Noteworthy Articles

Stay up to date with this selection of articles that caught Rebecca Mallick’s eye. Rebecca is a recently appointed consultant in Brighton and an active member of the Webcomms Subcommittee:

Byrne D, Curnow T, Smith P, et al. Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ Open 2018;7:e018924. doi:10.1136/bmjopen-2017-018924

https://www.bsge.org.uk/bsge-paper-in-bmjopen/

Saridogan et al. Joint ESGE/ESHRE/WES Recommendations on Surgical Tretament of Endometriosis. Part 1. Ovarian Endometrioma. Joint publication in Human Reproduction Open and Gynecological Surgery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735196/

Melamed et al. Survival after Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer. N Engl J Med 2018;379:1905-1914

Interesting and unexpected findings. This epidemiological study concluded that minimally invasive radical hysterectomy was associated with shorted overall survival rates when compared to open. Sure to be a controversial discussion point.

https://www.nejm.org/doi/full/10.1056/NEJMoa1804923

Uccella et al. Laparoscopic vs transvaginal cuff closure after total laparoscopic hysterectomy: a randomized trial by the Italian Society of Gynecologic Endoscopy.Am J Obstet Gynecol2018;218(5):500.e1-500.e13

A large randomized trial of over 1000 patients concluding laparoscopic vaginal cuff closure was associated with less complications including dehiscence and haematoma formation.

https://www.ajog.org/article/S0002-9378(18)30078-4/fulltext

Kargar et al. Transversus abdominis plane block under laparoscopic guide versus port‐site local anaesthetic infiltration in laparoscopic excision of endometriosis: a double‐blind randomised placebo‐controlled trial.BJOG 2018. Epub ahead of print.

A useful RCT assessing the benefits of laparoscopic guided tap block versus local anaesthetic infiltation for post-operative pain. Both appear to be as effective in reducing post operative pain in major gynaecological surgery

.https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.15502

Sheyn et al. Comparison of 30-day Complication Rates between Laparoscopic Myomectomy and Total Laparoscopic Hysterectomy for the Treatment of Uterine Leiomyoma in Women Older Than Age 40.JMIG 2018. Epub ahead of print.

Retrospective cohort study comparing complications between laparoscopic myomectomy and TLH in women over the age of 40. Reassuringly laparoscopic myomectomy was not associated with any increased risk.

https://www.jmig.org/article/S1553-4650(18)31339-6/fulltext

Izett et al. Safety and efficacy of non-absorbable mesh in contemporary gynaecological surgery.Gynecol Surg 2018;15:20

Detailed review paper on a very topical subject and well worth a read. This paper discusses the evolution of mesh used in gynaecological procedures, its safety and efficacy and also reviews specific complications.

https://gynecolsurg.springeropen.com/articles/10.1186/s10397-018-1051-7

Roman et al. High postoperative fertility rate following surgical management of colorectal endometriosis.Human Reproduction2018;33(9):1669–1676

Reassuring findings highlighting the benefits of surgery with regards to fertility outcomes in patients with severe endometriosis.

https://academic.oup.com/humrep/article/33/9/1669/5059386

Collins et al. Menopausal symptoms and surgical complications after opportunistic bilateral salpingectomy, a register-based cohort study. AJOG2019;220(1):85.e1–85.e10

Interesting observation cohort study of over 20,000 women undergoing hysterectomy for benign conditions. After 1 year of surgery, women undergoing prophylactic salpingectomy were associated with increased menopausal symptoms. Useful evidence when counseling patients pre-operatively.

https://www.ajog.org/article/S0002-9378(18)30898-6/fulltext

Madhvani et al.  Route of hysterectomy: a retrospective, cohort study in English NHS Hospitals from 2011 to 2017.BJOG 2018. Epub ahead of print.

Reassuring UK wide data highlighting a rising trend in the minimal access approach to hysterectomy between 2011-2017, however discrepancies still exist on a regional basis.

https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.15539

Kim et al.  Litigations Involving Ureteral Injury Related to Minimally Invasive Gynecologic Surgery: Lessons Learned from a Legal Literature Review. JMIG 2018. Epub ahead of print.

Thought-provoking review article and a must read for all discussing the implications of ureteric injury and the medico-legal consequences.

https://www.jmig.org/article/S1553-4650(18)31351-7/fulltext

 

If you read or publish anything new or noteworthy that you would like to share with the BSGE membership then send a link to: drjanegilbert@hotmail.com

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