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[PMID]: 29384844 [Au] Autor: You JP; Lu L; Li CJ; Ren B; Wang T [Ad] Endereço: Department of Emergency. [Ti] Título: Modified trapeziectomy with ligament reconstruction tendon interposition for the treatment of advanced thumb carpometacarpal arthritis: A case report. [So] Source: Medicine (Baltimore);97(5):e9665, 2018 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Thumb carpometacarpal (CMC) arthritis is a common disease. Various procedures have been described for the treatment of advanced thumb CMC arthritis. This essay shows a CMC arthritis case treated by modified trapeziectomy with ligament reconstruction tendon interposition (LRTI). PATIENT CONCERNS: A 53-year-old Chinese female complained of pain and swelling at the base of the left thumb for 10 years. Visual analog scale (VAS) for thumb was 7 points, Disabilities of Arm, Shoulder and Hand (DASH) score was 51 points, and Kapandji score was 6 points before surgery. Preoperative range of motion (ROM) for radial abduction and volar abduction were 63°and 62°, respectively. Grip power was 15.3 kg and key-pinch power was 1.8 kg before operation. Preoperative waist flexion power was 20.9 kg. Hand x-ray showed left thumb CMC arthritis in Eaton stage III and the height of the trapezial space was 10 mm. DIAGNOSES: She was diagnosed with left thumb CMC arthritis (Eaton III stage). INTERVENTIONS: The patient underwent modified trapeziectomy with LRTI. After exposing and removing trapezium, and a hole from the dorsal base to the center of the articular surface was drilled. Then we cut the whole flexor carpi radialis and divided it into 2 halves. Afterward, we passed one-half through the hole and tied it to the other part and sutured them. The rest tendon was then tied continuously and sutured. Then we rolled it up into the space where previous trapezium was located. OUTCOMES: Two years after operation, pain and swelling relieved and no recurrence of the clinical symptoms occurred. VAS, DASH, and Kapandji score were 2, 22, 7 points, respectively. ROM for radial abduction and volar abduction were 79° and 78°, respectively. Furthermore, grip power was 22.7 kg and key-pinch power was 3.8 kg. Waist flexion power was 20.0 kg. Hand x-ray showed that the height of the trapezial space was 9.8 mm. LESSONS: Modified trapeziectomy with LRTI in treatment of advanced thumb CMC arthritis had a satisfactory efficacy. This new procedure not only prevents thumb sinking, but also provides enough support for thumb. [Mh] Termos MeSH primário: Articulações Carpometacarpais Ligamentos/cirurgia Osteoartrite/cirurgia Procedimentos Cirúrgicos Reconstrutivos Tendões/cirurgia Trapézio/cirurgia [Mh] Termos MeSH secundário: Articulações Carpometacarpais/diagnóstico por imagem Articulações Carpometacarpais/cirurgia Feminino Seres Humanos Meia-Idade Procedimentos Ortopédicos Osteoartrite/diagnóstico por imagem Polegar/diagnóstico por imagem Polegar/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180221 [Lr] Data última revisão: 180221 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009665

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[PMID]: 29224568 [Au] Autor: Li A; Hu R; Zhou D; Li S; Huang D; Wei X; Cao Z [Ad] Endereço: Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 JieFang Avenue, Wuhan, 430030, Hubei, China. [Ti] Título: Internal herniation through lesser omentum hiatus and gastrocolic ligament with malrotation: a case report. [So] Source: J Med Case Rep;11(1):344, 2017 Dec 11. [Is] ISSN: 1752-1947 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Internal herniation through lesser omentum hiatus and gastrocolic ligament with malrotation is extremely rare. This type of internal hernia has rarely been described before. Preoperative diagnosis is difficult and prone to misdiagnosis. CASE PRESENTATION: A 38-year-old Chinese woman was an emergency admission to our hospital with a sudden onset of acute epigastralgia for the past 14 hours. We made a presumptive diagnosis of gastrointestinal perforation and septic shock. Due to the acute onset and rapid progress, she received timely surgical treatment. During operation, we observed that her small intestine herniated into the hepatogastric ligament and ligamentum gastrocolicum hiatus accompanied with intestinal malrotation