Clinicopathological study of hysterectomised specimens

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It can be done by abdominal or vaginal route and with the help of laparoscopy. Hysterectomy is an effective treatment option for many conditions like fibroid, abnormal uterine bleeding, endometriosis, adenomyosis, uterine prolapse, pelvic inflammatory disease and cancer of reproductive organ when other treatment options are contraindicated or have failed, or if the woman no longer wishes to retain her menstrual and reproductive. The aim and objective of the study was to correlate indications of hysterectomy with histopathological findings in hysterectomised patients.Methods: A retrospective study was carried on 113 hysterectomised cases over a period of one year from June 2015 to May 2016. The data regarding the patient’s age, parity, clinical diagnosis, type of hysterectomy and histopathological diagnosis were reviewed by the records and analyzed.Results: A total of 113 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 20 years to 75 years. Most common age group was 41-50 years. Among hystectomies majority were done through vaginal route 86 (76.1%) and 26 (23%) cases were done through abdominal route. Most common clinical diagnosis was fibroid uterus in 44(38.9%) cases. Most of the hysterectomies were done for benign conditions. In final histopathological report most common diagnosis was fibroid uterus in 45(39.8%) hysterectomy specimens. It was correlated well with clinical diagnosis. Next most common histopathological diagnosis was Adenomyosis.Conclusions: Histopathological analysis correlated well with preoperative clinical diagnosis in majority of cases. The commonest indication and histopathological finding in our study was fibroid uterus. Next most common histopathological finding was Adenomyosis. Most commonly hysterectomies were done through vaginal route in our study.

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An audit of hysterectomies: indications, complications and clinico pathological analysis of hysterectomy specimens in a tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183778 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3689

Author(s):

Vanithamani Sivapragasam ◽

Chellammal K. Rengasamy ◽

Aruna B. Patil

Keyword(s):

Clinical Diagnosis ◽

Surgical Procedure ◽

Care Center ◽

Treatment Options ◽

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Bladder Injury ◽

Histopathological Diagnosis ◽

Invasive Treatment ◽

Effective Treatment Option

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It is an effective treatment option for many gynecological conditions. Aim and objective of the study was to analyse the indications, complications of hysterectomies and to see whether preoperative clinical diagnosis was confirmed by histopathology.Methods: Authors present a retrospective study of 198 hysterectomised cases over a period of one year from January 2016 to December 2016. The data regarding patients age, parity, indication for hysterectomy, type of hysterectomy, complications during and after surgery and final histopathological diagnosis were collected from the records and analysed.Results: A total of 198 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 32 years to 75 years. Most common age group was 41-50 years. Majority were done through abdominal route 162 cases (81%). Most common indication was abnormal uterine bleeding 56 (28%) and fibroid 41 (21%). One case of accidental bladder injury was noted. Most common postoperative complication was fever (23%). Most common histopathological lesion was fibroid 101 (51%). In three cases preoperative clinical diagnosis did not correlate with final histopathological diagnosis.Conclusions: As any surgical procedure, hysterectomy is also associated with risk of complications. Hence the indication should be carefully evaluated. Reporting of all hysterectomies should be made mandatory and audit results should be used for improvement of quality of health service. Newer and less invasive treatment options should be offered to women with benign pathologies. This will further reduce the incidence of hysterectomy.

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Histopathological analysis of hysterectomy specimens in a tertiary care centre: study of 160 cases

International Surgery Journal ◽

10.18203/2349-2902.isj20193330 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2856

Author(s):

Roopali Jandial ◽

Mehnaz Choudhary ◽

Kuldeep Singh

Keyword(s):

Clinical Diagnosis ◽

Tertiary Care ◽

Life Time ◽

Total Abdominal Hysterectomy ◽

Clinical Indication ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Cervical Lesions ◽

Tertiary Care Centre ◽

Wide Range

Background: Hysterectomy is the most commonly performed gynaecological surgery as the female reproductive system has been affected by various non-neoplastic and neoplastic conditions during the life time of a woman.Methods: This retrospective study was conducted on 160 hysterectomy specimens reported to Department of Pathology. They were compared in terms of age of the patients and pathology of hysterectomy specimens. The histopathological findings of hysterectomy specimens was noted and these findings were then correlated with clinical diagnosis. The aim of the study was to evaluate the wide range of pathological lesions, commonest pathology involved and correlation of the preoperative clinical diagnosis with the histopathological diagnosis in the hysterectomy specimens.Results: The most common type of hysterectomy was total abdominal hysterectomy with bilateral salpingo-ophorectomy with 102 cases (63.7%). Peak incidence at 5th decade of life in 92 cases (57.5%) was noted. The most common clinical indication was fibroid uterus in 81 cases (50.6%). Proliferative phase of endometrium was the commonest finding in 87 cases (54.3%). In case of myometrium, 95 leiomyomas were noted. On histomorphological study of cervical lesions, chronic cervicitis was commonest finding in 75 (46.8%) cases.Conclusions: Few double pathologies can be missed clinically so clinico-pathological correlation in all cases of hysterectomy has been proved to be important to improve the clinical outcome and post-operative management.

