado anatomopatológico, quirúrgico y oncológico con baja morbilidad.

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Enquadramento: O confronto com a necessidade de ter que se submeter a histerectomia nem sempre é fácil por parte da mulher/casal. Diferentes problemas vivenciados, poderão empurrar para essa decisão, mesmo pairando no andar dúvidas e preocupações quanto ao que poderá vir a sentir pós-histerectomia. Objetivos: conhecer os desconfortos vivenciados pelas mulheres que se submetem a histerectomia. Metodologia: Estudo exploratório e descritivo de natureza qualitativa. Foram participantes dez mulheres submetidas a histerectomia pertencentes a uma Unidade de Cuidados de Saúde Primários da Região Norte de Portugal. Recorreu-se à entrevista semiestruturada, no último trimestre de 2018, tendo-se procedido à transcrição do verbatim das entrevistas e análise qualitativa dos dados, como proposto por Bardin, com ajuda do QSR NVivo na sua versão 12, software de investigação qualitativa. Foi obtida a autorização para a realização do estudo por parte de Comissão de Ética e cumprido todos os procedimentos éticos exigidos a um estudo desta natureza. Os dados apresentados enquadram-se num estudo mais alargado no âmbito das vivências das mulheres submetidas a histerectomia. Resultados: Apresentam-se três categorias emergentes: “Problemas apresentados pelas mulheres antes da histerectomia” constituída por nove subcategorias sendo as hemorragias, os tumores, e o risco de cancro os mais referidos; “Desconfortos manifestados pelas mulheres após a histerectomia” constituída por seis subcategorias das quais a secura vaginal, dor na relação sexual e alteração da imagem corporal sobressaem; e a categoria “Atitudes dos enfermeiros valorizadas pelas mulheres”, com quatro subcategorias, incluindo ajudarem a ultrapassar e tratarem bem Conclusões: se por um lado a histerectomia resolve problemas ginecológicos apresentados pela mulher, aumentado o seu bem-estar e qualidade de vida, por outro também a confronta com o aparecimento de novos desconfortos, para os quais nem sempre se sentia preparada.

Introducción: la histerectomía es un procedimiento operatorio utilizado como tratamiento de patologías uterinas. Se ha señalado que su realización puede repercutir negativamente en algunas esferas e impactar la calidad de vida (CV). Objetivo: evaluar la función sexual, insomnio y CV en un grupo de mujeres histerectomizadas. Metodología: estudio transversal realizado con tres escalas validadas: Índice de Función Sexual Femenina abreviado (IFFS-6), escala de insomnio de Atenas y Menopause Rating Scale (MRS), en mujeres con uno o más años de histerectomizadas, con edad entre 40-59 años, de etnias afrodescendientes y mestizas, residentes en el departamento de Bolívar, Colombia. Las participantes fueron captadas en sus propias comunidades. Resultados: fueron incluidas 202 mujeres, edad promedio 50.0±5.0 años, 10.8% solteras, 85.1% unidas de forma estable, 3.8% separadas o viudas. El 69.8% eran mestizas. La media de la calificación sexual fue 11.3±4.0 (rango 0 a 20, a mayor puntuación mejor satisfacción). El 29.7% tenía ooforectomia bilateral, el 28.7% unilateral y el 41.5% conservaban los ovarios. Solo el 20.3% utilizaba terapia de reemplazo hormonal. Disfunción sexual se observó en el 71.7% de las mujeres, teniendo la mitad compromiso del orgasmo. El 71.2% manifestó presentar insomnio, con una puntuación media de 8.1±4.5, teniendo la cuarta parte despertares durante la noche. El 42.5% presentó deterioro severo de la calidad de vida, el 22.7% de la dimensión somato vegetativa, el 37.6% de la psicológica y 52.9% de la urogenital. El 90.4% tenía síntomas vasomotores y el 25.7% informaron que tenían problemas sexuales severos o muy severos. La presencia de disfunción sexual y de insomnio tuvo OR significativo para deterioro severo de la calidad de vida de 2.1 y 2.4, respectivamente. Conclusión: fue elevada la presencia de disfunción sexual y de insomnio, ambas aumentaron dos veces el riesgo de deterioro severo de la calidad de vida. Cuatro de cada diez mujeres tuvieron deterioro severo de la calidad de vida, con mayor compromiso del área urogenital. Rev.cienc.biomed. 2014;5(2):235-246.