that resulted in internal hernia. We found a diverticulum of approximately 3.0 × 6.0 cm sited at a distance of 80 cm from the ileocecal intestine. We resected the strangulated intestinal loop and the diverticulum, performed an appendicectomy, and closed the ligamentous fissure. Postoperation, she recovered smoothly, without any complications, and was discharged on day 6. CONCLUSIONS: A case of internal hernia formation is quite rare; accurate preoperative diagnosis and timely surgery are essential because it can cause strangulation of the ileus. However, the incidence of this internal herniation is low and preoperative diagnosis is difficult. An accurate preoperative diagnosis of internal hernia is still a challenge. [Mh] Termos MeSH primário: Hérnia Herniorrafia/métodos Volvo Intestinal/cirurgia Intestino Delgado/cirurgia Ligamentos/cirurgia Mesentério/cirurgia Omento/cirurgia [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Intestino Delgado/diagnóstico por imagem Radiografia Abdominal [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180130 [Lr] Data última revisão: 180130 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171212 [St] Status: MEDLINE [do] DOI: 10.1186/s13256-017-1471-4

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[PMID]: 29016507 [Au] Autor: Katrikh AZ; Ettarh R; Kahn MA [Ad] Endereço: Departments of Structural and Cellular Biology, Obstetrics and Gynecology, and Urology, Tulane University School of Medicine, New Orleans, Louisiana; and the Department of Medical Education, California University of Science and Medicine, Colton, California. [Ti] Título: Cadaveric Nerve and Artery Proximity to Sacrospinous Ligament Fixation Sutures Placed by a Suture-Capturing Device. [So] Source: Obstet Gynecol;130(5):1033-1038, 2017 Nov. [Is] ISSN: 1873-233X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To simulate sacrospinous ligament fixation on cadaveric specimens, describe the surrounding retroperitoneal anatomy, and estimate the risk to nerves and arteries for the purposes of optimizing safe suture placement. METHODS: Sacrospinous ligament fixation was performed on eight fresh-tissue female cadavers using a Capio ligature capture device. Distances from placed sutures to the following structures were measured: ischial spine; fourth sacral root; pudendal nerve; the nerve to coccygeus muscle; the nerve to levator ani muscle; inferior gluteal artery; and internal pudendal artery. Periligamentous anatomy was examined in an additional 17 embalmed cadaver dissections. RESULTS: Sacrospinous ligament length was not seen to differ significantly between sides. The fourth sacral spinal nerve was seen most commonly associated with the medial third of the ligament, whereas the pudendal nerve and the nerves to coccygeus and levator ani muscles were associated with the lateral third. The inferior gluteal artery was seen leaving the greater sciatic foramen a median 15.8 mm (range 1.8-48.0, CI 14.9-22.3) above the ligament, whereas the internal pudendal artery exited just above the ischial spine. The two sets of sutures were placed 20.5 mm (range 9.2-34.4, CI 19.7-24.7) and 24.8 mm (range 12.4-46.2, CI 24.0-30.0) medial to the ischial spine, respectively. No structures were directly damaged by placed sutures. The nerves to coccygeus and levator ani were closest and arteries farthest from the placed sutures. CONCLUSION: The middle segment of the sacrospinous ligament has the lowest incidence of nerves and arteries associated with it. This study confirms that the nerves supplying the pelvic floor muscles are at a higher risk from entrapment than the pudendal nerve. [Mh] Termos MeSH primário: Ligamentos/cirurgia Sacro/cirurgia Âncoras de Sutura Técnicas de Sutura/instrumentação [Mh] Termos MeSH secundário: Artérias/anatomia & histologia Artérias/cirurgia Cadáver Feminino Seres Humanos Ligadura/instrumentação Síndromes de Compressão Nervosa/etiologia Músculos Paraespinais/anatomia & histologia Músculos Paraespinais/irrigação sanguínea Músculos Paraespinais/inervação Diafragma da Pelve/anatomia & histologia Diafragma da Pelve/irrigação sanguínea Diafragma da Pelve/inervação Nervo Pudendo/cirurgia Sacro/anatomia & histologia Sacro/inervação Âncoras de Sutura/efeitos adversos Técnicas de Sutura/efeitos adversos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171011 [St] Status: MEDLINE [do] DOI: 10.1097/AOG.0000000000002324

