Complications of Uterine Fibroids and Their Management, Surgical Management of Fibroids, Laparoscopy and Hysteroscopy versus Hysterectomy, Haemorrhage, Adhesions, and Complications

A critical analysis of the surgical treatment of fibroids compares all available techniques of myomectomy. Different statistical analyses reveal the advantages of the laparoscopic and hysteroscopic approach. Complications can arise from the location of the fibroids. They range from intermittent bleedings to continuous bleedings over several weeks, from single pain episodes to severe pain, from dysuria and constipation to chronic bladder and bowel spasms. Very seldom does peritonitis occur. Infertility may result from continuous metro and menorrhagia. The difficulty of the laparoscopic and hysteroscopic myomectomy lies in achieving satisfactory haemostasis using the appropriate sutures. The hysteroscopic myomectomy requires an operative hysteroscope and a well-experienced gynaecologic surgeon.

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The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

Orvosi Hetilap ◽

10.1556/oh.2013.29535 ◽

2013 ◽

Vol 154 (6) ◽

pp. 225-227 ◽

Cited By ~ 1

Author(s):

Csaba Halmy ◽

Zoltán Nádai ◽

Krisztián Csőre ◽

Adrienne Vajda ◽

Róbert Tamás

Keyword(s):

Surgical Treatment ◽

Skin Lesion ◽

Surgical Management ◽

Skin Grafting ◽

Skin Tumor ◽

Temporal Region ◽

Aesthetic Result ◽

Malignant Skin ◽

Dermal Regeneration Template ◽

Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

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Comprehensive Surgical Management of Chronic Suppurative Osteomyelitis Extending to The Lower Border of Mandible – A Case Report

International Journal of Recent Advances in Science and Technology ◽

10.30750/ijarst.532 ◽

2018 ◽

Vol 5 (3) ◽

Author(s):

Deepak Kaul ◽

Farahnaz Muddebihal ◽

Mohammed Anwar Ul Haque Chand

Keyword(s):

Developing Countries ◽

Case Report ◽

Surgical Treatment ◽

Surgical Management ◽

Surgical Debridement ◽

Reconstruction Plate ◽

Left Posterior ◽

High Nutrient ◽

Inferior Border ◽

Precipitating Factor

Osteomyelitis of maxillofacial skeleton is common in developing countries such as India. This case report describes successful surgical treatment of chronic suppurative osteomyelitis {CSO} of the mandible of a 35yr old female. The precipitating factor was thought to be eventful extraction in the {left } posterior body at the inferior border of mandible. Methods: Presurgical course of antibiotics ( Amoxycillin and metronidazole for 7 days and later followed by doxycycline for 1 month).Surgical debridement of the affected bone and reinforcing it with reconstruction plate using AO principles was done . Patient was kept on a high nutrient diet consisting of proteins. Conclusion: The case report demonstrates the typical features of CSO . The combination of the antibiotics therapy and surgical debridement was successful in the treatment of chronic suppurative osteomylitis.

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Surgical Management: Open Surgical Treatment of Infra-Inguinal Occlusive Disease

Limb Salvage of the Diabetic Foot ◽

10.1007/978-3-319-17918-6_24 ◽

2019 ◽

pp. 301-322

Author(s):

Hisham Rashid ◽

Raghvinder Gambhir ◽

Hani Slim

Keyword(s):

Surgical Treatment ◽

Surgical Management ◽

Occlusive Disease ◽

Open Surgical Treatment

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Intrauterine Adhesions following Conservative Treatment of Uterine Fibroids

Obstetrics and Gynecology International ◽

10.1155/2012/853269 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 21

Author(s):

Pietro Gambadauro ◽

Johannes Gudmundsson ◽

Rafael Torrejón

Keyword(s):

