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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our paper presents the experience gained in nearly 12 years by the General Surgery Clinic of "Sfantul Ioan" Hospital, Bucharest in the field of laparoscopic hysterectomy. The period of time is quite long compared to the evolving of mini-invasive techniques and also unequal towards the experience of the surgeons who perform these procedure. The total number of hysterectomies was 1491 from which 251 by laparoscopic approach, the rest being made by the classic methods (most of them by laparotomy and some by vaginal approach). In the statistic we have included 15 myomectomies, 4 cases of radical hysterectomy with pelvic lymphadenectomy and 4 cases of complete hysterectomy after partial procedures made by laparotomy. The indications were represented mostly by uterine fibroma (82.07%), but also by uterine prolapse (13.14%), uterine bleeding, cervix severe dysplasia, uterine and cervix neoplasia (stage I) or associated to ovariectomy related to breast cancer. The paper analyses the results looking at the incidents and accidents (hemorrhagic, ureteral, urinary bladder or rectal lesions) and also postoperative complications (we had three reinterventions, two by laparoscopy and one by laparotomy). We also recorded one death not directly as a consequence of surgery, but as a diagnosis error. Regarding the surgical technique we initially chose the laparoscopic assisted vaginal hysterectomy. Afterwards by gaining experience we started treating the uterine pedicle and now we settled for the integral laparoscopic procedure. In our opinion laparoscopic hysterectomy represents all the advantages of mini-invasive approach. The technological development, but essentially the experience gained by surgeons are the key factors in accepting and promulgating the technique.
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PMID:[Laparoscopic hysterectomy]. 1761 17

In the past, hysterectomy was routinely performed at the time of pelvic organ prolapse repair. Nowadays, in patients with abnormal uterus (fibroma, dysplasia...), hysterectomy should be performed at the time of surgery. In contrast, in young women especially with desire of childbearing, uterus preservation is the best choice. But there is still a debate in postmenopausal patients with normal uterus and POP. There is currently no argument for choosing hysterectomy or uterus preservation at the time of POP repair in regard of the anatomical results for the middle as well as the anterior and posterior compartments. But it has been proven that hysterectomy increased the perioperative morbidity. Subtotal hysterectomy decreases this morbidity and result in a decreased rate of mesh erosion. To date, literature is not conclusive about the impact of hysterectomy on lower urinary tract symptoms. Patient's counselling is important before hysterectomy with adequate information about potential psychosexual consequences of such procedure. At least, if uterus preservation, patients must be aware of the risk of malignant diseases (cervix or endometrial carcinoma) even if the risk is low in case of a good screening preoperatively.
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PMID:[The role of hysterectomy during the repair of prolapse by promonotofixation]. 1996 71

Spontaneous regeneration of bone tissue after mandibular resection is rare in adults, although it does often take place in children. Periosteum conservation appears to play a major role in this healing process. We here report regarding a 5-year-old boy who exhibited a large mandibular trabecular juvenile ossifying fibroma. The lesion was treated by mandibulectomy, with careful preservation of the periosteal layer and immediate reconstruction with a costal graft by an intraoral approach. Monitoring over the course of a year revealed spontaneous mandibular regeneration, and it allowed for a series of measurements of the graft to be made. During this follow-up period, the mandibular height increased from 41.5% to 75.2% (P=0.0008) of the height of the unaffected mandibular height, while the width grew from 34.4% to 82.8% (P=0.0078) of the width of the healthy side, thus demonstrating the importance of a conservative approach regarding the periosteum in such situations. The costal graft acted as a support for bone regeneration by immobilizing the remaining bone fragments and by preventing soft-tissue prolapse.
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PMID:Costal graft as a support for bone regeneration after mandibular juvenile ossifying fibroma resection: An unusual case report. 2864 88