76
|
Chipa-Ccasani F, San Antonio R, Trucco ME, Fernandez H, Cozzari J, Benito EM, Linhart M, Soto-Iglesias D, Alarcon F, Arbelo E, Guasch E, Berruezo A, Brugada J, Mont L, Tolosana JM. P408Long-term outcomes of leadless Micra transcatheter pacemakers: a single centre experience. Europace 2018. [DOI: 10.1093/europace/euy015.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
77
|
Margulescu AD, Enomoto N, Alarcon F, Fernandez H, Benito E, Guasch E, Mont L. P373Left atrial pressure correlates with atrial sphericity but not with the degree of atrial dilatation and scar burden, in patients who underwent pulmonary vein isolation. Europace 2018. [DOI: 10.1093/europace/euy015.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
78
|
Fuchs F, Lefevre C, Senat MV, Fernandez H. Accuracy of fetal fibronectin for the prediction of preterm birth in symptomatic twin pregnancies: a pilot study. Sci Rep 2018; 8:2160. [PMID: 29391455 PMCID: PMC5795002 DOI: 10.1038/s41598-018-20447-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/18/2018] [Indexed: 11/10/2022] Open
Abstract
Our goal was to evaluate the performance of fetal fibronectin (fFN) test alone or combined with cervical length (CL), to predict spontaneous preterm birth (PTB) in symptomatic twin pregnancies. We carry out a short pilot study including all uncomplicated diamniotic twin pregnancies with symptoms of preterm labor (PTL) and intact membranes at 24-33 weeks + 6 days of gestation. Studied outcome were spontaneous delivery within 7 and 14 days of testing and spontaneous PTB at <34 and <37 weeks of gestation. Among 40 women, fFN test was positive in 3 of them (7.5%). Regardless of the outcome studied CL did not significantly predict PTB. Performance of fFN was sensitivity (66.7%), specificity (97.2%), positive predictive value (66.7%), negative predictive value (97.2%), positive likelihood ratio (LR) (24.0), and negative LR (0.3) to predict spontaneous PTB within 7 days (p = 0.01). Thus, 66.1% of patients with a positive fFN test would deliver within 7 days versus 2.4% if negative testing; starting with a pre-test probability of 7.5%. Combining CL and fFN did not enable to increase enough positive LR or decrease significantly negative LR. In conclusion, fFN test alone might have a better ability to detect spontaneous delivery within 7 days among symptomatic twin pregnancies.
Collapse
|
79
|
Sobczyk O, Levy-Zauberman Y, Houllier M, Fernandez H. Ectopic pregnancy 6 years after subtotal hysterectomy: A case report. J Gynecol Obstet Hum Reprod 2017; 47:95-97. [PMID: 29197653 DOI: 10.1016/j.jogoh.2017.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/10/2017] [Accepted: 11/22/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Only 57 cases of ectopic pregnancy after hysterectomy have been published. CASE REPORT A 34-year-old patient with a history of subtotal hysterectomy for postpartum hemorrhage consulted for acute abdominal pain. The diagnosis of ectopic pregnancy was made using blood pregnancy test and transvaginal ultrasound. Emergency laparoscopy was performed. CONCLUSION Urine pregnancy test should be performed in case of unexplained haemoperitoneum in patient of childbearing age with a history of hysterectomy. Fistulous tracts between the patent cervix or the vaginal cuff and the peritoneal cavity may allow fecundation. TEACHING POINTS: (1) Ectopic pregnancy remains a differential diagnosis of abdominal pain and haemoperitoneum in patient of childbearing age even after hysterectomy. (2) Fistulous tract between the residual cervix and the peritoneal cavity or tubes may allow fecundation.
