Modern non-drug technologies of rehabilitation for patients after surgical treatment of uterine myoma

2020 ◽  
pp. 78-88
Author(s):  
Ekaterina Zhumanova ◽  
Elizaveta Koneva ◽  
Tatyana Shapovalenko ◽  
Konstantin Lyadov ◽  
Natalia Korchazhkina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Uterine Fibroids ◽  
Review Article ◽  
Uterine Myoma

The review article presents data on scientific studies carried out in recent decades on the use of modern non-drug technologies in the rehabilitation of patients after surgical treatment of uterine fibroids.

Uterine fibroids, laparoscopic surgery and morcellation. Literature review

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 22-25
Author(s):  
Alexander A Seregin ◽  
Anastasiia B Nadezhdenskaya ◽  
Aleksandra V Asaturova ◽  
Dmitry L Ovodenko
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Extraction Process ◽  
Uterine Myoma ◽  
Historical Aspect ◽  
Surgical Interventions ◽  
Oncological Safety ◽  
High Level

Aim. To analyze the literature data on modern approaches to morcellation of myomatous nodes in laparoscopic surgery and to highlight this area in a historical aspect. To form an idea of the main difficulties associated with morcellation, which contributed to and contribute to the improvement of the technique of this manipulation. Materials and methods. The review includes data from foreign articles published in the elibrary.ru and PubMed databases on this topic. Results. It describes both modern trends in the surgical treatment of patients with uterine myoma, and historical aspects of improving methods aimed at reducing risks, reducing the time of surgical intervention and improving its safety. Analyzed data on the use of electromorcellation, carried out both with the use of plastic containers, and without them. Conclusion. High requirements for surgical interventions contributed to the emergence of such a method of intracorporeal fragmentation of drugs, such as morcellation, which led to a significant reduction in the proportion of laparotomic operations in the treatment of patients with my uterus. The introduction of laparoscopy in the surgical treatment of uterine myoma allowed to achieve a fundamentally new high level of rehabilitation of patients. Removing removed drugs from the abdominal cavity is associated with a certain risk. Despite the significant number of proposed methods and devices for morcellation, they all require further improvement, since it is necessary to completely exclude contact of the myoma node tissue with abdominal organs in the extraction process. Currently, active research continues on ways to realize all the benefits of minimally invasive technologies in compliance with the rules of oncological safety.

New aspects in the treatment of uterine leiomyoma associated with endometriosis

2017 ◽  
pp. 32-35
Author(s):  
V.V. Kaminskiy ◽  
◽  
E.V. Prokopovych ◽  
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Uterine Fibroids ◽  
Progesterone Receptors ◽  
Objective Evaluation ◽  
Treatment Method ◽  
Integrated Treatment ◽  
Uterine Myoma ◽  
Ulipristal Acetate ◽  
High Level

Despite the high level of development of modern surgery and pharmacology, none of the surgical techniques (hysterectomy / myometectomy or embolization of the uterine arteries) or drug therapy is not a guarantee of the absence of a future recurrence of uterine fibroids and endometriosis. However, there are methods of effective pharmacotherapy for their manifestations. In particular, selective progesterone receptor modulators (SMPR) demonstrate high efficacy in respect of the symptoms of myoma and the size of the nodes, which allows them to be considered as a complete alternative to the surgical treatment of uterine fibroids. The objective: evaluation of the effectiveness of the use of SMPR in the treatment of combined gynecological diseases. Patients and methods. The study included materials for the observation of 40 women 20–52 years old with uterine myoma against the background of combined gynecological pathology (endometriosis, infertility), which carried out the enucleation of myomatous nodes by laparotomy, laparoscopic or transcervical access. Patients were divided into two groups. In the main group (n=20), women received SMPR – ulipristal acetate (UPA) 5 mg daily for 3 months. The UIA's bioavailability is 70%. The optimal therapeutic single dose for the analyzed pathology is 5 mg. After 3 months, the first assessment of the effectiveness of the drug with combined gynecological pathology was conducted, then 14 women were exposed to surgical treatment, and 6 of 20 patients continued conservative treatment for another 1–4 months. After the operation to prevent the recurrence of uterine fibroids and endometriosis, 8 patients continued treatment of UPA for 4 months. In the comparison group (n=20), women underwent surgical treatment at similar rates, but the SMPR was not assigned to surgery. Results. Of the studies indicate that the use of such a selective modulator of progesterone receptors, like vandalite acetate, in the treatment of uterine myomas in combination with endometriosis is safe and well tolerated, leads to rapid persistent coping of uterine bleeding, a significant decrease in the size of nodes and foci of endometriosis, and the achieved The therapeutic effect is maintained even after the abolition of therapy. Conclusion. Thus, the use of the drug ulipristal acetate in the treatment of uterine fibroate on the background of combined gynecologic pathology is highly effective and promising as an independent and integrated treatment method of this category of patients. Key words: uterine myoma, endometriosis, selective modulators of progesterone receptors, viperpatel acetate, combined oral contraceptives.

