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Bensaid C, Otmani M, El Asraoui L, Boumaaza O, Guerrouj H, Ghfir I, Çaoui M, Ben Rais Aouad N. Impact de la TEP-TDM au 18F-FDG dans la restadification lésionnelle dans le cancer du sein : à propos d’un cas. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Bensaid C, Otmani M, Nakro D, Guerrouj H, Ghfir I, Çaoui M, Ben Rais Aouad N. Exploration scintigraphique de l’algodystrophie : à propos de 4 cas. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Bensaid C, Guerrouj H, Ghfir I, Çaoui M, Ben Rais Aouad N. Les profils scintigraphiques de la perfusion pulmonaire des patients post COVID-19. Médecine Nucléaire 2022. [PMCID: PMC8916415 DOI: 10.1016/j.mednuc.2022.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
La maladie à coronavirus (COVID19) est une maladie infectieuse due au virus SARS-CoV-2. L’incidence des complications thromboemboliques dans l’infection COVID-19 est bien connue, même chez les patients recevant une anticoagulation prophylactique. La scintigraphie pulmonaire est un examen fonctionnel permettant d’étudier les processus physiologiques de la perfusion et d’éliminer une embolie. Matériels et méthodes Nous avons analysé rétrospectivement la scintigraphie pulmonaire de perfusion de 60 patients post-COVID-19, cette exploration consiste à l’injection intraveineuse de macro-agrégats d’albumine marqués au technétium (MAA-99mTc). Notre étude porte sur la présence ou non de défects de perfusion évocateurs de processus embolique ainsi que leurs différents aspects au niveau des deux champs pulmonaires. Résultats En plus de l’étude épidémiologique, des signes cliniques et paracliniques, nos résultats scintigraphiques sont exprimés en probabilité (de faible à forte) à défaut de couplage de la scintigraphie perfusion/ventilation et en confrontation avec les images scanographiques. Conclusion La scintigraphie pulmonaire de perfusion reste un examen incontournable dans le diagnostic de l’embolie, surtout si l’angioscanner est négatif. En cette pandémie, elle occupe une place importante dans le suivi post-COVID.
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Fournier M, Huchon C, Ngo C, Bensaid C, Bats AS, Combe P, le FrèreBelda MA, Fournier L, Berger A, Lecuru F. Morbidity of rectosigmoid resection in cytoreductive surgery for ovarian cancer. Risk factor analysis. Eur J Surg Oncol 2018; 44:750-753. [PMID: 29580734 DOI: 10.1016/j.ejso.2018.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 11/23/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022] Open
Abstract
AIM Rectosigmoid resection is often performed during cytoreductive surgery for ovarian cancer, to achieve the goal of no residual tumour. Here, we evaluated the morbidity associated with rectosigmoid resection and the underlying risk factors. METHODS We retrospectively assessed consecutive patients managed with rectosigmoid resection during cytoreductive surgery for ovarian cancer at our centre in Paris, France, between 2005 and 2013. All previously identified risk factors were analysed. Major complications were defined as grade III-IV in the Clavien-Dindo classification. RESULTS Of 228 patients, 116 had primary and 112 interval surgery; 43/228 [18.9%]; experienced major complications, and these were more common after primary surgery [24.1% vs. 13.4%, p = .04]. The 69 patients who had rectosigmoid resection [33 primary vs. 36 interval surgery, p = .32] had a higher morbidity rate compared to the other patients [30.4% vs. 14.6%, p = .006]. The anastomotic leakage rate was 2.89%. By multivariate logistic regression, independent risk factors for morbidity were postmenopausal status [adjusted odds ratio (aOR), 13.7; 95% confidence interval (95%CI), 1.2;161.9], surgery after neoadjuvant chemotherapy [aOR, 4.4; 95%CI, 1.1;18.8], and peritoneal stripping of the left; paracolic gutter [aOR, 11.3; 95%CI, 2.3;54.3]. CONCLUSION The morbidity of rectosigmoid resection during cytoreductive surgery for ovarian cancer seems acceptable. Ileostomy does not seem associated with a lower risk of major complications or adjuvant bevacizumab with a higher complication rate.
