Can coffee consumption be used to accelerate the recovery of bowel function after cesarean section? Randomized prospective trial

Objectives: To evaluate whether coffee consumption accelerates the recovery of bowel function after cesarean section or not.Material and methods: This study was designed as randomized controlled study. Patients were randomly assigned to oneof two groups: Ultimately, Group 1 (n = 51) was the study group and drank three cups of coffee after cesarean, whereasgroup 2 (n = 52) was not given any treatment. The primary outcome measure was the time to first defecation after surgery,the secondary outcomes were time to first bowel movement, passage of flatus, time to toleration of a solid diet, additionalantiemetic and analgesic requirement.Results: There were no significant differences in demographic variables between the groups. The mean time to passageof first flatus was significantly shorter in the study group than the control group (8.6 ± 3.3 h vs 11.3 ± 7.5 h, respectively;p = 0.022). First defecation was 20.7 ± 11.5 h for the study group and at 29.1 ± 14.3 h for the control group (p = 0.001). Inaddition, there was a significant difference in mean time to toleration of solid food between the study and control groups(8.78 ± 2.33 h vs 12.88 ± 4.2.60 h, respectively; p < 0.001).Conclusions: Coffee can be used in patients to enhance the recovery of gastrointestinal function after elective cesareansection

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY

Objective: To analyze the expression patterns of extracellular signal-regulated kinase (ERK1/2) and phosphorylated (p)-AKT in the tissues of non-pathologic endometrium, endometrial hyperplasia, and early and advanced stage endometrioid endometrial adenocancer using indirect immunohistochemistry, and also to investigate the effect of ERK1/2 and p-ART expression patterns on prognosis in endometrioid adenocancer. Study design: Immunolocalization of ERK1/2 and p-Ala was examined in six different types of endometrial tissues: proliferative endometrium (PE; n = 10, 11.2%), secretuar endometrium (SE; n = 10, 11.2%), simple hyperplasia (SH; n = 15,16.9%), complex hyperplasia (CH; n=3, 3.4%) and atypical complex hyperplasia (ACH; n = 10, 11.2%), which were obtained from endometrial biopsies, curettage materials, and hysterectomy specimens and classified as the benign group; and both early stage endometrioid (n = 21, 23.6%) and advanced stage endometrioid adenocancer (AC; n=20, 22.5%), which were obtained from complete surgical staging materials and classified as the malignant group. All specimens were fixed in 10% formalin and processed using routine paraffin protocols. Immunostaining intensities were evaluated as negative or weak (assigned as low expression) and moderate or strong (assigned as high expression). Results: In the malignant group, 23 of 41 patients (56.1%) had high ERK1/2 and p-AKT expression, whereas only three of 48 patients in the benign group (6.3%) had high ERK1/2 and p-ART expression (P < 0.0001 and P < 0.0001, respectively), p-ART expression was significantly higher in women with positive lymph nodes (OR 9.0; 95% CI: 1.2-100.0; P = 0.03). Higher expression of p-Ala was significantly associated with poor progression-free survival (PFS) and overall survival (OS). In contrast, ERK1/2 expression was not associated with PFS or OS. Conclusions ERK1/2 and p-ART can be useful in the differential diagnosis of benign vs. malignant endometrial lesions, as well as early vs. advanced stage endometrioid endometrial adenocancer. Additionally, higher p-ART expression could be used as a marker of poor prognosis in the management of patients with endometrioid endometrial adenocancer. (C) 2014 Elsevier Ireland Ltd. All rights reserved

Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial

BACKGROUND: Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation

Is the measurement of the size of uterine lesions with positron emission tomography consistent in pre- and postmenopausal periods in endometrioid-type endometrial cancer?

Objective: We aimed to investigate the correlation of the size and volume of uterine tumors obtained using positron emission tomography/computed tomography (PET/CT) and pathology specimens in patients with endometrioid-type endometrial cancer (EEC) in the premenopausal period, and to compare the results with those of postmenopausal women. In the premenopausal period, the endometrium uses more glucose than in the postmenopausal period. Therefore, the measurement of uterine tumor size using PET/CT in the premenopausal period may normally be different

MELF Pattern for Predicting Lymph Node Involvement and Survival in Grade I-II Endometrioid-type Endometrial Cancer

The aim of this study was to examine the associations between microcystic, elongated, and fragmented (MELF) pattern and other prognostic factors and lymph node involvement, disease-free survival, and overall survival (OS) using a case-control group consisting of grade I-II endometrioid endometrial carcinoma (EEC) patients with/without lymph node involvement. The files of the patients were searched electronically for all hysterectomy specimens with a diagnosis of grade I-II EEC of the uterine body from January 1, 2008 to July 31, 2014. Lymph node involvement was detected in 27 patients who were histologically diagnosed with grade I-II EEC, and these patients made up the case group. Using a dependent random sampling method, 28 grade I-II EEC patients without lymph node involvement were selected. According to multivariate regression analysis, lymphovascular space invasion [odds ratio, 23.5; 95% confidence interval (CI), 2.4-223.5] and MELF pattern (odds ratio, 13.3; 95% CI, 1.4-121.8) were significant predictors of lymph node involvement. There was recurrence in 15.8% of cases that showed a MELF pattern and in 19.4% of those that did not (P=0.738). According to Kaplan-Meier analysis, the MELF pattern revealed no significant differences in disease-free survival (hazard ratio, 1.0; 95% CI, 0.1-36.5), whereas the effect on OS was significant (hazard ratio, 2.2; 95% CI, 1.3-4.2). The presence of MELF pattern was a substantial risk factor for detecting lymph node involvement in patients with grade I-II EEC. The MELF pattern may be important for identifying which patients need staging surgery, in addition to its effect on the OS