scholarly journals Reproductive outcomes following surgical removal of uterine fibroids

2019 ◽  
pp. 110-118
Author(s):  
A. E. Mitichkin ◽  
Yu. E. Dobrokhotova ◽  
N. Yu. Ivannikov ◽  
V. I. Dimitrova ◽  
O. A. Slyusareva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Drug Withdrawal ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Surgical Removal ◽  
Birth Canal ◽  
Uterine Arteries ◽  
Natural Birth ◽  
Prospective Comparative Study

The cohort prospective comparative study investigated the efficacy of mifepristone use in patients after surgical treatment of uterine myoma. It was shown that the use of mifepristone at a dose of 50 mg/day in a continuous mode for 3 months after surgical treatment for proliferating uterine myoma led to the absence of recurrences of the disease for 2 years after the drug withdrawal. The use of mifepristone after embolization of uterine arteries allowed to significantly reduce the size of the node by 25% during 12 months and by 50% (p<0.05) after 24 months. Complex treatment of uterine myoma, including myomectomy and drug therapy with mifepristone, allowed to realize reproductive function in 46% of patients, and delivery through the natural birth canal occurred in 24% of patients.

scholarly journals The Surgical Treatment of Uterine Myoma

BMJ ◽  
1890 ◽  
Vol 2 (1557) ◽  
pp. 1005-1007
Author(s):  
L. Tait
Keyword(s):  
Surgical Treatment ◽  
Uterine Myoma

scholarly journals Surgical treatment of tandem stenosis of the internal carotid artery

2021 ◽  
Vol 25 (3) ◽  
pp. 20
Author(s):  
A. D. Pryamikov ◽  
A. B. Mironkov ◽  
A. I. Khripun
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
World Literature ◽  
Large Scale ◽  
Internal Carotid ◽  
Review Article ◽  
Conflicts Of Interests ◽  
Tandem Stenosis ◽  
Instrumental Methods

<p>This review article presents an analysis of the world literature devoted to treating patients with tandem stenosis of the intra- and extra-cranial parts of the internal carotid artery. We indicate the frequency of tandem lesion occurrence and describe the applied instrumental methods of its diagnosis. The review demonstrates the results of tandem stenosis surgical treatment in both early and more modern studies and describes the possibilities of endovascular correction of extra- and intra-cranial stenosis of the internal carotid artery. The authors emphasise the lack of large-scale studies — including randomised studies — regarding combined, tandem carotid stenosis and the need for further studies.</p><p>Received 30 March 2021. Revised 8 May 2021. Accepted 11 May 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors:</strong> The authors contributed equally to this article.</p>

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

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.

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

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
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.

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

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Liselotte Mettler ◽  
Thoralf Schollmeyer ◽  
Andrea Tinelli ◽  
Antonio Malvasi ◽  
Ibrahim Alkatout
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Critical Analysis ◽  
Severe Pain ◽  
Uterine Fibroids ◽  
Statistical Analyses ◽  
Hysteroscopic Myomectomy

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.

Atrial fibrillation surgery with a focus on patients with reduced left ventricular function and heart failure

EP Europace ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 517-521
Author(s):  
Johannes Petersen ◽  
Hermann Reichenspurner ◽  
Simon Pecha
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Left Ventricular Function ◽  
Treatment Options ◽  
Left Ventricular ◽  
Review Article ◽  
Surgical Ablation ◽  
Ablation Therapy ◽  
Patients With Heart Failure

Abstract This review article aims to give an overview on the different surgical treatment options for atrial fibrillation It includes concomitant- as well as stand-alone surgical ablation therapy and outlines the main issues in patients with heart failure and reduced LVEF.

Sign in / Sign up

Export Citation Format

Share Document