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  • 1
    ISSN: 1432-2218
    Keywords: Key words: Ovarian mature teratoma — Dermoid cyst — Complex adnexal mass — Operative laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This study was undertaken to assess the value of laparoscopic surgery as treatment for benign mature teratomas of the ovary. Methods: A total of 70 patients treated exclusively with laparoscopic surgery for ovarian mature teratoma were studied. The tumors were either enucleated with preservation of the ovary or removed by salpingo-oophorectomy. Results: Ovary-preserving surgery was performed in 60 cases; salpingo-oophorectomy was accomplished in 10 cases. All tumors removed were histologically benign. No surgical complications were encountered throughout the series. In eight patients who underwent primary ovary-preserving surgery, a second-look laparoscopy was undertaken with virtually no pathological findings noted. Conclusions: Our findings confirm those of other authors—when performed by experienced surgeons, laparoscopic removal of ovarian mature teratomas is a safe and recommendable alternative to laparotomy. Preoperative diagnosis and intraoperative inspection of the tumor must be as thorough as possible.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2218
    Keywords: Ovarian mature teratoma ; Dermoid cyst ; Complex adnexal mass ; Operative laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This study was undertaken to assess the value of laparoscopic surgery as treatment for benign mature teratomas of the ovary. Methods: A total of 70 patients treated exclusively with laparoscopic surgery for ovarian mature teratoma were studied. The tumors were either enucleated with preservation of the ovary or removed by salpingo-oophorectomy. Results: Ovary-preserving surgery was performed in 60 cases; salpingo-oophorectomy was accomplished in 10 cases. All tumors removed were histologically benign. No surgical complications were encountered throughout the series. In eight patients who underwent primary ovary-preserving surgery, a second-look laparoscopy was undertaken with virtually no pathological findings noted. Conclusions: Our findings confirm those of other authors—when performed by experienced surgeons, laparoscopic removal of ovarian mature teratomas is a safe and recommendable alternative to laparotomy. Preoperative diagnosis and intraoperative inspection of the tumor must be as thorough as possible.
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  • 3
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: Allgemeinnarkose – Ketamin – In-vitro-Fertilisations-Embryotransfer (IVF-ET) – Prolaktin –β-Endorphine ; Key words: General anaesthesia – Ketamine – In vitro fertilization-embryo transfer – Prolactin –β-endorphins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Different anaesthetic procedures that were used during an in vitro fertilisation and embryo transfer (IVF-ET) program have been analysed in order to determine their influence on plasma levels of estradiol, progesterone, prolactin, and β-endorphin and results of IVF-ET. Methods. Fifty-four patients awaiting transvaginal oocyte aspiration were randomised into three groups: (1) anaesthesia with ketamine as an induction agent and analgesic (n=20); (2) general intubation anaesthesia using thiopentone for induction and enflurane for maintenance (n=18); and (3) no anaesthesia (n=16). Estradiol, progesterone, prolactin, and β-endorphin were measured from day 3 to 14 referring to follicle aspiration. Differences between preoperative hormone levels and their intra- and postoperative peaks were analysed using the Kruskal-Wallis test (P〈0.03). The results were corrected using the Holms method (α=0.05). Results. No differences were observed in estradiol and progesterone levels (Figs. 1, 2). Prolactin levels were 1.4 times higher (P〈0.001) when ketamine was used and 2.2 times higher (P〈0.001) after short general anaesthesia than in the control group (Fig. 3). Similar results were observed with respect to β-endorphin: in comparison with the control group we found significant elevation by a factor of 2.1 when ketamine was used (P〈0.001). The discrepancy became even more marked with general anaesthesia: β-endorphin was 3.9 times higher compared to the controls (P〈0.001) (Fig. 4). Comparing the two groups who were given anaesthetics, prolactin and β-endorphin levels were also significantly different (P〈0.001). The IVF procedure itself did not appear to be affected by different anaesthetic procedures during oocyte aspiration (Table 2). Conclusions. The increased prolactin and β-endorphin plasma levels associated with ketamine and general anaesthesia reflect a significant alteration of the observed hormone levels. When anaesthesia is indicated, we try to avoid general intubation anaesthesia in favor of ketamine.
    Notes: Zusammenfassung. Im Rahmen der in-vitro-Fertilisations-Embryotransfer-(IVF-ET-)Behandlung werden bei der Oozytengewinnung u. a. systemische Kurznarkosen eingesetzt. Ihr Einfluß auf die Östradiol-, Progesteron-, Prolaktin- und β-Endorphin-Plasmaspiegel sowie auf die Ergebnisse der IVF-Verfahren wurde an 54 Patientinnen untersucht. Diese wurden vor einer geplanten transvaginalen Follikelpunktion zwischen einer Narkose mit Ketamin als Einleitungshypnotikum und Analgetikum (n=20), einer "Allgemeinnarkose" mit Thiopental als Einleitungs- und Enfluran als Inhalationsnarkotikum (n=18) und einer Kontrollgruppe ohne Anästhesie (n=16) randomisiert. Die Hormonspiegelbestimmungen erfolgten peri- und intraoperativ zwischen Tag −3 und +14. Die Differenzbeträge zum individuellen Vor- bzw. Nullwert wurden mittels Kruskal-Wallis-Test analysiert (p〈0,03) und nach dem Holm-Verfahren korrigiert (α=0,05). Der Prolaktinspiegel war unter Ketaminanästhesie 1,4fach und Allgemeinanästhesie 2,2fach gegenüber der Kontrollgruppe erhöht (jeweils p〈0,001). Auch die β-Endorphine stiegen um den Faktor 2,1 (p〈0,001) bzw. 3,9 (p〈0,001) signifikant an. Beim Vergleich der Narkoseformen untereinander waren Prolaktin- sowie Endorphinspiegel ebenfalls signifikant unterschiedlich (p〈0,001). Keine Unterschiede ergaben sich bezüglich der Östradiol- und Progesteronspiegel sowie in bezug auf die IVF-Durchführung und die klinischen Ergebnisse nach Embryotransfer. Wenngleich die klinischen Ergebnisse der IVF-Behandlung nicht durch den Einsatz der Narkoseverfahren beeinflußt wurden, sollte dennoch ein Anästhesieverfahren mit einer geringen Beeinflussung der Hormonspiegel gewählt werden. In unserer Untersuchung war dies die Ketaminnarkose ohne endotracheale Intubation.
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  • 4
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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