Management of Isolated Vaginal Metastasis in Squamous Cell Cervical Cancer: 23 Years' Experience at a Single Center

Aim: The aim of this study was to investigate the treatment options and survival of cervical cancer (CC) patients who develop isolated vaginal metastasis (IVM), and to establish risk factors for IVM. Patients and Methods: A total of 21 cases with IVM were evaluated retrospectively. In addition, 42 control patients diagnosed with CC without recurrence were matched. Tumor size, depth of stromal invasion (DOI), lymphovascular space invasion (LVSI), and size of vaginal and lymph node metastases were analyzed in accordance with the pathology reports. Patients who had IVM were investigated in terms of treatment options (chemotherapy (CT), radiotherapy (RT), or chemoradiotherapy (CRT)) and survival. Results: After detection of IVM, the 1-, 3-, and 5-year survival rates were 57.1, 23.8, and 9.5%, respectively. The mean survival time after metastasis detection was 23.1 +/- 31.3 months. LVSI, DOI >= 1/2, hemoglobin = 4 cm were independent risk factors for IVM. The 5-year survival rates were 30.0% for patients receiving RT, 17.1% for patients receiving CRT, and 0% for patients receiving CT. Conclusion: IVM typically develops within the first 2 years after the diagnosis of CC, and survival is generally poor. RT was the most effective treatment in patients with IVM. (C) 2016 S. Karger GmbH, Freibur

Management of Vertebral Metastasis in Patients With Uterine Cervical Cancer

Aim We sought to identify risk factors and management options for uterine cervical cancer (UCC) patients with a vertebral metastasis (VM) treated over the course of 23 years

Preoperative predictors of pelvic and para-aortic lymph node metastases in cervical cancer

Aim: This study investigated potential preoperative predictors of pelvic lymph node (PLN) and para-aortic LN (PaLN) involvement in cervical cancer (CC).Materials and Methods: This study retrospectively analyzed 283 patients diagnosed with early (stage IA1-IIA) CC who underwent retroperitoneal LN dissection between January 1992 and February 2015. Several risk factors that are believed to influence PLN and PaLN involvement in CC were analyzed as follows: age >50 years, lymphovascular space invasion (LVSI), tumor size >= 2 cm, hemoglobin <12 g/dL, and nonsquamous cell histologic type.Results: LVSI (odds ratio [OR] = 11.3, 95% confidence interval [CI] = 5.2-24.3) and tumor size (OR = 3.2, 95% CI = 1.4-7.2) were independent predictors of PLN involvement. None of the factors predicted PaLN involvement in a regression analysis. However, all nine patients who had PaLN involvement also had PLN involvement.Conclusion: LVSI and tumor size independently increase the risk of PLN involvement

Comparison of laparoscopic adnexal mass extraction via the transumbilical and transvaginal routes

This study was performed to compare the transumbilical (TU) and transvaginal (TV) routes for adnexal mass removal from the abdominal cavity. Data from 93 women who underwent laparoscopic (LS) surgery for the removal of benign adnexal masses at three centres between January 2016 and December 2020 were examined retrospectively. The specimen retrieval times in the TU and TV groups were 9.0 +/- 2.0 and 9.8 +/- 2.5 min, respectively (p = .373). Additional analgesic was required in 13.8% and 14.3% of cases in the TU and TV groups, respectively. The mean 3-month (2-4 months) postoperative visual analogue scale (VAS) score was lower in the TV group than in the TU group. The postoperative vaginal length did not differ between the TU and TV groups (8.9 (8.7-9.1) vs. 8.7 (8.4-9.1) cm; p = .465). Oophorectomy and the TU route were found to be independent risk factors for the worsening of the VAS score. Sexual function index scores were similar in the two groups. The TV method for specimen removal in LS surgery may cause less pain in the early postoperative period and less dyspareunia in the later period without shortening the length of the vagina.Impact Statement What is already known on this subject? Compared with open procedures, minimally invasive surgery (MIS) is associated with faster recovery times, better patient quality of life and lower postoperative complication rates. The removal of an adnexal mass from the abdominal cavity is performed most commonly using the suprapubic, transumbilical (TU) or transvaginal (TV) route. What do the results of this study add? The specimen retrieval times in the TU and TV groups were 9.0 +/- 2.0 and 9.8 +/- 2.5 min, respectively (p = .373). The mean 3-month (2-4 months) postoperative visual analogue scale (VAS) score was lower in the TV group than in the TU group. Oophorectomy and the TU route were found to be independent risk factors for the worsening of the VAS score. Sexual function index scores were similar in the two groups. What are the implications of these findings for clinical practice and/or further research? In conclusion, specimen removal via the TV route in LS surgery may cause less pain in the early postoperative period and less dyspareunia in the later period without reducing the length of the vagina