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Affiliation(s)
- M Fournier
- Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France.
| | - C Huchon
- Obstetrics and Gynecology Department, CHI Poissy-St-Germain, Université Versailles- Saint-Quentin en Yvelines, Poissy, France; EA 7285, Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles-Saint- Quentin en Yvelines, Versailles, France
| | - C Ngo
- Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - C Bensaid
- Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - A S Bats
- Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; ARCAGY-GINECO, Hôpital Hôtel Dieu, 1 parvis Notre Dame, 75004, Paris, France; UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - P Combe
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; ARCAGY-GINECO, Hôpital Hôtel Dieu, 1 parvis Notre Dame, 75004, Paris, France; Medical Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - M A le FrèreBelda
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Pathology Department, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - L Fournier
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Imaging Department, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - A Berger
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; General and Digestive Surgery, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - F Lecuru
- Gynecologic Oncology, Centre Expert Oncologie Gynécologique, Paris Descartes- Hôpital Européen Georges Pompidou, APHP, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; ARCAGY-GINECO, Hôpital Hôtel Dieu, 1 parvis Notre Dame, 75004, Paris, France; UMR S 1124, Faculté de Médecine, Université Paris Descartes, Paris, France
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Balaya V, Rossi L, Cornou C, Ngô C, Bensaid C, Mathevet P, Querleu D, Leblanc E, Morice P, Daraï E, Bats A, Lecuru F. Is sentinel lymph node biopsy safe during radical trachelectomy? A prospective multicenter study. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Loaec C, Bats A, Ngô C, Bensaid C, Cornou C, Lecuru F. A dual docking robotic technique for surgical staging in high-risk endometrial cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Balaya V, Rossi L, Cornou C, Ngô C, Bensaid C, Mathevet P, Querleu D, Leblanc E, Morice P, Daraï E, Bats A, Lecuru F. Functional outcomes of laparoscopic-assisted vaginal radical trachelectomy in early-stage cervical cancer: A prospective multicentric cohort of 50 patients. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Balaya V, Ngo C, Rossi L, Cornou C, Bensaid C, Douard R, Bats A, Lecuru F. Bases anatomiques et principe du nerve-sparing au cours de l’hystérectomie radicale pour cancer du col utérin. ACTA ACUST UNITED AC 2016; 44:517-25. [DOI: 10.1016/j.gyobfe.2016.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 07/17/2016] [Indexed: 10/21/2022]
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Cornou C, Bats A, Vannieuwenhuyse G, Capmas P, Bensaid C, Ngô C, Nos C, Lecuru F. Impact of gynecologic screening in Lynch syndrome. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mokbel M, Bats A, Ngô C, Bensaid C, Capmas P, Cornou C, Nos C, Lecuru F. Robotically assisted laparoscopy for the evaluation of nodal status in early-stage cervical and endometrial cancer: The fluorometric and isotopic technique on a face-to-face. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Balaya V, Uhl JF, Lanore A, Salachas C, Samoyeau T, Ngo C, Bensaid C, Cornou C, Rossi L, Douard R, Bats AS, Lecuru F, Delmas V. Modélisation anatomique 3D du pelvis féminin par dissection anatomique assistée par ordinateur : applications et perspectives. ACTA ACUST UNITED AC 2016; 45:467-77. [DOI: 10.1016/j.jgyn.2016.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/29/2015] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
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Achouri A, Huchon C, Bats AS, Bensaid C, Nos C, Lécuru F. Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol 2012; 39:81-6. [PMID: 23117018 DOI: 10.1016/j.ejso.2012.10.011] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 10/02/2012] [Accepted: 10/12/2012] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Symptomatic postoperative lymphocysts (SPOLs) and lower-limb lymphedema (LLL) are probably underestimated complications of lymphadenectomy for gynecologic malignancies. Here, our objective was to evaluate the incidence and risk factors of SPOLs and LLL after pelvic and/or aortocaval lymphadenectomy for gynecologic malignancies. METHODS Single-center retrospective study of consecutive patients who underwent pelvic and/or aortocaval lymphadenectomy for ovarian cancer, endometrial cancer, or cervical cancer between January 2007 and November 2008. The incidences of SPOL and LLL were computed with their 95% confidence intervals (95%CIs). Multivariate logistic regression was performed to identify independent risk factors for SPOL and LLL. RESULTS We identified 88 patients including 36 with ovarian cancer, 35 with endometrial cancer, and 17 with cervical cancer. The overall incidence of SPOL was 34.5% (95%CI, 25-45) and that of LLL was 11.4% (95% confidence interval [95%CI], 5-18). Endometrial cancer was independently associated with a lower risk of SPOL (adjusted odds ratio [aOR], 0.09; 95%CI, 0.02-0.44) and one or more positive pelvic nodes with a higher risk of SPOL (aOR, 4.4; 95%CI, 1.2-16.3). Multivariate logistic regression failed to identify factors significantly associated with LLL. CONCLUSION Complications of lymphadenectomy for gynecologic malignancies are common. This finding supports a more restrictive use of lymphadenectomy or the use of less invasive techniques such as sentinel node biopsy.
