A 55-year-old female who had been diagnosed with stage 4 pancreatic cancer visited the emergency department of our hospital owing to sudden lower abdominal pain and was found to have an ovarian tumor. An urgent laparoscopic resection of the right adnexa was performed with a diagnosis of ovarian tumor stalk torsion. Postoperative pathological diagnosis revealed ovarian metastasis of pancreatic cancer. Our case report demonstrates that an ovarian tumor on one side in a patient with advanced pancreatic cancer may represent ovarian metastasis of the primary tumor.
Background/Objective:Although robotic and laparoscopic total hysterectomies are widely used as minimally invasive procedures, consensus on which is superior regarding lesser postoperative pain is lacking. Thisstudy determines whether there is a difference in the proportion of postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen between robotic and laparoscopic total hysterectomies.
Methods: This retrospective cohort study enrolled patients who underwent robotic or laparoscopic total hysterectomy for uterine fibroids, adenomyosis, or cervical intraepithelial neoplasia grade 3 at a hospital between July 2016and November 2021. The outcome was postoperative analgesics (i.e., NSAIDs or acetaminophen) use. Unadjusted and adjusted logistic regression analyses were performed to evaluate the association between the procedure and outcome. Adjusted variables were age, body mass index, surgeon’s laparoscopic technique certification, intravenous patient-controlled analgesia, and wound local anesthesia.
Results: Of 127 patients, 3 were excluded, and 124 were included. Robotic and laparoscopic hysterectomy was performed in 38 and 86 patients, respectively. Postoperative analgesics were administered to 10 (26.3%) and 52 (60.5%) patients in the robotic and laparoscopic groups, respectively. Unadjusted logistic regression analysis showed significantly more frequent analgesics use in the laparoscopy group (odds ratio [OR] 4.28; 95% confidence interval [CI] 1.85–9.93; p < 0.01). Adjusted logistic regression analysis did not detect significant differences (OR 2.62; 95% CI 0.91–7.56; p = 0.07).
Conclusion: No significant difference in the proportion of postoperative analgesia was observed betweenrobotic total hysterectomy and laparoscopy. Future studies must include largersample sizes andaligned intraoperative and postoperative analgesic management.
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