Objective: To describe the safety of early discharge in the first 12 hours of the postoperative period in women undergoing laparoscopic hysterectomy for benign uterine disease. Materials and methods: Descriptive historical cohort study. The study included all women undergoing laparoscopic hysterectomy due to benign disease and discharged after 12 hours of the procedure in a high complexity hospital in Bogota Colombia, between January 2013 and April 2019. Patients with comorbidities (diabetes, cardiovascular disease and chronic obstructive pulmonary disease) mobility limitations and intraoperative complications were excluded. Consecutive sampling was used. The variables assessed included demographics and safety variables such as readmission through the emergency service and complications classified according to the Dindo scale on the fifteenth postoperative day. A descriptive analysis is made. Results: Of 860 laparoscopic hysterectomies performed during the study period, 67 (7.8%) met the selection criteria. Eleven patients (16.4%) were readmitted through the emergency service, one (9%) due to active bleeding, and two (18%) because of urinary symptoms. There were six (8.9%) postoperative complications, including vaginal vault hematoma in two patients (2.9%), hemoperitoneum in two cases (2,9%), one (1.4%) urinary infection and one (1.4%) ureteral injury; four patients (5.9%) required hospitalization and were classified as stage IIIb on the Dindo scale. Conclusions: Early discharge emerges as an alternative to in-hospital care for this type of population. Randomized controlled studies are needed to produce additional evidence regarding this management approach. [ABSTRACT FROM AUTHOR]

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Objetivo: objetivo describir las complicaciones intra y posoperatorias de la histerectomía total por laparoscopia (HTL) para patología benigna del útero y hacer una comparación con otros hospitales que tienen altos volúmenes de HTL. Materiales y métodos: estudio de cohorte retrospectivo en mujeres que se sometieron a HTL por patología ginecológica benigna entre 2007 y 2017 en una institución privada de mediana complejidad, que atiende población perteneciente al régimen contributivo y subsidiado por el Estado en el Sistema General de Seguridad Social, en Pereira, Colombia, por el grupo de cirujanos del centro de entrenamiento ALGIA. Muestreo consecutivo. Se describen la características sociodemográficas y clínicas basales, los hallazgos intraoperatorios y las complicaciones intra y posoperatorias. Se usó estadística descriptiva. Resultados: en el periodo de estudio se incluyeron 1.350 pacientes. El tiempo quirúrgico fue de 95 min (DE ± 31), el sangrado quirúrgico 88 cc (DE ± 66), el peso promedio del útero fue de 236 g (DE ± 133). El 96,5% de las pacientes fueron evaluadas entre los 30 y 45 días. El 3,48 % de las pacientes tuvieron complicaciones menores y el 2,5 % complicaciones mayores. Tres pacientes requirieron conversión a laparotomía (0,23%). No hubo mortalidad en la muestra estudiada. Conclusión: la HTL es un procedimiento seguro y la tasa de complicaciones es similar a la de los mejores estándares internacionales. Es importante que se sigan haciendo estudios prospectivos con criterios objetivos de evaluación para comparar el desempeño de los diferentes grupos e instituciones que ofrecen procedimientos quirúrgicos y entrenamiento.

RESUMO Objetivos: Analisar os resultados de morbidade e sobrevida após cirurgias curativas e paliativas em pacientes com câncer cervical recidivado após tratamento primário com radioterapia e quimioterapia. Outro objetivo foi avaliar os fatores associados aos procedimentos curativos e não curativos. Métodos: Coorte retrospectiva de pacientes submetidos à cirurgias curativas e paliativas, entre janeiro de 2011 a dezembro de 2017, em um centro de alta complexidade em oncolologia. O desfecho da morbidade foi relatado de acordo com a classificação de Clavien-Dindo e a análise de sobrevida foi realizada pelo método de Kaplan-Meir. Para avaliar os fatores associados aos procedimentos, foi realizada análise univariada pelo teste U de Mann-Whitney. Resultados: Foram realizadas duas histerectomias radicais, três exenterações pélvicas com intenção curativa e cinco exenterações pélvicas paliativas. No grupo curativo, houve complicações maiores em 40% dos casos, e o tempo mediano de sobrevida foi 16 meses. No grupo paliativo, houve complicações maiores em 60% dos casos, e o tempo mediano de sobrevida foi 5 meses. Estadiamento avançado (p=0,02), sintomas (p=0,04), tamanho do tumor maior que cinco centímetros (p=0,04) e mais de três órgãos envolvidos (p=0,003) foram fatores significativamente associados a cirurgia não curativa. Conclusões: As taxas de morbidade foram maiores no grupo paliativo, e o tempo mediano de sobrevida foi menor no grupo paliativo do que no grupo curativo, entretanto esta diferença na sobrevida não teve significância estatística. Estádio avançado, sintomas, tamanho tumoral e número de órgãos envolvidos são fatores que devem ser levados em consideração na indicação de resgate cirúrgico.

