The use of coffee for the prevention of ileus following abdominal surgery: A review of the current evidence

Postoperative ileus (POI) is a form of intestinal paralysis that is seen especially after surgical procedures performed by entering the abdominal cavity. POI is common, particularly after abdominal surgery, with an incidence of 8-30%. The initial phase of postoperative paralytic ileus is treated with decompression using a nasogastric tube to correct electrolyte imbalances, with analgesia applied as needed. Prokinetic compounds have been used to prevent ileus and control pain (such as serotonin receptor antagonists, neostigmine, alvimopan, and ghrelin agonists), along with early mobilization, minimally invasive surgery, early introduction of solid food into the diet, thoracic epidural analgesia, and fluids. Coffee has been shown to accelerate postoperative bowel movements. However, despite extensive research on the physiological impacts of coffee, little is acknowledged regarding how it affects the gut. Coffee increases colonic motility within 4 min of consumption. In the postoperative period, the number of intestinal vocals heard by auscultation of intestinal vocals, first gas and first defecation times of patients who consume coffee are smaller/shorter than patients who do not consume coffee. Patients who drink coffee also have shorter hospital stays

Retrospective analysis of urogynecological symptoms of patients undergoing gynecological oncology surgery

Objectives: Treating gynecological cancer with radical surgery, pelvic radiotherapy, and systemic chemotherapy may lead to pelvic floor dysfunction. Materials and Methods: Lower urinary tract symptoms are common after surgery for gynecological cancer. We used the Urogenital Distress Inventory (UDI)-6, Incontinence Impact Questionnaire (IIQ)-7, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) to compare the severity of urinary incontinence and quality of life between patients who underwent staging surgery for gynecological caner and those who underwent hysterectomy for benign disease. In total, 50 patients with cancer and 50 patients with benign disease were included in the patient and control groups, respectively. Results: There were no significant differences between the groups in terms of preoperative IIQ-7, UDI-6, and ICIQ-SF scores. There was a significant difference between the groups in scores 1 and 12 months after surgery. Postoperative IIQ-7, UDI-6, and ICIQ-SF scores were significantly increased compared to preoperative scores, although there were no significant differences between preoperative and postoperative scores in the control group. Incontinence was present after surgery in 15 (43.2%) and 4 (21.1%) patients in the test and control groups, respectively. In multivariate analyses of variance, surgery for cancer was an independent risk factor for urinary incontinence. Conclusion: Genitourinary symptoms should be evaluated in cancer patients undergoing staging procedure. The quality of life of patients should be assessed in terms of incontinence in the postoperative period

Effect of adenomyosis on prognosis of patients with endometrial cancer

OBJECTIVE: Our goal was to contrast the prognoses of patients with endometrial cancer who had adenomyosis against those that did not. METHODS: All patients who had received surgical staging for hysterectomy-based endometrial cancer had their medical data retrospectively examined. The analysis covered 397 patients, who were split into two groups depending on the presence of adenomyosis. Comparisons were made between patients covering type of surgery, histopathology, endometrial cancer stage, lymphovascular space invasion, presence of biochemical or histochemical markers, adjuvant therapy, presence of adenomyosis in the myometrial wall, and outcomes in terms of overall survival and disease-free survival. RESULTS: There is no statistically significant difference in the 5-year disease-free survival or overall survival rates between endometrial cancer patients with and without adenomyosis. This is based on comparisons of tumor stage, tumor diameter, histological type and grade of tumor, myometrial invasion, lymphovascular space invasion, and biochemical markers that affect the course of the disease. The median follow-up times were 61 months for the adenomyosis-positive group and 56 months for the group without adenomyosis. CONCLUSION: Coexisting adenomyosis in endometrial cancer has no bearing on survival rates and is not a prognostic factor

Isolated pulmonary metastases in patients with cervical cancer and the factors affecting survival after recurrence