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Affiliation(s)
- A Achouri
- Service de Chirurgie Cancérologique Gynécologique et du Sein, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
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Capmas P, Bats AS, Bensaid C, Bady J, Lécuru F. [Robotic surgery in endometrial cancer: a review]. ACTA ACUST UNITED AC 2012; 41:219-26. [PMID: 22480595 DOI: 10.1016/j.jgyn.2012.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 02/10/2012] [Accepted: 02/17/2012] [Indexed: 11/24/2022]
Abstract
Robotic surgery has spread for a few years. This access is now important in urologic surgery, especially for prostatic procedures. Development of robotic surgery in gynecology is more recent. Gynecologic oncology is probably one of the most interesting fields of development of this access. Robotic surgery is frequently used in endometrial cancer. As no randomized study is available, it seems to be interesting to make a review of retrospective studies. Feasibility seems to be high and the learning curve is short (around 20 cases). Operative lengths are longer when compared to laparotomy, but are similar or shorter than laparoscopy. Robot setting increases the global length of the procedure, but decreases with experience. Operative blood loss, as well as transfusion rate are decreased when compared to laparotomy, but are similar to those of laparoscopy. The overall morbidity rate seems lower than with other approaches. Postoperative pain, hospital stay and time to recovery are decreased when compared to laparotomy as well as to laparoscopy for some authors. The main limit to the diffusion of robotic surgery is accessibility because of its important cost. Other limits are pointed out by the most trained teams.
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Affiliation(s)
- P Capmas
- Service de chirurgie cancérologie, gynécologique et du sein, hôpital européen Georges-Pompidou, AP-HP, 20 rue Leblanc, Paris, France.
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Huchon C, Bats AS, Achouri A, Lefrère-Belda MA, Buénerd A, Bensaid C, Farragi M, Mathevet P, Lécuru F. [Sentinel lymph node procedure and uterine cancers]. ACTA ACUST UNITED AC 2011; 38:760-6. [PMID: 21111648 DOI: 10.1016/j.gyobfe.2010.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Accepted: 09/28/2010] [Indexed: 11/26/2022]
Abstract
Lymph node metastases in cervical and endometrial cancer are major prognostic factors. Lymph-nodal involvement determines adjuvant therapy. As imagery is not reliable to diagnose lymph node status, pelvic +/- para-aortic lymphadenectomy remains the gold standard. These surgical procedures are, however, responsible for specific morbidity: lymphocele and lymphedema. Sentinel lymph node procedure could avoid lymphadenectomy and their complications in cervical and endometrial cancer with good negative predictive values. We present actual indications, procedure and results of sentinel lymph node procedures in cervical and endometrial cancer.
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Affiliation(s)
- C Huchon
- Service de chirurgie gynécologique et cancérologique, hôpital européen Georges-Pompidou, AP-HP, 20 rue Leblanc, Paris cedex 15, France.