RESUMO Objetivo: descrever a qualidade de vida e sexualidade de mulheres histerectomizadas que se submeteram à cirurgia no Hospital da Mulher - HMML de Macapá-Amapá. Método: estudo do tipo descritivo exploratório, com delineamento transversal e abordagem quantitativa, realizado com mulheres de uma maternidade de Macapá, estado do Amapá, que se submeteram à histerectomia total nos anos de 2006 a 2016. Utilizaram-se como instrumentos para avaliar a qualidade de vida e a sexualidade de mulheres submetidas à histerectomia total a entrevista individual e os testes WHOQOL-bref e QS-F. Resultados: a amostra incluiu 41 mulheres histerectomizadas com idades entre 24 e 60 anos. A maioria delas considera que a sua QV é boa (53,7%). Quanto à satisfação com a saúde, pouco mais da metade referiu estar satisfeita (36,5%). No tocante à caracterização do desempenho sexual, 13 (31,7%) relataram desempenho sexual desfavorável a regular. Conclusão: a análise das médias dos escores de cada dimensão mostra melhor qualidade de vida no domínio psicológico. No entanto, as correlações do quociente sexual com os domínios da qualidade de vida são todas positivas e significativas.

Introducción. La histerectomía es un procedimiento común en la práctica ginecológica para el manejo de condiciones benignas y malignas. En la actualidad, se ha demostrado que el abordaje mínimamente invasivo es mejor que la cirugía abierta, ya que presenta menos complicaciones intraoperatorias y posoperatorias. Objetivo. Describir la experiencia de pacientes sometidas a histerectomía laparoscópica entre 2014 y 2018 en el Hospital Universitario San José de Popayán Empresa Social del Estado. Materiales y métodos. Estudio observacional descriptivo de serie de casos que incluyó 36 pacientes intervenidas entre enero de 2014 y abril de 2018. Se evaluaron variables sociodemográficas y clínicas. Para medir el grado de satisfacción posoperatoria y la calidad de vida se realizó una encuesta telefónica. Resultados. La edad promedio de las entrevistadas fue 45 años, el tiempo quirúrgico promedio fue 124 minutos, la tasa de complicaciones intraoperatorias fue 2.78% (n=1) y la estancia hospitalaria promedio fue 1.3 días. Los principales diagnósticos preoperatorios fueron carcinoma in situ (28%) y leiomiomatosis (17%). En cuanto al grado de satisfacción, el 92% refirió mejoría en la calidad de vida y el 64% manifestó tener una recuperación posoperatoria rápida. Conclusión. Para la población estudiada, la histerectomía laparoscópica fue un procedimiento seguro con una baja tasa de complicaciones y un alto grado de satisfacción posoperatoria.