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Clinicopathological correlation of abdominal hysterectomy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204781 ◽

2020 ◽

Vol 9 (11) ◽

pp. 4361

Author(s):

Tara Manandhar ◽

Sarita Sitaula ◽

Baburam Thapa Dixit ◽

Ajay Agrawal

Keyword(s):

Abnormal Uterine Bleeding ◽

Laparoscopic Hysterectomy ◽

Abdominal Hysterectomy ◽

Uterine Bleeding ◽

Common Finding ◽

Clinical Indication ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Common Indication ◽

Fibroid Uterus

Background: Hysterectomy is the most common gynaecological procedure performed worldwide. Abdominal hysterectomy remains the most common approach though recently there has been preference towards laparoscopic hysterectomy. Fibroid uterus is the most common indication for hysterectomy followed by pelvic organ prolapse, benign ovarian tumour and abnormal uterine bleeding. The objective of this study was to analyse the indication, outcome and correlate the clinical indication with the histopathological diagnosis.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, B. P. Koirala Institute of Health Sciences, from January 2017 to December 2019. This is a descriptive analysis of the patients who had undergone abdominal hysterectomy during the study period.Results: A total of 801 patients underwent abdominal hysterectomy and the most common indication was fibroid uterus (n=391, 48.81%), followed by abnormal uterine bleeding. The total complication rate was 3.24% (n=26) and we had one (0.1%) mortality. Histopathological analysis of the specimen revealed leiomyoma (54.43%) as the most common finding. The clinical indication and histopathological diagnosis matched in 373 (86.94%) patients.Conclusions: Abdominal hysterectomy is the most common approach and it is associated with risk of complications, so the indication for hysterectomy should be adequately evaluated. With the improvement in the different organ-preserving options, hysterectomy in benign disease should only be opted when all the other conservative options fails.

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A retrospective study on indications and histopathological analysis of non-oncological hysterectomies in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204962 ◽

2020 ◽

Vol 9 (12) ◽

pp. 5050

Author(s):

Ananthi Kasinathan ◽

Himabindu Nagulapally

Keyword(s):

Retrospective Study ◽

Clinical Diagnosis ◽

Ovarian Cyst ◽

Preoperative Evaluation ◽

Tertiary Care ◽

Pelvic Organ ◽

Clinical Indication ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

Care Hospital

Background: An increase in the number of women undergoing hysterectomy especially in South India is of great concern. Whenever hysterectomy is performed, it is imperative that clinical diagnosis is accurate. The purpose of current study is to assess whether the histopathological diagnosis after surgery is correlated with the clinical diagnosis. Methods: This is a retrospective study conducted in the department of obstetrics and gynaecology at Indira Gandhi medical college and research institute Puducherry, from January 2018 to December 2018. Patients, who underwent hysterectomy for benign causes, were included in the study. Data was collected from the patients' case records. Whether the histopathological diagnosis was in tandem with the clinical diagnosis, was notedResults: Out of the 234 hysterectomies performed, 46.15% were by abdominal route and 53.84% were by vaginal route. 24.7% were TAH with BSO with mean age of 49.72 years. VH with PFR (46.5%) was the most common surgery done. Out of the 80 cases of fibroid, 66 (28.2%) were confirmed on histopathology. Histopathological diagnosis corroborated the clinical diagnosis in patients with ovarian cyst, fibroid with ovarian cyst and DUB. Adenomyosis was validated in 7 of 9 cases. Endometriosis of ovary was confirmed in 4 (1.7%) cases. In patients with pelvic organ prolapse, histopathology showed atrophic changes.Conclusions: Accurate clinical diagnosis, supported by in-depth preoperative evaluation and a sound clinical knowledge helps to avoid unnecessary hysterectomies. It is imperative to study the histopathology of the operated specimen and confirm the appropriateness of the clinical indication.

