Purpose: To assess myometrial invasion and cervical invasion by endometrial carcinoma, using CO 2 -volumetric interpolated breathhold examination (VIBE) enabling more precise evaluation of depth of tumor invasion.Materials and Methods: CO 2 -VIBE was performed in 21 cases of endometrial carcinoma (Stage Ia-IIb) prior to treatment. The images were interpreted by performing multiplanar reconstruction (MPR), and the findings obtained from the images (degree of myometrial invasion and presence or absence of cervical invasion) were assessed in comparison with the histopathological diagnosis.
Results:The sites of the endometrial carcinoma lesions were clearly visualized by the CO 2 -VIBE method. Evaluation of the degree of myometrial invasion enabled a high correct diagnosis rate of 90.5%, and evaluation for the presence of cervical invasion also allowed a high correct diagnosis rate of 90.5%.
Conclusion:VIBE permits evaluation of any plane desired by means of thin slices, and it is a truly revolutionary method for preoperative evaluation of depth of invasion of endometrial carcinoma that enables highly accurate determination of the extent of lesion sites and degree of invasion before treatment.
The evolution of therapy for malignant ovarian germ cell tumors is one of the true success stories in oncology. Treatment outcome has improved greatly thanks to cisplatin-based combination chemotherapy. According to the well-established treatment guidelines for advanced cases, we treated a case of stage IV undifferentiated germ cell tumor in which we were able to preserve the patient’s fertility. We concluded that the PEP regimen is an effective treatment for the patient with metastatic germ cell tumor.
Background:Laparoscopic myomectomy is more difficult than other laparoscopic surgeries because it requires advanced techniques such as extensive suturing and ligation, traction removal of the fibroids, and removal of the fibroids from the bodyObjective:To evaluate the usefulness of gasless reduced port laparoscopic myomectomy using a subcutaneous abdominal wall lifting method developed by us.Study Design:In gasless reduced port laparoscopic myomectomy, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed, and a 5-mm trocar is punctured in the fossa of the umbilicus to create a laparoscopic port under the supervision of an endoscope. The surgeon inserts multiple instruments through the Lap Protector and performs the operation, while the assistant operates the laparoscope and uterine manipulator.Results:Gasless reduced port laparoscopic myomectomy was performed in 966 patients. The operative time (mean ± standard deviation) was 156 ± 56 min, blood loss was 157 ± 214 ml, fibroid weight was 174 ± 123 g, number of fibroids removed was 5.0 ± 4.3, and hospital stay was 5.7 ± 5.1 days. The number of complications of this method was remarkably low at 5 out of 966 cases (0.5 %), blood transfusion was 3 out of 966 cases (0.3 %), and there were no cases that were converted to laparotomy. The average number of sutures per case was 21, and the average suture time was 12 seconds, with the posterior wall taking longer to suture than the anterior wall. The average surgical wound size was 1.5 cm.Conclusion:Gasless reduced port laparoscopic myomectomy is a suitable surgical laparoscopic myomectomy because it allows powerful grasping and traction of the fibroid and rapid and reliable suture and ligation, despite having only one port for the procedure. In addition, it is a new laparoscopic myomectomy that is economical due to the reduction of manpower and disposable products.
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