Collapse
|
80
|
Capmas P, Marty O, Fernandez H. Cornual Pregnancy: Conservative Management by Laparoscopic Methotrexate Administration and Resection of Rudimentary Horn in a Two-Stages Surgery. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
81
|
Capmas P, Vienet-Legue L, Fernandez H. SPRM (Selective Progesterone Receptor Modulator): a Real Option for Abnormal Uterine Bleeding with Myoma and Anticoagulation Therapy? J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
82
|
Capmas P, Nikodijevic K, Fernandez H. Is there Any Oxytocin Receptor in Non Pregnant Myomatous Utérus? J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
83
|
Théodore C, Levaillant JM, Capmas P, Chabi N, Skalli D, Vienet-Legué L, Haddad B, Fernandez H, Touboul C. MRI and Ultrasound Fusion Imaging for Cervical Cancer. Anticancer Res 2017; 37:5079-5085. [PMID: 28870937 DOI: 10.21873/anticanres.11925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/11/2017] [Accepted: 07/21/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Evaluating locoregional extension of cervical cancer is a key step in patient management. This study evaluated the feasibility of fusion imaging - a combination of magnetic resonance imaging (MRI) with real-time high-resolution ultrasound (US) - to diagnose cervical cancer and its extension. PATIENTS AND METHODS This prospective bi-center study included 13 women who underwent a 1.5-T MRI protocol including at least one T2-weighted plane. The results of imaging fusion were then compared with US and MRI results alone. RESULTS Cervical cancer was detected as a hyperechogenic hypervascularized lesion. Parametrial extension was detected by exploration of the stromal ring and the use of color Doppler mode in fusion imaging, and characterized by visualization of a vascular bridge. CONCLUSION Fusion imaging could be used as a complementary technique for MRI to enhance diagnostic performance for cervical cancer lesions. While MRI remains the reference, real-time fusion imaging could improve its characterization and detect parametrial infiltration.
Collapse
|
84
|
Fernandez H, Jourdain O, Villefranque V, Lehmann M, Lafuma A, Trancart M. Economic impact of ulipristal acetate on surgical procedures for uterine fibroids in France. BMJ Open 2017; 7:e015571. [PMID: 28871011 PMCID: PMC5588963 DOI: 10.1136/bmjopen-2016-015571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the budget impact of using ulipristal acetate (UPA) 5 mg to treat women with uterine fibroids (UF) causing moderate to severe symptoms. DESIGN We modelled trends in the number of surgical procedures for symptomatic UF, with and without the use of UPA for preoperative or intermittent treatment and assessed the budget impact of UPA use from the French national healthcare insurance system perspective. SETTING A French national hospital database (PMSI) that records admissions and relative procedures to public and private hospitals. PARTICIPANTS Women eligible for surgical procedures for uterine fibroids. MAIN OUTCOME MEASURES Economic impact of UPA treatment. RESULTS This study based on observational retrospective data shows that the current use of UPA in its preoperative indication was associated with 5645 fewer surgeries from 2013 to 2015. Extrapolation suggests 17 885 fewer surgeries from 2016 to 2019. Overall, preoperative use of UPA results in substantial cost savings for the French national healthcare insurance system, with a cumulated budget impact estimated at €-5 million from 2013 to 2015 and €-13.5 million from 2016 to 2019. In addition, treating women nearing the menopause (≥48 years old) with intermittent treatment from 2017 to 2019 could produce an incremental cost saving of €19 million. CONCLUSIONS This study shows that the use of UPA in women eligible for surgical procedures for UF is associated with considerable savings for the French national healthcare insurance system in both preoperative and intermittent indications by decreasing the need to perform surgeries.
Collapse
|
85
|
Capmas P, Letendre I, Leray C, Deffieux X, Duminil L, Subtil D, Fernandez H. Vaginal cervico-isthmic cerclage versus McDonald cerclage in women with a previous failure of prophylactic cerclage: A retrospective study. Eur J Obstet Gynecol Reprod Biol 2017; 216:27-32. [DOI: 10.1016/j.ejogrb.2017.06.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/21/2017] [Accepted: 06/25/2017] [Indexed: 10/19/2022]
|
86
|
Fernandez H, Descamps P, Koskas M, Lopès P, Brun J, Darai E, Agostini A. Real-world data of 197 patients treated with ulipristal acetate for uterine fibroids: PREMYA study French population main outcomes. J Gynecol Obstet Hum Reprod 2017; 46:559-564. [DOI: 10.1016/j.jogoh.2017.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/20/2017] [Accepted: 06/28/2017] [Indexed: 11/30/2022]
|
87
|
Baratta S, Melchiori R, Ayerdi M, Benticuaga Nava A, Chejtman D, Failo M, Fernandez H, Bilbao J, Ferroni F, Ortuno E, Hita A. P3361A new echo-Doppler index to predict early myocardial toxicity secondary to chemotheraphy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
88
|
