This is a repository copy of An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45.
Background
Most serous ovarian cancers are now understood to originate in the fallopian tubes. Removing the tubes (salpingectomy) likely reduces the risk of developing high‐grade serous ovarian cancer. Numerous gynaecological societies now recommend prophylactic (or opportunistic) salpingectomy at the time of gynaecological surgery in appropriate women, and this is widely done. Salpingectomy at the time of non‐gynaecological surgery has not been explored and may present an opportunity for primary prevention of ovarian cancer.
Methods
This study investigated whether prophylactic salpingectomy with the intention of reducing the risk of developing ovarian cancer would be accepted and could be accomplished at the time of elective laparoscopic cholecystectomy. Women aged at least 45 years scheduled for elective laparoscopic cholecystectomy were recruited. They were counselled and offered prophylactic bilateral salpingectomy at the time of cholecystectomy. Outcome measures were rate of accomplishment of salpingectomy, time and procedural steps needed for salpingectomy, and complications.
Results
A total of 105 patients were included in the study. The rate of acceptance of salpingectomy was approximately 60 per cent. Salpingectomy was performed in 98 of 105 laparoscopic cholecystectomies (93·3 per cent) and not accomplished because of poor visibility or adhesions in seven (6·7 per cent). Median additional operating time was 13 (range 4–45) min. There were no complications attributable to salpingectomy. One patient presented with ovarian cancer 28 months after prophylactic salpingectomy; histological re‐evaluation of the tubes showed a previously undetected, focal serous tubal intraepithelial carcinoma.
Conclusion
Prophylactic salpingectomy can be done during elective laparoscopic cholecystectomy.
High-grade serous ovarian carcinomas originate in the fallopian tube 1 , and salpingectomy is associated with a considerable risk reduction for ovarian cancer. 2,3 Numerous professional societies have recommended so-called opportunistic salpingectomy at the time of gynecologic surgery in appropriate women, 4,5 so nongynecologic procedures, such as laparoscopic cholecystectomy, might afford an opportunity for salpingectomy.
Introduction: Treatment for vulvodynia is challenging and a multidisciplinary approach is recommended.Aim: To examine the effectiveness, safety and treatment satisfaction of vulvovaginal microablative laser treatment for vulvodynia. Methods: Case study of women who received laser treatment as part of a multidisciplinary treatment program for vulvodynia. Subjective improvement was compared to a retrospective cohort of women treated for vulvodynia without LASER therapy. LASER treatment was offered to women with vulvodynia presenting to a gynecologic pain clinic of a tertiary university hospital. LASER treatments were performed with a microablative 2,940 nm Er: YAG LASER and potentially repeated after 1 month. Main outcome measures: Change in local vulvar pain was assessed with cotton-swab tests and rated on a numeric rating scale (NRS). Treatment discomfort and short-term adverse events were recorded. The Freiburg Index of Patient Satisfaction was used to assess treatment satisfaction. Subjective symptom improvement was assessed with the Patient Global Impression of Improvement questionnaire. Results: 35 women received at least 1 laser treatment, with overall mild treatment adverse effects (mean pain NRS 2.4 § 1.9) and good treatment satisfaction (mean total score of 27.6 § 5.1; potential range 8−32). One month after last LASER treatment the pain NRS on vulvar cotton swab test improved from 6.1 § 2.6 at baseline to 3.1 § 2.6 (P < .001), and 74% of women (n = 26) reported symptom improvement. At 9−12 months follow-up 66% reported ongoing symptom improvement, with no significant difference to the control group of 32 women. Conclusion: Microablative Er:YAG vulvovaginal LASER therapy appears safe and well accepted among vulvodynia patients, but there was no significant difference in symptom improvement compared to a control group. G
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