Introducción. El cáncer de cuello uterino es la segunda causa de muerte más frecuente mundialmente; por ello, existen terapias tanto invasivas como poco invasivas que buscan impactar la supervivencia de la enfermedad. Entre los diferentes métodos de tratamiento se encuentran la radioterapia externa, la braquiterapia, la quimioterapia, la conización, la traquelectomía y la histerectomía radical. Objetivo. Revisar las características de cada uno de los métodos de tratamiento disponibles para el manejo del cáncer de cuello uterino. Metodología. Se realizó una búsqueda, en las bases de datos PUBMED y LILACS, de artículos publicados entre los años 2013 y 2016 que tuvieran como tema central el cáncer de cuello uterino y su tratamiento; luego de aplicar criterios de inclusión y exclusión, se seleccionaron 41 artículos para la revisión. Resultados. Para el manejo del cáncer de cérvix se plantean, como métodos poco invasivos: la conización, con supervivencia a cinco años de 95.1% en cáncer microinvasor; la radioterapia de haz externo, con supervivencia total de 92.2% a cinco años; la quimioterapia, con supervivencia similar a la radioterapia, pero con disminución de la necesidad de cirugía; y la braquiterapia combinada con quimioterapia, que logró respuesta en 64% de pacientes con cáncer estadio IA, IIA y IB. En relación con métodos más invasivos, se encuentran la traquelectomía en cáncer temprano sin compromiso local o a distancia, alcanza supervivencia del 95%, con tasas de embarazo de 50% posteriores al tratamiento y la histerectomía radical, con supervivencia total de 100% a cinco años en cáncer estadio IA2 y IB1, requiriendo algunas veces combinación con otros métodos. Para las técnicas quirúrgicas se han desarrollado nuevos abordajes y variantes. Conclusiones. Los tratamientos en cáncer de cérvix han mostrado resultados alentadores en cuanto a supervivencia, además, la conización y traquelectomía permiten preservar la fertilidad. La quimioterapia, la radioterapia de haz externo y la braquiterapia logran buen control del cáncer de cérvix en estadios tempranos y se pueden usar como coadyuvantes de los métodos quirúrgicos. Sin embargo, la histerectomía radical es el estándar esencial para manejo del cáncer de cérvix, con buenos resultados en supervivencia; sus variantes, además, han logrado disminuir las complicaciones.

Fundamento: La histerectomía obstétrica es una alternativa terapéutica ante procesos graves (hemorrágicos y/o sépticos), que de no solucionarse influirían directamente en la morbimortalidad materna. El conocimiento sobre el tema permite actuar de manera coherente y racional ante situaciones de riesgo.Objetivo: caracterizar las pacientes que requirieron histerectomía obstétrica de urgencia relacionada con el embarazo en Cienfuegos.Métodos: se realizó un estudio descriptivo, de serie de casos, de todas las pacientes a las cuales se realizó histerectomía obstétrica (N=37) en el Hospital Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, entre los años 2013-2015. Las variables analizadas fueron: edad de la paciente edad gestacional, paridad, eventos relacionados con el embarazo y el parto, tipo de parto y tipo de histerectomía obstétrica.Resultados: el grupo de pacientes de 31-35 años fue el más numeroso, representativo del 40,5 % de total. El 73 % de las mujeres histerectomizadas tuvieron partos anteriores y 10 (27 %) pacientes eran nulíparas. La atonía uterina constituyó la causa más habitual (45,9 %), sobre todo en el grupo de 31-35 años (41,2 %), seguida de la rotura uterina y el acretismo placentario. El tipo de histerectomía más utilizado fue la total sin anexectomía (43,3 %).Conclusión: generalmente los embarazos llegaron a término, y la atonía, como en la gran mayoría de los estudios similares, fue la indicación que predominó. Se corroboró que el parto por cesárea eleva el riesgo relativo para realizar la histerectomía.

Foundation: Obstetric hysterectomy is a therapeutic alternative on severe processes (hemorrhagic and/or septic) which if not solved would directly influenced in maternal morbi/mortality. Knowing about the topic allows to proceed rationally and coherently on risky situations.Objective: to charaterize the patients, series of cases who needed urgent obstetric hysterectomies in Cienfuegos 2013-2015.Methods: a descriptive study was developed, a series of cases of all the patients who were performed an obstetric hysterectomy (N=37) in the Hospital Dr. Gustavo Aldereguía Lima. Cienfuegos, from 2013 to 2015. The variables analyzed were patient age, gestational age, parity, events related to pregnancy, delivery, kind of birth and type of obstetric hysterectomy.Results: the group of patients between 31-35 years old was the most numerous, representing 40,5 % of the total. The 73% of the hysterectomized women had previous deliveries and 10 (27 %) patients were nulliparous. Uterine atony was de most frequent cause (45,9 %), mainly in the 31-35 year group (41,2 %), followed by uterine rupture and placenta accreta. The total hysterectomy without ophorectomy was the most used type(43,3 %).Conclusion: in general pregnancies arrived to the term and the atony, as in many of similar studies was the predominating indication. It was corroborated that birth by cesarean section increases the relative risk to perform a hysterectomy.