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[PMID]: 28985853 [Au] Autor: Zhiying Y; Haidong T; Xiaolei L; Yongliang S; Shuang S; Liguo L; Li X; Atyah M [Ad] Endereço: Department of Hepatobiliary Surgery, China-Japan Friendship Hospital, Beijing, China. Electronic address: yangzhy@aliyun.com. [Ti] Título: The falciform ligament as a graft for portal-superior mesenteric vein reconstruction in pancreatectomy. [So] Source: J Surg Res;218:226-231, 2017 Oct. [Is] ISSN: 1095-8673 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Tumor invasion or adherence to the portal vein-superior mesenteric vein (PV/SMV) may be encountered during pancreatic surgery. In such cases, venous resection and reconstruction might be required for complete resection of the tumor. We report an innovative technique in which the graft for PV/SMV reconstruction was made with the falciform ligament. METHODS: Between May 2011 and July 2016, PV/SMV reconstruction with a falciform ligament graft was performed in 10 cases during pancreatectomy. Among these cases, including six cases with a patch graft and four cases with a conduit graft. Retrospective reviews of medical records and radiologic studies were performed. RESULTS: Ten patients with pancreatobiliary cancer underwent en bloc tumor resection with concurrent PV/SMV resection and reconstruction with a falciform ligament graft. There were six males and four females, and the mean age was 65.3 ± 9.4 (48-80) y. Using Doppler ultrasound examination, all 10 grafts were shown to be patent at postoperative 2 wk. However, occlusion was found in one case with conduit graft and stenosis in the other three cases with conduit graft using enhanced computed tomography at postoperative 2 mo. Complete patency was shown in three of six cases with patch graft and stenosis in the other three cases at 2 mo after the operation. Although occlusion or stenosis of the grafts was observed, no severe adverse events occurred, and normal liver function was discovered in all 10 cases at postoperative 2 mo. CONCLUSIONS: Falciform ligament grafts might be considered for reconstruction of PV/SMV in the absence of appropriate vascular grafts. [Mh] Termos MeSH primário: Ligamentos/transplante Veias Mesentéricas/cirurgia Pancreatectomia/métodos [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171024 [Lr] Data última revisão: 171024 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171008 [St] Status: MEDLINE

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[PMID]: 28926386 [Au] Autor: Sanders TL; Johnson NR; Levy NM; Cole PA; Krych AJ; Stuart M; Levy BA [Ad] Endereço: 1Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota. [Ti] Título: Effect of Vascular Injury on Functional Outcome in Knees with Multi-Ligament Injury: A Matched-Cohort Analysis. [So] Source: J Bone Joint Surg Am;99(18):1565-1571, 2017 Sep 20. [Is] ISSN: 1535-1386 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Multi-ligament knee injury (MLKI) associated with knee dislocation can result in vascular injury. The purpose of this study was to compare knee function after MLKI between patients with a vascular injury requiring popliteal artery bypass grafting and patients without vascular involvement. Additionally, factors associated with poor knee function in patients who had MLKI with vascular injury were evaluated. METHODS: This retrospective study identified patients with an MLKI between 1992 and 2014. Each patient who had a concomitant vascular injury requiring bypass grafting (vascular cohort, n = 16; mean age, 30.3 years) was matched to 2 patients without a vascular injury (control cohort, n = 32; mean age, 31.4 years) on the basis of age, knee dislocation (KD) grade, and peroneal nerve status. Fifteen patients in the vascular cohort and 26 patients in the control cohort had an isolated knee injury. Functional outcomes were assessed with physical examination of range of motion and ligamentous stability as well as patient-reported outcome scores. RESULTS: The vascular cohort had a mean Lysholm score of 62.5 points (range, 16 to 100 points) and a mean International Knee Documentation Committee (IKDC) score of 59.7 points (range, 14.9 to 100 points) at a mean (and standard deviation) of 8.3 ± 5.0 years after surgery. The