Capmas P, Letendre I, Levaillant JM, Fuchs F, Panel P, Chambon G, Villefranque V, Levy-Zauberman Y, Fernandez H. Reproducibility of the interpretation of coronal 3D ultrasound view of the uterus to evaluate the position of Essure ® 3 months after hysteroscopic procedure. J Gynecol Obstet Hum Reprod 2017; 46:571-573. [PMID: 28676451 DOI: 10.1016/j.jogoh.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/22/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Three-dimensional sonography is a good alternative method to assess the position of microinserts. Adequate position after three months allows for the interruption of other contraception. Objective is to evaluate inter-observer reproducibility of the interpretation of coronal transvaginal 3D ultrasound view of the uterus to evaluate the position of Essure®. STUDY DESIGN Inter-observer reproducibility study. Fifty women underwent successful bilateral placement of microinserts (Essure®) by hysteroscopy in the Department of Gynaecology of a teaching hospital and were included in the study. At three month, 3D ultrasound coronal views of the fifty uterus (accounting for one hundred microinserts) were assessed by five different observers and microinsert position was classified according to the classification described by Legendre et al. Inter-observer reproducibility in reading the 3D coronal view of the uterus was evaluated. RESULTS The k-value was disparate, from 0.26 to 0.82. Inter-observer reproducibility then ranged from fair to almost perfect, depending on a prior knowledge of the position classification. CONCLUSIONS Transvaginal 3D coronal view of the uterus is sufficient to assess the positioning of the microinserts when the practionner or the surgeon is familiar with the classification method.
Collapse
|
89
|
Neveu ME, Debras E, Niro J, Fernandez H, Panel P. Standardizing hysteroscopy teaching: development of a curriculum using the Delphi method. Surg Endosc 2017. [PMID: 28634628 DOI: 10.1007/s00464-017-5620-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hysteroscopy is performed often and in many indications but is challenging to learn. Hands-on training in live patients faces ethical, legal, and economic obstacles. Virtual reality simulation may hold promise as a hysteroscopy training tool. No validated curriculum specific in hysteroscopy exists. The aim of this study was to develop a hysteroscopy curriculum, using the Delphi method to identify skill requirements. METHODS Based on a literature review using the key words "curriculum," "simulation," and "hysteroscopy," we identified five technical and non-technical areas in which skills were required. Twenty hysteroscopy experts from different French hospital departments participated in Delphi rounds to select items in these five areas. The rounds were to be continued until 80-100% agreement was obtained for at least 60% of items. A curriculum was built based on the selected items and was evaluated in residents. RESULTS From November 2014 to April 2015, 18 of 20 invited experts participated in three Delphi rounds. Of the 51 items selected during the first round, only 25 (49%) had 80-100% agreement during the second round, and a third round was therefore conducted. During this last round, 80-100% agreement was achieved for 31 (61%) items, which were used to create the curriculum. All 14 residents tested felt that a simulator training session was acceptable and helped them to improve their skills. CONCLUSIONS We describe a simulation-based hysteroscopy curriculum focusing on skill requirements identified by a Delphi procedure. Its development allows standardization of training programs offered to residents.
Collapse
|
90
|
Perrot D, Fernandez H, Levaillant JM, Capmas P. Quality assessment of pelvic ultrasound for uterine myoma according to the CNGOF guidelines. J Gynecol Obstet Hum Reprod 2017. [PMID: 28643658 DOI: 10.1016/j.jogoh.2017.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION French guidelines regarding the minimum criteria for gynaecological ultrasound were given in a recent report in 2016, by the French National College of Obstetricians and Gynaecologists (CNGOF). An accurate report is essential for the optimal care of women, especially those presenting myomas. The goal of this study was to evaluate the quality of gynaecological ultrasound reports for women with type 0 to 2 uterine myomas, referring to the items contained in the French guidelines. MATERIALS AND METHODS A retrospective descriptive study was conducted from reports of ultrasounds performed in private offices and in the gynaecologic department of a hospital, between June 2014 and June 2016 (before the report of CNGOF). These reports involved women who underwent hysteroscopic resection of myoma(s). A search of validated items was conducted for all of the reports, and the missing items were analysed. The different types of practitioners and between hospital and private medical offices were also compared with Chi-square tests. RESULTS A total of 138 reports were analysed; 71 were performed in private offices and 67 were performed in the gynaecologic unit of the hospital. Many items were missing in the reports, with disparities between the type of institution (private offices or hospital) and the speciality of practitioners (radiologists or gynaecologists). Specific items regarding myomas, such as the International Federation of Gynaecologists and Obstetricians (FIGO) classification or measurement of the posterior wall, were more often missing in reports from radiologists (89.7% and 79.5%, respectively) than in reports from gynaecologists (21.2% and 34.3%, respectively) (P<0.05). A significant difference was also observed for these data between private offices' reports and hospitals' reports. Items relative to ultrasound structures, such as the appearance of myomas or associated abdominal effusion, were more frequently missing in gynaecologists' reports (88.9% and 49.5%, respectively) compared to radiologists' reports (56.4% and 12.8%, respectively) (P<0.05). CONCLUSIONS Certain items are present in all the reports, while others are insufficiently mentioned. These inequalities can be explained in part by the type of practice; however, methods to overcome these difficulties must be developed. Information campaigns to educate professionals on the minimum reporting and training conducted jointly by radiologists and gynaecologist surgeons might improve reports and improve the care of women.