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Objective: To describe intra- and postoperative complications of total laparoscopic hysterectomy (TLH) for benign uterine pathology and to compare with other hospitals with large volumes of laparoscopic hysterectomies. Materials and Methods: Retrospective cohort study of women who underwent TLH for benign gynecological pathology between 2007 and 2017 in a private high complexity institution that serves populations covered by contributive and state-subsidized insurance in Pereira, Colombia. The procedures were performed by the group of surgeons of the ALGIA training center. Consecutive sampling was used. Sociodemographic and baseline clinical characteristics, intra-operative findings and intraand post-operative complications are described. Descriptive statistics were used. Results: A total of 1350 patients were included during the study period. Surgical time was 95 minutes (SD ± 31), blood loss 88 cc (SD ± 66), and average uterine weight was 236 g (SD ± 133); 96.5% of the patients were assessed within the next 30 to 45 days; 3.48% had minor complications and 2.5% had major complications; 3 patients were converted to laparotomy. There were no deaths in the study sample. Conclusion: TLH is a safe procedure and the rate of complications is similar to the best international standards. Further prospective studies using objective criteria are important in order to compare the performance of different groups and institutions offering surgical procedures and training. [ABSTRACT FROM AUTHOR]

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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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 Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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 Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia 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 Matronas Profesion is the property of Ediciones Mayo 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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.)

BACKGROUND: Endometrioid stromal sarcoma is a rare tumor, representing 0.2% of malignant neoplasms of the uterus. Few cases of extrauterine endometrial stromal sarcoma, also called endometrioid stromal sarcomas, have been reported to date. CLINICAL CASE: 74-year-old woman, attended for abdominal pain of 5 days of progression. Medical history: hysterectomy and left salpingo-oophorectomy 30 years ago. The pathological anatomy study of the uterus was negative for malignancy; endometriosis was found in the ovary. The tomography reported a 23 x 21 cm mass, multicavitate, intra-abdominal, extending to the pelvic cavity, which was partially resected, in addi-tion to carrying out a colostomy. The patient was operated 20 days later, resecting the sigmoid colon segment, with a mass on the left lateral aspect, adhering to the urinary bladder and the left pelvic wall. Immunohistochemistry for S100 was focally positive. The diagnosis of sarcoma was established. The histological study of the colon reported a neoplasm related to endometriosis. Immunohistochemical studies for estrogen and progesterone receptors were positive in 80%, and for cyclin D1 in 40%; the CD10 marker was focally positive. With the results described, the diagnosis of low-grade extrauterine endometrial stromal sarcoma associated with colonic endometriosis was established. Actually the follow-up of the patient is satisfactory. CONCLUSIONS: The histological study is decisive to establish the diagnosis of endometrial stromal sarcoma. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ectopic adrenal tissue is a rare alteration, especially in older adults, that is identified incidentally during a surgical procedure or at the time of autopsy. CLINICAL CASE: A 60-year-old woman, who began with symptoms one year before attending the consultation, with urinary incontinence, a sensation of a foreign body in the vagina, especially during defecation, and discomfort during sexual intercourse. Endocrine imbalance data were not detected. The gynecological examination revealed uterine prolapse related to symptoms, which is why a total hysterectomy with bilateral salpingo-oophorectomy was scheduled. The histopathological analysis of the surgical specimen reported an oval, yellowish nodule, of firm consistency, measuring 0.2 x 0.2 cm, in the hilum of the right ovary, with a congestive appearance of the surrounding tissues. Under the microscope, it was observed that the nodule located in the ovarian hilum corresponded to adrenal cortex tissue, surrounded by a thin fibrous capsule of connective tissue, made up of cells in a "zonation" pattern, with eosinophilic cytoplasm and uniform nuclei (from oval to round), arranged in short trabeculae, but without medullary coexistence. With immunostaining, the nodule cells were positive for a-inhibin and melan A. The nodule morphology and immunohistochemical profile were consistent with ectopic adrenal cortex. The patient was discharged from the hospital three days after surgery in adequate conditions. CONCLUSION: Ectopic adrenal tissue is a rare alteration in older women; Some studies show that there is a minimal risk of neoplastic transformation, which is why surgical removal is recommended if it is identified. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina 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.)