control cohort had a mean Lysholm score of 86.4 points (range, 51.0 to 100.0 points) and a mean IKDC score of 83.8 points (range, 35.6 to 100.0 points) at a mean of 6.0 ± 4.0 years. The vascular cohort had significantly lower Lysholm (p = 0.001) and IKDC (p = 0.002) scores than the control cohort. A body mass index (BMI) of >30 kg/m was predictive of lower IKDC (p = 0.0009) and Lysholm (p = 0.0008) scores. CONCLUSIONS: Patients who sustain an MLKI with an associated popliteal artery injury requiring bypass grafting have significantly lower knee function scores than patients without vascular involvement. This information can be used to help counsel patients with combined multiple ligament and popliteal artery injuries. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. [Mh] Termos MeSH primário: Traumatismos do Joelho/fisiopatologia Ligamentos/lesões Artéria Poplítea/lesões Lesões do Sistema Vascular/fisiopatologia [Mh] Termos MeSH secundário: Adolescente Adulto Estudos de Casos e Controles Feminino Seres Humanos Escala de Gravidade do Ferimento Luxação do Joelho/fisiopatologia Traumatismos do Joelho/complicações Ligamentos/fisiopatologia Masculino Meia-Idade Análise Multivariada Artéria Poplítea/cirurgia Amplitude de Movimento Articular/fisiologia Estudos Retrospectivos Lesões do Sistema Vascular/cirurgia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170922 [Lr] Data última revisão: 170922 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170920 [St] Status: MEDLINE [do] DOI: 10.2106/JBJS.16.01540

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[PMID]: 28819516 [Au] Autor: Dean M; Stamatopoulos N; Vancaillie T [Ad] Endereço: Royal Hospital for Women, Department of Obstetrics and Gynaecology, Randwick, Australia. [Ti] Título: A severed IP ligament as a cause for trans-vaginal uterine bleeding post termination of pregnancy: a case report. [So] Source: Pan Afr Med J;27:95, 2017. [Is] ISSN: 1937-8688 [Cp] País de publicação: Uganda [La] Idioma: eng [Ab] Resumo: Uterine perforation is an uncommon yet serious complication of surgical management of first and second trimester termination of pregnancies. The rate of uterine perforation is under reported, as patients are usually asymptomatic. Although uncommon, uterine perforation can cause life-threatening complications for some patients. This case report discusses a second trimester surgical termination resulting in uterine perforation and haemorrhage secondary to an avulsion of the infundibulopelvic ligament and prolapse of the left fallopian tube and ovary into the uterine cavity. A literature search was undertaken to compare this case report to those previously published. To the best of our knowledge, this is the first case report in Australia that discusses a unique case of a severed infundibulo-pelvic ligament as a cause for trans-vaginal uterine bleeding post second trimester termination of pregnancy. [Mh] Termos MeSH primário: Aborto Induzido/efeitos adversos Ligamentos/lesões Hemorragia Uterina/etiologia Perfuração Uterina/etiologia [Mh] Termos MeSH secundário: Aborto Induzido/métodos Adulto Austrália Tubas Uterinas/patologia Feminino Seres Humanos Ovário/patologia Gravidez Segundo Trimestre da Gravidez [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170904 [Lr] Data última revisão: 170904 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170819 [St] Status: MEDLINE [do] DOI: 10.11604/pamj.2017.27.95.12435

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[PMID]: 28803621 [Au] Autor: Chilvers G; Janjua U; Choudhary S [Ad] Endereço: Department of Imaging, Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. [Ti] Título: Blunt cervical spine injury in adult polytrauma: incidence, injury patterns and predictors of significant ligament injury on CT. [So] Source: Clin Radiol;72(11):907-914, 2017 Nov. [Is] ISSN: 1365-229X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIM: To describe the pattern of cervical spine fractures in adult major trauma and identify computed tomography (CT) parameters that can predict significant ligament injury when fractures are absent; to define the normal range for parameters used; and identify common variations due to position of cervical immobilisation in a trauma patient. MATERIALS AND METHODS: In this retrospective study all polytrauma patients imaged using