Conservative Treatment ◽

Current Knowledge ◽

Uterine Fibroids ◽

Reproductive Age ◽

Surgical Trauma ◽

Tumor Removal ◽

Intrauterine Adhesions ◽

Hysteroscopic Myomectomy ◽

Uterine Arteries ◽

Diagnostic Pitfalls

Uterine fibroids are common in women of reproductive age and various conservative treatments are available. In order to achieve a successful conservative treatment of fibroids, functional integrity of the uterus is as important as tumor removal or symptoms relief. In this context, intrauterine adhesions must be recognized as a possible complication of conservative management of uterine fibroids, but diagnostic pitfalls might justify an underestimation of their incidence. Hysteroscopic myomectomy can cause adhesions as a result of surgical trauma to the endometrium. The average reported incidence is around 10% at second-look hysteroscopy, but it is higher in certain conditions, such as the case of multiple, apposing fibroids. Transmural myomectomies also have the potential for adhesion, especially when combined with uterine ischemia. Uterine arteries embolization also carries a risk of intracavitary adhesions. Prevention strategies including bipolar resection, barrier gel or postoperative estradiol, might be useful, but stronger evidence is needed. In view of current knowledge, we would recommend a prevention strategy based on a combination of surgical trauma minimization and identification of high-risk cases. Early hysteroscopic diagnosis and lysis possibly represents the best means of secondary prevention and treatment of postoperative intrauterine adhesions.

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Uterine submucosal leiomyomas: modern diagnosis and miniinvasive surgery

Journal of Clinical and Investigative Surgery ◽

10.25083/2559.5555/6.2.2 ◽

2021 ◽

Vol 6 (2) ◽

pp. 88-93

Author(s):

Oana Denisa Balalau ◽

◽

Mihai-George Loghin ◽

Sabin Vasilache ◽

Octavian Gabriel Olaru ◽

...

Keyword(s):

Recovery Time ◽

Uterine Fibroids ◽

Therapeutic Decision ◽

Common Complication ◽

Hysteroscopic Myomectomy ◽

Abdominal Myomectomy ◽

Pelvic Tumors ◽

Submucosal Fibroids ◽

Miniinvasive Surgery ◽

Vaginal Myomectomy

Uterine leiomyomatosis is one of the most common benign pelvic tumors diagnosed in women aged 25-44 years. Clinically, it is manifested by vaginal bleeding, pelvic pain, infertility, digestive and urinary symptoms. The diagnosis of uterine fibroids requires careful clinical and paraclinical evaluation. Based on these data, the therapeutic decision is conducted in most cases. The treatment of uterine leiomyomatosis involves several procedures, such as: total abdominal hystectomy, total vaginal hystectomy, abdominal myomectomy, vaginal, laparoscopic or hysteroscopic myomectomy. Hysteroscopic myomectomy is currently the preferred procedure for submucosal fibroids. It has multiple advantages: shorter recovery time, reduced pain related to movements, shorter duration procedure and fewer risks. The procedure has few contraindications. The most common complication is recurrence. The treatment of choice for prolapsed pedunculated submucous leiomyoma is vaginal myomectomy. As described, the procedure has multiple advantages and generally has a low recurrence rate.

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Myoma pseudocapsule - a biological and surgical structure to respect during myomectomy

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh190720014t ◽

2020 ◽

Vol 148 (3-4) ◽

pp. 236-241

Author(s):

Andrea Tinelli ◽

Radmila Sparic

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Biological Process ◽

Positive Impact ◽

Uterine Fibroids ◽

Reproductive Function ◽

Muscle Scar ◽

New Techniques ◽

Anatomical Studies ◽

Surgical Practice

Uterine fibroids affect almost one in two patients, causing many pelvic problems and requiring pharmacologic and surgical treatment. For many years, the importance of the fibroid was emphasized as uterine pathology, without focusing on the complex myometrial biology peripheral to fibroid. Moreover, the traditional surgical technique in fibroid removal has not been investigated for years. In recent years, on the contrary, morphological, neuroendocrine and anatomical studies have demonstrated the importance of a biological and surgical structure surrounding myoma, rich in neurotransmitters and neurofibres, the myoma pseudocapsule. This structure is formed in the womb peripheral to fibroid onset, it separates the fibroid from the myometrium and acts as a tissue regenerator after the removal of the fibroid from the uterus. The translation of scientific research on pseudocapsules into surgical practice has allowed us to identify new techniques of myomectomy, removing the myoma inside the pseudocapsule and promoting the pseudocapsules sparing surgery. All this to favor the subsequent biological process of uterine scarring and healing, by activating the neurotransmitters and neurofibres present in the myometrial fovea. The correct healing after fibroid removal restores the uterine anatomy, with a positive impact on subsequent reproductive function, reducing problems related to the muscle scar.

