Background: The prediction of antibiotic treatment failure is helpful to identify patients with a high likelihood of needing surgical treatment early in patients diagnosed with tubo-ovarian abscess (TOA). The aim of this study was to compare the clinical characteristics of patients with TOA) who responded to medical treatment and those who underwent surgical intervention due to medical treatment failure. Material and Methods: Electronic medical records were evaluated retrospectively to identify patients who were diagnosed with TOA and hospitalized in our obstetrics and gynecology department between March 2014 and June 2019. Demographic, clinical, and laboratory data including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were compared between the medical treatment group and the surgical intervention group. Logistic regression was used to determine the independent predictors of treatment failure. Results: Patient age, TOA diameter, WBC count, CRP, and ESR were signi cantly different between the groups. On multiple regression analysis, signi cant correlations were identi ed between age (p = 0.001), ESR (p = 0.045), and failure of medical treatment. TOA diameter (p = 0.065) showed a borderline association with surgical intervention. The risk group was de ned as the combination of factors producing a risk score > 2. The area under the curve (AUC) for the risk group (age >34.3 years, ESR > 45 mm/h, and TOA size > 5.9 cm) was 0.844.
This study aimed to compare the risks of intraoperative and postoperative urologic complications after robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). Data Sources: We searched Pubmed, EMBASE, and the Cochrane Library for studies published up to March 2019. Related articles and relevant bibliographies of published studies were also checked. Methods of Study Selection: Two researchers independently performed data extraction. We selected comparative studies that reported perioperative urologic complications. Tabulation, Integration, and Results: Twenty-three eligible clinical trials were included in this analysis. When all studies were pooled, the odds ratio for the risk of any urologic complication after RRH compared with LRH was .91 (95% confidence interval [CI], .64−1.28; p = .585). The odds ratios for intraoperative and postoperative complications after RRH versus LRH were .86 (95% CI, .48−1.55; p = .637) and .94 (95% CI, .64−1.38; p = .767), respectively. In a secondary analysis study quality, study location, and the publication year were not associated with intraoperative or postoperative urologic complications. Conclusion: Current evidence suggests that RRH is not superior to LRH in terms of perioperative urologic complications.
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