4 research outputs found
Quality of life and sexual function in patients aged 35 years or younger undergoing hysterectomy for benign gynecologic conditions: A prospective cohort study
Objective: To evaluate how hysterectomy performed for benign gynecologic pathologies affects the quality of life and sexual function of patients aged 35 years or younger,
and if outcomes differ according to the surgical technique.
Methods: Seventy-three patients who underwent total laparoscopic hysterectomy
(TLH), supracervical laparoscopic hysterectomy (SLH), or vaginal hysterectomy (VH)
for benign uterine disorders between April 2014 and June 2020 at the Department of
Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany, were
enrolled in this prospective observational cohort study. Quality of life and sexual
function were assessed preoperatively and 6 months postoperatively using standardized validated questionnaires: the European Quality of Life Five-Dimension Scale
(EQ-5D) and the Female Sexual Function Index (FSFI).
Results: Thirty-three (45%) patients underwent TLH, 25 (34%) underwent SLH, and
15 (21%) patients underwent VH. The median preoperative EQ-5D score, FSFI score,
and EQ-5D visual analog scale were 0.9 (range 0.62–1), 19.25 (range 2.4–27.4), and 50
(range 0–100); postoperative scores were 1 (range 0.61–1), 24.15 (range 3.9–29.3), and
90 (range 30–100), respectively (P ≤ 0.001). Postoperative scores were significantly
higher than preoperative scores, with no significant difference according to the surgical technique.
Conclusion: Hysterectomy for benign indication in women aged 35 years or less significantly improved the patients' quality of life and sexual function with no differences regarding the surgical technique
Laparoscopic Fertility-Sparing Surgery for Early Ovarian Malignancies
The demand for fertility-sparing surgery (FSS) has increased in the last decade due to
increased maternal age, increased incidence of ovarian malignancies in younger patients, and technical advances in surgery. Data on oncological safety and fertility outcomes of patients with ovarian
cancer after laparoscopic FSS are sparse, but some retrospective studies have shown that open FSS
may be offered to selected patients. We assessed the role of minimally invasive FSS in comparison
with radical surgery (RS) in terms of oncological safety and reproductive outcomes after FSS in this
multicenter study. Eighty patients with FIGO stage I/II ovarian cancer treated with laparoscopic
FSS or RS between 01/2000 and 10/2018 at the participating centers (comprehensive gynecological
cancer centers with minimally invasive surgical expertise) were included in this retrospective analysis
of prospectively kept data. Case–control (n = 40 each) matching according to the FIGO stage was
performed. Progression-free survival [150 (3–150) and 150 (5–150) months; p = 0.61] and overall
survival [36 (3–150) and 50 (1–275) months; p = 0.65] did not differ between the FSS and RS groups.
Eight (25.8%) women became pregnant after FSS, resulting in seven (22.5%) deliveries; three (37.5%)
patients conceived after in vitro fertilization, and five (62.5%) conceived spontaneously. Laparoscopic
FSS seems to be applicable and oncologically safe for patients with early-stage ovarian cancer, with
adequate fertility outcomes
Diagnostic performance of 18F-fluorodeoxyglucose-PET/MRI versus MRI alone in the diagnosis of pelvic recurrence of rectal cancer
Purpose!#!To compare the diagnostic performance of !##!Methods!#!All PET/MRIs of patients in the follow-up of rectal cancer performed between 2011 and 2018 at our institution were retrospectively reviewed. Recurrence was confirmed/excluded either by histopathology or imaging follow-up (> 4 months). Four groups of readers (groups 1/2: one radiologist each, groups 3/4: one radiologist/one nuclear medicine physician) independently interpreted MRI and PET/MRI. The likelihood of recurrence was scored on a 5-point-scale. Inter-reader agreement, sensitivity, specificity, PPV/NPV and accuracy were assessed. ROC curve analyses were performed.!##!Results!#!Fourty-one PET/MRIs of 40 patients (mean 61 years ± 10.9; 11 women, 29 men) were included. Sensitivity of PET/MRI in detecting recurrence was 94%, specificity 88%, PPV/NPV 97% and 78%, accuracy 93%. Sensitivity of MRI was 88%, specificity 75%, PPV/NPV 94% and 60%, accuracy 85%. ROC curve analyses showed an AUC of 0.97 for PET/MRI and 0.92 for MRI, but the difference was not statistically significant (p = 0.116). On MRI more cases were scored as equivocal (12% versus 5%). Inter-reader agreement was substantial for PET/MRI and MRI (0.723 and 0.656, respectively).!##!Conclusion!#!1