multidetector CT over a period of 5 years were identified. Patients with cervical spine fracture and suspected ligament injury in the absence of fracture were collated based on the polytrauma CT report. Predictors of ligament injury were defined based on published historical data on plain radiographs and posterior paraspinal fat pad assessment at CT. These parameters were recorded for each study with comparison to subsequent magnetic resonance imaging (MRI) as the reference standard. RESULTS: Significant ligament injury on MRI was detected at the craniocervical junction, when CT showed a basion dens interval of >10 mm, widened incongruous C0/C1 facet joint space of >3 mm, and widened C1/2 facet joint space of >6 mm. In the subaxial cervical spine, facet subluxation >50% and obscured posterior paraspinal fat pad were the only reliable predictors of ligament injury, as confirmed on subsequent MRI. CONCLUSION: When fractures are absent, signs of significant ligament injury on CT at the craniocervical junction were increased basion dens interval and widened facet joints. In the subaxial cervical spine, >50% subluxation of a facet joint and obscured posterior paraspinal fat pad are indicators of significant ligament injury. [Mh] Termos MeSH primário: Vértebras Cervicais/lesões Ligamentos/lesões Traumatismo Múltiplo/diagnóstico por imagem Traumatismos da Coluna Vertebral/diagnóstico por imagem Tomografia Computadorizada por Raios X/métodos Ferimentos não Penetrantes/diagnóstico por imagem [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Vértebras Cervicais/diagnóstico por imagem Feminino Seres Humanos Incidência Ligamentos/diagnóstico por imagem Imagem por Ressonância Magnética Masculino Meia-Idade Estudos Retrospectivos Fraturas da Coluna Vertebral/diagnóstico por imagem Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171012 [Lr] Data última revisão: 171012 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170815 [St] Status: MEDLINE

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[PMID]: 28783735 [Au] Autor: Hong S; Hong L; Li B; Wu D; Liu C; Min J; Guo W; Hu M; Tang J; Li Y [Ad] Endereço: Department of Obstetrics and Gynaecology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China. [Ti] Título: The role of GPX1 in the pathogenesis of female pelvic organ prolapse. [So] Source: PLoS One;12(8):e0181896, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Gestation and delivery can increase intra-abdominal pressure, which are well-known risk factors for Pelvic Organ Prolapse (POP). But the pathogenesis mechanism of POP remains unclear. Our previous research showed that the expression of glutathione peroxidase type 1 (GPX1) decreased in pelvic floor ligaments from POP patients, implying that oxidative stress (OS) may be related to POP. The aim of this study was to figure out the role of GPx1 regulation in the pathogenesis of POP. Women (>45 years) who received hysterectomy surgery were enrolled in this research, identified by screening. We applied mechanical strain of 0µ, 5333 µ to GPX1-overexpressing human uterosacral ligament fibroblasts (hUSLFs) isolated from menopausal women without POP respectively for 4 hours, in order to investigate the changes of cell apoptosis, oxidative status and ECM metabolism when cytomechanics model loaded on GPX1-overexpressing hUSLFs. Comparing with the non-transfection and mock-vehicle groups, we found that GPX1 not only protects hUSLFs from cell apoptosis, oxidative damage, but also improves the remodeling of ECM induced by mechanical stimulation. These results suggested that mechanical strain caused abnormalities of ECM metabolism via OS pathway in hUSLFs, which was involved in the pathogenesis of POP, and that GPx1 played a significant role in regulating mechanical strain induced POP. [Mh] Termos MeSH primário: Glutationa Peroxidase/metabolismo Prolapso de Órgão Pélvico/metabolismo Prolapso de Órgão Pélvico/patologia [Mh] Termos MeSH secundário: Apoptose/genética Apoptose/fisiologia Western Blotting Células Cultivadas Feminino Fibroblastos/citologia Fibroblastos/metabolismo Citometria de Fluxo Glutationa Peroxidase/genética Seres Humanos Ligamentos/citologia Ligamentos/metabolismo Meia-Idade Estresse Oxidativo/genética Estresse Oxidativo/fisiologia Prolapso de Órgão Pélvico/genética Espécies Reativas de Oxigênio/metabolismo Reação em Cadeia da Polimerase Via Transcriptase Reversa [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Reactive Oxygen Species); EC 1.11.1.- (glutathione peroxidase GPX1); EC 1.11.1.9 (Glutathione Peroxidase) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170907 [Lr] Data última revisão: 170907 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170808 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0181896