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Capmas P, Bats AS, Bensaid C, Huchon C, Scarabin C, Nos C, Lécuru F. Place de la cœlioscopie dans le traitement des cancers de l’endomètre à un stade précoce (stade I). ACTA ACUST UNITED AC 2009; 38:537-44. [DOI: 10.1016/j.jgyn.2009.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 08/24/2009] [Accepted: 09/09/2009] [Indexed: 11/28/2022]
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Desfeux P, Bats AS, Bensaid C, Chatellier G, Blanc B, Querleu D, Lecuru F. [Impact of the surgical route on staging and outcome of early borderline ovarian tumors]. ACTA ACUST UNITED AC 2007; 35:193-8. [PMID: 17306593 DOI: 10.1016/j.gyobfe.2006.12.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Accepted: 12/19/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the impact of the surgical route on the management and outcome of early borderline ovarian tumors (BOT). PATIENTS AND METHODS We have retrospectively analysed BOT operated on between January 1st 1985 and December 31st 2001. We included cases with clinical stages Ia to Ic. We compared the prevalence of deleterious acts according to the surgical access, as well as the quality of staging. Univariate and multivariate analysis assessed the impact of factors on quality of staging. Survival was also compared according to the initial surgical access. Data were computed and analysed using SPPS 7.5 and STATA 8. RESULTS 118 cases have been included, 48 (41%) have been operated on by laparoscopy, 54 (45%) by laparotomy and 16 (14%) had a conversion. A conservative treatment has been done in 57% of patients, with increased frequency in case of laparoscopy (P<0.05) and in aged patients (P<0.001). A tumor rupture occurred in 9% of cases, without difference between accesses (P=0.1). A bag was used for the specimen delivery in only 40% of cases of laparoscopy. Most of patients (73%) had an incomplete staging. Year of treatment, and a radical treatment were associated with a better staging. Survival curves showed no detrimental effect of laparoscopy. DISCUSSION AND CONCLUSION Despite an incomplete staging, this series does not show any detrimental effect of laparoscopy on the outcome of early BOT.
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Affiliation(s)
- P Desfeux
- Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges-Pompidou (HEGP), APHP, Université Paris-Descartes (Paris-V), 20, rue Leblanc, 75015 Paris, France
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Bensaid C, Le Frère Belda MA, Metzger U, Larousserie F, Clément D, Chatellier G, Lécuru F. Performance of laparoscopy in identifying malignant ovarian cysts. Surg Endosc 2006; 20:1410-4. [PMID: 16802080 DOI: 10.1007/s00464-005-0350-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 10/21/2005] [Indexed: 12/01/2022]
Abstract
BACKGROUND Peroperative identification of malignancy is crucial to management planning for ovarian cysts. The aim of this study was to evaluate the performance of laparoscopy in identifying malignant ovarian cysts. METHODS Patients undergoing laparoscopy for ovarian cysts from 1998 to 2001 were enrolled prospectively. Physical findings, Doppler ultrasonography, and serum CA 125 served to compute two risk-of-malignancy indexes (RMI-1 and RMI-2), and laparoscopy findings served to categorize lesions as benign, possibly malignant, or malignant. Frozen sections were examined as needed. Final histology was the reference. RESULTS Of 313 patients, 294 had benign cysts, six borderline lesions, and 13 malignancies. Sensitivity and specificity were respectively 84 and 93% for RMI-1, 92 and 80% for RMI-2, 100 and 99% for laparoscopy, 91 and 100% for frozen sections, and 100 and 100% for laparoscopy plus frozen sections, which had 100% negative predictive value. Six (1.8%) adverse events occurred. CONCLUSIONS Laparoscopy reliably identifies ovarian cancer and borderline disease. Morbidity is low compared to oncologic surgery.
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Affiliation(s)
- C Bensaid
- Gynecological and Oncological Surgery Department, European Georges Pompidou Teaching Hospital, and René Descartes School of Medicine, AP-HP, Paris V, 75015, Paris, France
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Bensaid C, Metzger U, Camatte S, Leleivre L, Lefrere-Belda MA, Lecuru F. INTEREST OF LAPAROSCOPY FOR THE RECOGNITION OF EARLY OVARIAN CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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