Collapse
|
91
|
Giral E, Capmas P, Levaillant JM, Berman A, Fernandez H. [Interest of saline contrast sonohysterography for the diagnosis of cesarean scar defects]. ACTA ACUST UNITED AC 2016; 43:693-8. [PMID: 26603330 DOI: 10.1016/j.gyobfe.2015.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 09/24/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine the interest of saline contrast sonohysterography in the evaluation of number, size and shape of cesarean scar defects in comparison with 3D-transvaginal ultrasound examination. METHODS Patients who had surgical reparation of cesarean scar defect by operative hysteroscopy were included in this retrospective study. Before surgery, they all had 3D-transvaginal ultrasound examination and saline contrast sonohysterography to establish the diagnosis. Then those two exams were compared to determine which one is better for cesarean scar defect evaluation, in terms of diagnosis and severity. RESULTS Fourteen patients were enrolled, they underwent transvaginal ultrasound and saline contrast sonohysterography before the surgery. 3D-transvaginal ultrasound examination made the diagnosis in 50% of patients with cesarean scar defect, whereas saline contrast sonohysterography enabled to detect 86% of defects, in comparison with hysteroscopy (100%). In 29% of patients, the size and depth of the cesarean scar defect was more important with saline contrast sonohysterography and hysteroscopy than expected by 3D-transvaginal ultrasound examination. After surgical repair, symptoms improvement was found in 82% of case (pain or abnormal uterine bleeding), and fertility was restored in 67%. CONCLUSION Saline contrast sonohysterography is better to characterize cesarean scar defects than 3D-transvaginal ultrasound, with a higher sensibility. Moreover, it evaluates more precisely the size and shape of the defect, thus severity.
Collapse
|
92
|
Fernandez H. [A new history…]. ACTA ACUST UNITED AC 2016; 45:1205-1206. [PMID: 27865587 DOI: 10.1016/j.jgyn.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
93
|
Fernandez H, Capmas P, Nazac A. Uterine Synechiae After Hysteroscopic Myomectomy: Should We Use Bipolar or Monopolar Energy? J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
94
|
Capmas P, Mihalache A, Fernandez H. Rate of Pregnancy After Hysteroscopic Management of Synechiae. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
95
|
Rachedi LS, Lesavre M, Pourcelot AG, Fournet S, Capmas P, Fernandez H. Évaluation de la sexualité des patientes après pose de prothèse Elevate™ pour cure de prolapsus. ACTA ACUST UNITED AC 2016; 45:661-72. [DOI: 10.1016/j.jgyn.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/22/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
|
96
|
Capmas P, Pourcelot AG, Giral E, Fedida D, Fernandez H. Office hysteroscopy: A report of 2402 cases. ACTA ACUST UNITED AC 2016; 45:445-50. [DOI: 10.1016/j.jgyn.2016.02.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/08/2016] [Accepted: 02/24/2016] [Indexed: 11/15/2022]
|
97
|
Debras E, Fernandez H, Pourcelot AG, Houllier M, Capmas P. [Medical management of interstitiel pregnancy by in situ methotrexate]. ACTA ACUST UNITED AC 2016; 45:673-8. [PMID: 26993077 DOI: 10.1016/j.jgyn.2015.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/06/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Interstitial pregnancy accounts for 3 to 11% of ectopic pregnancy; these pregnancies are the more frequently non-tubal ectopic pregnancy. Medical treatment can be used in case of unruptured interstitial pregnancy and is used more and more frequently to avoid hemorrhagic risk and risk of conversion to radical surgery when a surgical management is decided. However, a larger use of methotrexate in interstitial pregnancy and conditions of use are not clearly defined. The aim of this study is to report a series of unruptured interstitial pregnancy managed by in situ injection of methotrexate. WOMEN AND METHODS This retrospective observational study included women treated for an interstitial pregnancy