Objetivos: reportar un caso de evisceración intestinal transvaginal posterior a histerectomía abdominal total y realizar una revisión de la literatura sobre su diagnóstico y tratamiento. Materiales y métodos: se presenta el caso de una paciente de 48 años que consulta a una institución de alta complejidad por evisceración intestinal transvaginal de 10 horas de evolución, se realiza laparotomía para reducción de la evisceración y reparación del defecto de cúpula vaginal. Se hace una búsqueda en Medline vía PubMed, Embase, Elsevier, Medigraphic, Wolters Kluwer Health y UpToDate con los términos: “dehiscencia de cúpula vaginal”, “evisceración intestinal transvaginal”, “dehiscencia posterior a histerectomía”, “complicaciones histerectomía”, y en bola de nieve a partir de los estudios identificados, en idiomas inglés y español. Resultados: se incluyeron 14 estudios. El diagnóstico de la evisceración transvaginal es eminentemente clínico al observar salida de contenido abdominal por vagina, se puede asociar a signos de peritonitis u obstrucción intestinal. Su manejo inicial debe intentar el empaquetamiento vaginal y la profilaxis antibiótica. Se han descrito varias técnicas quirúrgicas para corregir el defecto de la cúpula vaginal y reforzar el cierre de la dehiscencia de la cúpula. Conclusiones: la evisceración transvaginal se considera una urgencia quirúrgica. Se requieren más estudios que evalúen la seguridad y la efectividad de las diferentes intervenciones para el manejo.

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Enfermagem Brasil is the property of Atlantica Editora 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.)

Foundation: Dexamethasone, long-acting corticosteroid, is a drug whose characteristics favor its use in the treatment of nausea and vomiting in certain circumstances, however, its usefulness to prevent postoperative nausea and vomiting in patients undergoing neuroaxial intrathecal anesthesia, performed an abdominal hysterectomy, is not determined. Objective: to demonstrate the effectiveness of dexamethasone in the prevention of postoperative nausea and vomiting in hysterectomized patients under intraaxial neuraxial anesthesia. Methods: a descriptive and prospective study was conducted in patients who underwent hysterectomy under regional intraaxial neuraxial anesthesia (N = 50), from December 2012 to February 2013, at the Ambrosio Grillo Hospital in Santiago de Cuba. Two groups of similar number of patients, randomly selected were used: one treated conventionally (diazepam and diphenhydramine), and another group which was also administered dexamethasone. Results: in general, 8 patients (32%) presented postoperative nausea, 8 from the group treated with the usual form, and 6 treated dexamethasone (24%). Conclusion: the use of dexamethasone in hysterectomized patients under intrathecal neuraxial anesthesia decreases the total incidence of postoperative nausea and vomiting, though not significantly. [ABSTRACT FROM AUTHOR]

Objective: To analyze the humanized care in the immediate postoperative period of hysterectomized patients, from 25's to 40's, of the Olympus Clinic, during the period March-August 2017. Method: The study is carried out under a quantitative approach, with a descriptive level, supported by a field investigation. The information was based on a 11 items questionnaire, which was applied to 18 nurses in order to obtain the required data. Results: The application of humanized care is evidenced partially in the attention of biological needs in patients. It is noted that most of the respondents communicate effectively, however, a high level of indifference is manifested, on the part of nursing staff, in the pain attention as a basic need in the postoperative hysterectomy. Likewise, the absence of an instrument for evaluating user satisfaction is a weakness. Conclusions: Humanized care is a complex but essential process during post-operative care in hysterectomies. Within the health institution addressed, it is developed in a fragmented manner, however, there is an opening in nursing professionals for the humanization of care. [ABSTRACT FROM AUTHOR]

Objetives: To report a case of transvaginal bowel evisceration following total abdominal hysterectomy, and to conduct a review of the literature on its diagnosis and treatment. Materials and methods: A 48-year-old female patient who presented to a high complexity institution with transvaginal bowel evisceration lasting 10 hours. Laparotomy was performed in order to reduce the evisceration and repair the vaginal vault defect. A search was conducted in Medline via PubMed, Embase, Elsevier, Medigraphic, Wolters Kluwer Health and UpToDate using the terms "vaginal vault dehiscence," "transvaginal bowel evisceration," "dehiscence following hysterectomy," "hysterectomy complications," and using a snowball search strategy based on the studies identified, both in English and Spanish. Results: Fourteen studies were included. The diagnosis of transvaginal evisceration is primarily clinical with the observed bulging of the abdominal content through the vagina. It may also be associated with signs of peritonitis or bowel obstruction. Initial management must be an attempt at vaginal packing and prophylactic antibiotics. Several surgical techniques have been described for vaginal vault correction and reinforcement of dehiscence closure. Conclusions: Transvaginal evisceration is considered a surgical emergency. Further studies assessing the safety and effectiveness of the various management interventions are required. [ABSTRACT FROM AUTHOR]