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Clinicopathological correlation of uterine cervical lesions with focus on premalignant and malignant lesions

Journal of Pathology of Nepal ◽

10.3126/jpn.v9i2.26447 ◽

2019 ◽

Vol 9 (2) ◽

pp. 1560-1563

Author(s):

Ramesh Makaju ◽

Binod Dhakal ◽

Rachana Dhakal

Keyword(s):

Cell Carcinoma ◽

Clinical Diagnosis ◽

Clinical Examination ◽

Pap Smear ◽

Precancerous Lesions ◽

Demographic Data ◽

University Hospital ◽

Histopathological Diagnosis ◽

Cervical Lesions ◽

Common Diagnosis

Background: Cervical cancer ranks as the most frequent cancer among women in Nepal and the first most frequent cancer among women between 15 and 44 years of age. The objectives of the study are to find the incidence of premalignant and malignant cervical conditions and to correlate histopathological diagnosis with that of clinical diagnosis. Materials and Methods: This was a retrospective study carried out at Kathmandu University Hospital. All cervical biopsy done from January 2009 to December 2018, were included in the study. A proforma was created in which relevant demographic data like age, sex along with clinical findings, gross and histopathological findings were collected. Results: Mean age of patients with cervical intraepithelial lesion- 1, 2 and 3 was 43.5 years, 48 years and 43.4 years respectively. The most common diagnosis was cervical polyp were (38.65%) followed by 52 cases (15.9%) of unhealthy cervix which bleeds easily on touch and 42 (12.8%) cases of inflammatory condition. Clinical diagnosis of carcinoma of cervix comprised of 42 cases (12.8%). On histopathology, 51(15.6%) cases had invasive carcinoma of which 48 (94.1%) were squamous cell carcinoma, two (3.92%) were adenocarcinoma, and one (1.9%) was of small cell carcinoma. In 33 cases (78.57%), clinical examination was correctly able to identify the invasive cancer. The sensitivity rate of diagnosing cancerous and precancerous lesions by clinical examination and cervical pap smear was 80.95 percent. Conclusions: Proper clinical history, examination, pap smearing and biopsy report helps through appropriate clinical intervention and prevents development of advanced stage of cervical carcinoma

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Clinical Diagnosis and Histopathological Diagnosis

Nishi Nihon Hifuka ◽

10.2336/nishinihonhifu.37.500 ◽

1975 ◽

Vol 37 (4) ◽

pp. 500-512

Author(s):

Kazukata NISHIO

Keyword(s):

Clinical Diagnosis ◽

Histopathological Diagnosis

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Effectiveness of web-based feedback interventions for people with overweight and obesity: systematic review and network meta-analysis of randomized controlled trials

Journal of Eating Disorders ◽

10.1186/s40337-021-00432-6 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Carmen Varela ◽

Camila Oda-Montecinos ◽

Ana Andrés ◽

Carmina Saldaña

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Weight Control ◽

Meta Analysis ◽

Treatment Options ◽

Overweight And Obesity ◽

Mean Difference ◽

Effective Treatment Option ◽

Web Based ◽

Self Help

Abstract Background Web-based delivered interventions have become an innovative option to treat health problems, like obesity. The aim of this systematic review and network meta-analysis was to analyze the effectiveness of web-based behavioral treatments for adults with overweight and obesity. Web-based interventions and comparison interventions (traditional weight control programs) were classified according to the following feedback characteristics: frequency, personalization, and provider (human versus machine). Method From the initial 1789 studies, 15 were included in this review. A network meta-analysis was conducted to analyze the efficacy of web-based programs with traditional interventions, considering direct and indirect comparisons. The main outcome was the weight loss mean difference (kg) between baseline and post-treatment. Heterogeneity and consistency assumptions were validated to conduct the network meta-analysis. Results Network meta-analysis showed comparisons between different treatment options. The main results were that Intensive Contact Web-based programs were more effective than wait-list (Mean Difference − 1.86 kg; 95% Confidence Interval: − 3.61, − 0.12). Moreover, Intensive Contact Web-based programs were more effective than the other web-based options and self-help traditional interventions. However, the only significant comparison was Intensive Contact Web-based programs versus Guided Self-Help Web-based programs (Mean Difference − 4.31 kg; 95% Confidence Interval: − 5,22, − 3,41). Intensive Contact Web-based programs were the most effective treatment option according the obtained results, achieving the first place in the ranking provided by the network meta-analysis with 98.5% of probabilities. Conclusions Intensive Contact Web-based interventions have obtained the first position in the ranking, proving the relevance of frequent, personalized, and professional feedback and their association with a better prognosis for people with overweight and obesity. These results provide relevant information to design more effective treatments for people with overweight and obesity, in a new format especially appropriate for the current situation.