between 2010 and 2013 in a teaching hospital. Medical management used was an in situ injection of methotrexate (1mg/kg) guided by vaginal sonography plus an intramuscular injection of methotrexate (1mg/kg) in the 48hours following in situ injection and 600mg of mifepristone when progesterone blood rate was more than 9ng/mL. A great decrease of serum hCG without surgery was considered a success. RESULTS Fourteen women had an interstitial pregnancy during the study period. Six were managed surgically in 5 cases for suspicion of uterine rupture and one for pregnancy of unknown location. Eight women had a medical management and the success rate was 100%. Mean time for decrease of serum hCG until 2 UI/L was 54.4 days [34.0-74.8]. No uterine rupture or immediate complication was reported. Five women out of 8 had a spontaneous pregnancy after management of interstitial pregnancy. CONCLUSION Medical management by in situ injection of methotrexate under sonographic guidance with an intramuscular injection within the 48hours following the in situ injection and mifepristone when ectopic pregnancy was active can be proposed in first-line therapy in case of unruptured interstitial pregnancy. This treatment has a great efficiency and low rate of complications.
Collapse
|
98
|
Houllier M, Capmas P, Fernandez H. Cœlioscopie en gynécologie : quelle place pour la prise en charge en ambulatoire ? ACTA ACUST UNITED AC 2016; 45:226-33. [DOI: 10.1016/j.jgyn.2015.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 02/05/2015] [Accepted: 04/15/2015] [Indexed: 11/15/2022]
|
99
|
Srikumar T, Markow M, Centeno B, Hoffe S, Tao J, Fernandez H, Strosberg J, Shibata D. Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. ACTA ACUST UNITED AC 2016; 23:e70-4. [PMID: 26966416 DOI: 10.3747/co.23.2711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Synchronous cancers of different primary origin are rare. Here, we describe the case of a patient with concomitant diagnoses of rectal adenocarcinoma and splenic marginal zone lymphoma (smzl). A 57-year-old woman initially presented with abdominal pain. Physical examination and computed tomography demonstrated massive splenomegaly, and a complete blood count revealed microcytic anemia and lymphopenia. During the subsequent evaluation, she presented with hematochezia, melena, and constipation, which prompted gastroenterology referral. Subsequent endoscopic rectal ultrasonography revealed a T3N1 moderately differentiated rectal adenocarcinoma, with computed tomography imaging of chest, abdomen, and pelvis confirming no metastasis. Thus, the cancer was classified as clinical stage T3N1M0, stage iii. Bone marrow biopsy confirmed co-existing marginal zone lymphoma, and with the clinical presentation of massive splenomegaly, a diagnosis of smzl was made. The patient's management was individually tailored for simultaneous optimal treatment of both conditions. Concurrent treatment with neoadjuvant rituximab and 5-fluorouracil chemotherapy, with external-beam radiation therapy to the pelvis, was administered, followed by surgery consisting of en bloc splenectomy and distal pancreatectomy, and low anterior resection. The patient completed a standard course of adjuvant folfox (fluorouracil-leucovorin-oxaliplatin) chemotherapy and has remained disease-free for 7 years. To our knowledge, this report is the first to specifically describe simultaneous diagnoses of locally advanced rectal cancer and smzl. We also describe the successful combined neoadjuvant treatment combination of 5-fluorouracil, rituximab, and pelvic radiation.
Collapse
|
100
|
Legendre G, Gonzalves A, Levaillant JM, Fernandez D, Fuchs F, Fernandez H. Impact of at-home self-rehabilitation of the perineum on pelvic floor function in patients with stress urinary incontinence: Results from a prospective study using three-dimensional ultrasound. ACTA ACUST UNITED AC 2016; 45:139-46. [DOI: 10.1016/j.jgyn.2015.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 07/13/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
|