Objectives: The aim of this study was to assess the treatment options and survival of uterine cervical cancer (UCC) patients who develop isolated pulmonary metastases (IPM) and to establish risk factors for IPM.Material and Methods: Data from patients diagnosed with UCC between June 1991 and January 2017 at the Gynecological Oncology Department, Tepecik Training and Research Hospital, were investigated. In total, 43 cases with IPM were evaluated retrospectively. Additionally, 172 control patients diagnosed with UCC without recurrence were matched according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 stage when the tumor was diagnosed. They wereselected using a dependent random sampling method.Results: Of the 890 patients with UCC, 43 (4.8%) had IPM. The presence of lymphovascular space invasion (LVSI) anda mid-corpuscular volume (MCV) < 80 fL were statistically significant prognostic factors for IPM development in UCC patientsaccording to univariate regression analyses, and the presence of LVSI, a hemoglobin level < 12 g/dL, and an MCV < 80 fLwere statistically significant according to the multivariate regression analyses. We were unable to assess the role of lymph node status (involvement or reactive) as a prognostic factor in the development of IPM, because only seven patients (16.2%) in the case group underwent lymph node dissection.Conclusions: IPM typically develops within the first 3 years after the diagnosis of UCC, and survival is generally poor. AnMCV < 80 fL and the presence of LVSI are significant risk factors for IPM development

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

Objectives: This study was performed to investigate prognostic factors status at smaller tumors in patients with stageIB1 cervical cancer (CC) who underwent modified radical or radical hysterectomy.Matherial and metods: Data from patients diagnosed with CC between January 1995 and January 2017 at the GynecologicalOncology Department, Tepecik Training and Research Hospital and Bakirkoy Dr. Sadi Konuk Training and Research Hospital,Istanbul, Turkey, were investigated. A total of 182 stage IB1 CC cases were evaluated retrospectively.Results: Patients were divided into two groups according to tumor size (< 2 cm and ≥ 2 cm). There were no complicationsassociated with the operation in patients with a tumor size < 2 cm. Among patients with a tumor size ≥ 2 cm, however, 0.9% (n = 1) developed bladder laceration, 0.9% (n = 1) rectum laceration, and 0.9% (n = 1) pulmonary emboli (P = 0.583). The rates of intermediate risk factors (depth of stromal invasion and lymphovascular space invasion) were significantly higher and lymph node involvement significantly more frequent in patients with a tumor size ≥ 2 cm. However, there were no significant differences in parametrial invasion or vaginal margin involvement between the two groups.Conclusions: Intermediate risk factors and lymph node metastasis were significantly less frequent in patients with smalltumors measuring < 2 cm. However, although parametrial involvement and vaginal margin involvement were less common in patients with small tumors compared with large tumors (≥ 2 cm), the differences were not significant

Laparoscopic surgery of large adnexal masses (>12 cm): Single port or conventional?

Introduction We aimed to compare single-port laparoscopic surgery (SPLS) and conventional multiport laparoscopic surgery (CMLS) for large adnexal mass (AM).Methods Patients undergoing laparoscopy (LS) due to huge AMs (>= 12 cm) between 2016 and 2021 were evaluated retrospectively. The SPLS procedure was applied in 25 cases, and CMLS was performed in 32 cases. The premier result was the grade of the postoperative improvement according to the Quality of Recovery (QoR)-40 questionnaire score (24 h after the surgical procedure; postoperative day 1). Observer Scar Assessment Scale (OSAS) and Patient Observer Scar Assessment Scale (PSAS) were also evaluated.Results A total of 57 cases undergoing SPLS (n = 25) or CMLS (n = 32) due to a large AM (>= 12 cm) were analyzed. No meaningful distinctions in age, menopausal status, body mass index, or mass size were observed between the two cohorts. The operation time was shorter in the SPLS than CPLS cohort (42.2 +/- 3.3 vs. 47.6 +/- 6.2; p < 0.001). Unilateral salpingo-oophorectomy was performed in 84.0% of cases in the SPLS cohort and 90.6% of patients in the CMLS cohort (p = 0.360). The QoR-40 points were significantly higher in the SPLS than the CMLS group (154.9 +/- 12.0 vs. 146.2 +/- 17.1; p = 0.035). The OSAS and PSAS scores were lower in the SPLS than the CMLS group.Conclusion LS can be used for large cysts that are not considered to be at risk of malignancy. The postoperative recovery time was shorter in patients undergoing SPLS compared to CMLS