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The Histopathological Analysis of 122 Cases of Ovarian Lesions

10.53350/pjmhs211561397 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1397-1399

Author(s):

Z. Kashif ◽

S. Z. Warriach ◽

M. B. Pasha ◽

S. S. Ali ◽

A. U Rehman ◽

...

Keyword(s):

Marital Status ◽

Retrospective Review ◽

Malignant Neoplasm ◽

Ovarian Cysts ◽

Histopathological Analysis ◽

Histopathological Diagnosis ◽

The Mean ◽

Final Histological Diagnosis ◽

Bilateral Lesions ◽

Ovarian Involvement

Aim: To outline various histopathological types of ovarian cysts received in our teaching hospital along with their prevalence and mode of presentation and to assess the proportion of physiologic versus pathological cysts and benign versus malignant ovarian cysts. Duration of study: From Jan 2019 to March 2021. Methods: Histopathology Department of Bakhtawar Amin Medical & Dental College & Hospital, Multan. A retrospective review of 122 ovarian lesions including physiological/functional cysts, pathological non neoplastic cysts as well as benign, borderline and malignant neoplasm. Histopathology reports of all ovarian specimens were reviewed and counted. Details like age, marital status, parity, presenting complaints, procedure opted, laterality, size, gross and microscopic details and final histological diagnosis etc were recorded. H&E stained slides of all cases were reviewed. In difficult suspicious cases, immunohistochemistry was also carried out. Percentage and proportions were calculated for all the variables. Relevant tables and charts were computed. Results: A total of 122 ovarian specimens with some lesion were segregated in histopathology department of Bakhtawar Amin Hospital from 117 patients with 5 patients having bilateral lesions. The mean age was 33.2 years (ranging from 13-71 years). Most ladies presented between 25-45 years of age. Out of these 117 patients, 18 ladies were unmarried. Out of the 99 married, 12 were nulliparous. Sixty four ladies (54.7%) found to have cysts/neoplasm in right sided ovary, forty eight (41%) presented with left sided ovarian involvement and 5 (4.3 %) presented with bilateral ovarian lesions. Conclusion: Non neoplastic ovarian cysts are more frequent as compared to neoplastic masses. Histopathological diagnosis is mandatory for final confirmatory diagnosis. Keywords: Ovarian lesions, reproductive cells, cyst

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Office-Based Laryngeal Laser Surgery: A Review of 443 Cases Using Three Wavelengths

Otolaryngology ◽

10.1016/j.otohns.2007.02.041 ◽

2007 ◽

Vol 137 (1) ◽

pp. 146-151 ◽

Cited By ~ 83

Author(s):

Jamie A. Koufman ◽

Catherine J. Rees ◽

William D. Frazier ◽

Lauren A. Kilpatrick ◽

S. Carter Wright ◽

...

Keyword(s):

Laser Surgery ◽

Selection Criteria ◽

Carbon Dioxide Laser ◽

Yttrium Aluminum Garnet ◽

Treatment Options ◽

Treatment Modalities ◽

Wavelength Selection ◽

Upper Aerodigestive Tract ◽

Effective Treatment Option ◽

Yttrium Aluminum

BACKGROUND: Unsedated office-based laser surgery (UOLS) of the larynx and trachea has significantly improved the treatment options for patients with laryngotracheal pathology including recurrent respiratory papillomas, granulomas, leukoplakia, and polypoid degeneration. UOLS delivered by flexible endoscopes has dramatically impacted office-based surgery by reducing the time, costs, and morbidity of surgery. OBJECTIVES: To review our experience with 443 laryngotracheal cases treated by UOLS. METHODS: The laser logbooks at the Center for Voice and Swallowing Disorders were reviewed for UOLS, and the medical and laryngological histories were detailed, as were the treatment modalities, frequencies, and complications. RESULTS: Of the 443 cases, 406 were performed with the pulsed-dye laser, 10 with the carbon-dioxide laser, and 27 with the thulium: yttrium-aluminum-garnet laser. There were no significant complications in this series. A review of indications and wavelength selection criteria is presented. CONCLUSION: Unsedated, office-based, upper aerodigestive tract laser surgery appears to be a safe and effective treatment option for many patients with laryngotracheal pathology.

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