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[PMID]: 28727377 [Au] Autor: Kale A; Biler A; Terzi H; Usta T; Kale E [Ad] Endereço: Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey. [Ti] Título: Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery. [So] Source: Int Braz J Urol;43(5):903-909, 2017 Sep-Oct. [Is] ISSN: 1677-6119 [Cp] País de publicação: Brazil [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique. MATERIALS AND METHODS: Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed. RESULTS: The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period. CONCLUSION: Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery. [Mh] Termos MeSH primário: Laparoscopia/métodos Telas Cirúrgicas Prolapso Uterino/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Estudos de Viabilidade Feminino Seres Humanos Ligamentos/cirurgia Meia-Idade Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171117 [Lr] Data última revisão: 171117 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170721 [St] Status: MEDLINE [do] DOI: 10.1590/S1677-5538.IBJU.2017.0070

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[PMID]: 28647958 [Au] Autor: Ren C; Song XC; Zhu L; Ai FF; Shi HH; Sun ZJ; Chen J; Lang JH [Ad] Endereço: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. [Ti] Título: [Prospective cohort study on the outcomes of sacrospinous ligament fixation using conventional instruments in treating stage â…¢-â…£ pelvic organ prolapse]. [So] Source: Zhonghua Fu Chan Ke Za Zhi;52(6):369-373, 2017 Jun 25. [Is] ISSN: 0529-567X [Cp] País de publicação: China [La] Idioma: chi [Ab] Resumo: To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage â…¢-â…£ pelvic organ prolapse (POP). A prospective cohort analysis was conducted in the Peking Union Medical College Hospital, between May 2007 and June 2015, enrolling 55 women with stage â…¢-â…£ POP who intended to receive SSLF. Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually. Exploratory outcomes included perioperative parameters and complications. Of these 55 POP patients enrolled, 52 (95%, 52/55) received SSLF using conventional surgical instruments, the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing. Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes). Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients, both recovered fully with conservative methods. All patients were able to micturate spontaneously after catheter withdrawal. One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy. The objective success rate was 100% (52/52) at 3 months. With a medium follow-up time of 23.7 months, the objective success rate was 98% (51/52), the recurrence rate was 2% (1/52) and the satisfactory rate was 94% (49/52). De novo urinary incontinence occurred in 6% (3/52) of patients. Most POP could be corrected with SSLF using conventional instruments which is a feasible, economic and effective procedure for Asian patients with medium compartment prolapse. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos em Ginecologia/métodos Ligamentos/cirurgia Prolapso de Órgão Pélvico/cirurgia Sacro/cirurgia [Mh] Termos MeSH secundário: Idoso Feminino Procedimentos Cirúrgicos em Ginecologia/efeitos adversos Seres Humanos Ísquio Meia-Idade Satisfação do Paciente Diafragma da Pelve/cirurgia Complicações Pós-Operatórias/epidemiologia Estudos Prospectivos Qualidade de Vida Índice de Gravidade de Doença Slings Suburetrais Inquéritos e Questionários Resultado do Tratamento Incontinência Urinária por Estresse/etiologia Incontinência Urinária por Estresse/cirurgia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170731 [Lr] Data última revisão: 170731 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170627 [St] Status: MEDLINE [do] DOI: 10.3760/cma.j.issn.0529-567X.2017.06.003

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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