Transvaginal natural orifice transluminal endoscopic surgery (VNOTES) total retroperitoneal sentinel lymph node biopsy for an endometrial cancer patient with prior colon cancer surgery

Endometrial cancer (EC) is the most common gynecological malignancy. Although EC is surgically staged, sentinel lymph node biopsy has become more widely used and has been featured in recently published guidelines for EC

Robotic platforms for endometrial cancer treatment: review of the literature

INTRODUCTION: The cornerstone in the management of endometrial cancer (EC) is surgical staging. Over the last few decades, minimally invasive surgery has been widely accepted as a mainstay in the treatment of endometrial cancer. The first robotic-assisted gynecological surgery was performed in 1998. EVIDENCE ACQUISITION: The literature search was conducted using MEDLINE, EMBASE and PUBMED databases from January 1998 to September 2020. EVIDENCE SYNTHESIS: Several studies have reported the advantages of robotic-assisted surgery over laparoscopy in the management of EC. These are most pronounced in obese patients. Robotic-assisted surgery is also associated with a shorter learning curve, particularly for lymphadenectomy, which enables more surgeons to perform minimally invasive surgery for EC. CONCLUSIONS: The effectiveness and oncological results of robotic surgery for EC appear to be similar to those of other surgical methods, but fewer intraoperative complications occur than with other methods

Paracervical block before laparoscopic total hysterectomy: A randomized controlled trial

Objective: To test the hypothesis that paracervical block with 0.5 % bupivacaine decreases postoperative pain after total laparoscopic hysterectomy (TLH). Materials and method: This randomized double-blind placebo control trial included 152 women. We injected 10 mL 0.5 % bupivacaine (study group, n = 75) or 10 mL normal saline (control group, n = 77) at the 3 and 9 o'clock positions of the uterine cervix. The primary outcome was the visual analog scale score (VAS) determined 1 h (h) postoperatively. Results: The 152 patients did not differ in their baseline demographics or perioperative characteristics. The mean VAS 1 h postoperatively was significantly lower in the study group than in controls (5.7 ± 1.2 vs. 6.8 ± 1.1, P < 0.001). The average VAS at 30 min, 3 h, and 6 h postoperatively was also significantly lower in the study group. Patients in the study group had a significantly lower analgesic requirement than did controls during the first 24 h postoperatively (6 [7.8 %] vs. 16 [21 %], P = 0.021). Total QoR-40 questionnaire scores were higher in patients who received bupivacaine. Conclusion: Paracervical bloc with 0.5 % bupivacaine just before TLH is an effective and safe method to reduce pain and lower postoperative analgesic requirement. URL link that leads directly to the trial registration: https://clinicaltrials.gov/ct2/show/NCT05341869?cond=NCT05341869&draw=2&rank=1

Effects of human papillomavirus and LEEP on sexual function

Background: Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection in humans. Aims: We evaluated the sexual function of human papillomavirus positive patients after colposcopy and loop electrosurgical excision procedure (LEEP). Methods: This study enrolled 344 patients with an HPV infection detected on routine screening in 2020–2022. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of six sections: desire, arousal, lubrication, orgasm, satisfaction, and pain. Results: The mean age of the 344 HPV-positive patients was 37.2 ± 8.2 years, and 28.2% of them were unmarried. Colposcopy, cervical biopsy, and LEEP were performed in 251 (73.0%), 189 (54.9%), and 42 (12.2%) patients, respectively. The sexual history and FSFI scores of the patients were recorded. The total and individual parameter scores on the FSFI decreased significantly after colposcopy. Similarly, the total and individual parameter scores on the FSFI were lower at 8 weeks after LEEP compared to those before LEEP. Conclusion: Cancer-related fear and anxiety and LEEP may cause sexual dysfunction in HPV-positive patients