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Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO

Case Reports in Medicine ◽

10.1155/2009/454161 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

M. De Vos ◽

M. Leunen ◽

C. Fontaine ◽

Ph. De Sutter

Keyword(s):

Surgical Treatment ◽

Complete Remission ◽

Treatment Option ◽

Hydatidiform Mole ◽

Uterine Fibroids ◽

Treatment Method ◽

Primary Treatment ◽

Molar Pregnancy ◽

Complete Hydatidiform Mole ◽

Hydatidiform Moles

Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment.Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission.Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.

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Prognostic factors influencing the outcome of empyema surgical management: prospective study in a Moroccan university center.

British Journal Of Surgical Science ◽

10.54323/bjoss.2021.10 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Sara Hafidi ◽

Souheil Boubia ◽

Abdellah Fatene ◽

Najat Id El Haj ◽

Mohammed Ridai

Keyword(s):

Surgical Treatment ◽

Surgical Management ◽

Public Health Problem ◽

Pleural Empyema ◽

Chronic Alcoholism ◽

University Teaching ◽

University Center ◽

Post Traumatic ◽

Surgery Department ◽

Delay Of Diagnosis

Background: Pleural empyema is a public health problem, and is the most frequent complication of pleural infection with significant morbidity and mortality worldwide. Our study aims to highlight the management of pleural empyema and evaluate its prognosis factors involved especially in surgical treatment. Patients and Methods: A prospective analysis of 53 patients who underwent surgical treatment of pleural empyema, from January 2015 to December 2019 at the thoracic surgery department in a tertiary referral university teaching hospital. Our study included patients who required surgical treatment for pleural empyema and were excluded patients with destroyed lungs associated with pyothorax. Results: The mean age of patients was 39.24±15.89 years and 79,24% of them were males. In 85.7% of the cases, the etiology was undetermined in 34%, parapneumonic in 1.9%, of tuberculosis in 54.71%, post-traumatic in 11, 3%, postoperative in 7.5% and iatrogenic in 1.9%. 45 patients were treated with broad-spectrum antibiotics therapy adapted after antibiogram 14.38±21.76 days before the operation. A complete debridement and decortications were performed by VATS in 28 and by PLT in 22 patients. No major complications occurred. At a mean term follow-up of 20 months (3months—3 years); all patients were alive with no recurrence. The analysis of the results showed 4 factors of poor prognosis: delay of diagnosis and surgery (P = 0.02), chronic alcoholism (P = 0.034), preoperative ventilation disorder/COPD (P = 0.04) and active tuberculosis (P= 0, 05). Conclusion: The success of surgical management of pleural empyema depends on several factors, which predict the prognosis, but can be prevented.

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Combined Hemimandibular Hyperplasia and Elongation: the Orthodontic-Surgical Management

Orthodontic Update ◽

10.12968/ortu.2020.13.3.134 ◽

2020 ◽

Vol 13 (3) ◽

pp. 134-140

Author(s):

Ciarán Devine ◽

Anna Sayan ◽

Velupillai Ilankovan

Keyword(s):

Primary Care ◽

Surgical Treatment ◽

Surgical Management ◽

Clinical Relevance ◽

Care Setting ◽

Primary Care Setting ◽

Diagnostic Techniques ◽

Mandibular Asymmetry ◽

Contemporary Management

Patients commonly present to orthodontists with complaints of facial and/or mandibular asymmetry. It is important that all asymmetry complaints are taken seriously and further investigated. Orthodontists play an important role in the diagnosis, management and follow-up of these conditions. For condylar hyperactivity, management is generally in a multidisciplinary setting. Clinicians who practice orthodontics in a primary care setting need to be aware of the correct terminology and the appropriate investigations required for diagnosis and the management of this condition. This paper aims to describe the contemporary management of condylar hyperactivity and presents a case of combined orthodontic-surgical treatment. CPD/Clinical Relevance: Condylar hyperactivity can lead to severe orofacial deformities and severe malocclusions. The orthodontist must understand the terminology, diagnostic techniques and treatment of this condition in order to offer the most appropriate management. The entire dental team may be involved in cases of condylar hyperactivity from diagnosis through to follow-up. Increased awareness may therefore improve diagnosis and ensure appropriate early referrals are made, thus potentially improving outcomes.

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