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Prevention of complications in gynecologic endoscopic surgery
Froind, Shay ; Kučera, Eduard (advisor)
This diploma work is about endoscopy and the relative thesis. I start with short information from history of endoscopy and than continue with present. I have there two parts of my work, first shown that type of hysterospcopic proceduer is a strong predictor of complications. Second patrs, that is not less important, is speaking about individual patient characteristics presented in chapter 2.
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Prevention of complications in pregnancy after laparoscopic myomectomy
David, Martin ; Kučera, Eduard (advisor)
Gynecology and obstetrics monitor many clinical areas, which are very complex and not only medical side of things. Uterine myomatóza between such areas undoubtedly belongs. In the last time monitor several important phenomena occurring at the same time, giving rise to many questions. In recent years we have witnessed not only the rising birth rate but also shift to higher fertility age groups. According to data from 2007 significantly increased the number of pregnancies after twenty-fifthyear of age (> 70%) and rapidly increases the fertility of women between 30 and 34year (35%) [1]. In this age group is also a high incidence of uterine fibroids. We speak a very frequent clinical finding - fibroid is the most commongynecological tumor. It is therefore of considerable morbidity originator. So there is a growing group of women in roughly the same age, at where there is a fibroid, which are planning pregnancy andpregnant more often not. Symptomatic myoma is obviously an indication for its removal through various treatment modalities including surgical therapy. The result is a subgroup of patients who need to predict subsequent course of pregnancy, including mode of delivery, to analyze
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Optimization approach to the detection of sentinel node in endometrial cancer
Valha, Petr ; Kučera, Eduard (advisor) ; Rob, Lukáš (referee) ; Sláma, Jiří (referee)
Title: "Optimization Approach to the Detection of Sentinel Node in Endometrial Cancer." Design: prospective experimental study Aim of thesis : The purpose of this study was to evaluate predictive value of the in vivo sentinel lymphnode (SLN) mapping in patientswithendometrialcancer and verifyamodified method of the application of subserosal blue dye by laparotomy versus laparoscopy approach. Detection substance is applied subserosally in the uterine edges vicinity the round ligament of uterus and uterine vessels in the isthmic portion of the uterus. Detection rate of the SLN was endpoint of this study. Presence of nodular adenomyosis in uterine specimens with endometrial cancer was another endpoint. The findings were compared with our retrospective study on malignant changes in adenomyosis in women with endometrial cancer. Materials and methods: Altogether thirty-one patients were divided into two groups. Group A - patients with intermediate and high risk endometrial cancer stages I were subjected to staging laparotomy with intraoperative detection of SLN and subsequent completion of the pelvic and paraaortic lymphadenectomy. Harvested SLN was routinely examined by classical haematoxilin eosin staining and in case of negativity, immunohistochemistry with antikeratine antibodies AE1/AE3 was applied....
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Evaluation of postoperative lymphoedema after differently radical surgery for vulvar and cervical carcinoma
Nováčková, Marta ; Halaška, Michael (advisor) ; Špaček, Jiří (referee) ; Mlynček, Miloš (referee) ; Kučera, Eduard (referee)
The aim of this study was a prospective detection of postoperative lymphedema of the lower limbs in patients after the surgery for cervical and vulvar cancer using different methods of examination and their comparison and monitoring of postoperative complications and quality of life. Totally 78 women were followed after the surgery for cervical cancer and 36 for carcinoma of the vulva. Due to the radicality of the surgery the patients were divided into the conservative and radical groups. Lower limbs lymphedema were evaluated preoperatively and 3, 6 and 12 months after the surgery by the measurement of the lower limbs circumference, multifrequency bioelectrical impedance analysis (MFBIA) and subjective feeling. Quality of life using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires was evaluated before and 6 and 12 month after the surgery. 12 months after the cervical cancer surgery 35.9 % of patients reported subjective lymphedema, 37.18 % lymphedema were objectively diagnosed by the measurement of lower limb circuits and in 52.56 % of cases the increase of amount of extracellular fluid was detected by the MFBIA Ri/R0 method. The prevalence of lymphedema after the surgery for vulvar cancer reached 19.44% by the subjective assessment, 38.89 % by the measurement of...
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Optimization approach to the detection of sentinel node in endometrial cancer
Valha, Petr ; Kučera, Eduard (advisor) ; Rob, Lukáš (referee) ; Sláma, Jiří (referee)
Title: "Optimization Approach to the Detection of Sentinel Node in Endometrial Cancer." Design: prospective experimental study Aim of thesis : The purpose of this study was to evaluate predictive value of the in vivo sentinel lymphnode (SLN) mapping in patientswithendometrialcancer and verifyamodified method of the application of subserosal blue dye by laparotomy versus laparoscopy approach. Detection substance is applied subserosally in the uterine edges vicinity the round ligament of uterus and uterine vessels in the isthmic portion of the uterus. Detection rate of the SLN was endpoint of this study. Presence of nodular adenomyosis in uterine specimens with endometrial cancer was another endpoint. The findings were compared with our retrospective study on malignant changes in adenomyosis in women with endometrial cancer. Materials and methods: Altogether thirty-one patients were divided into two groups. Group A - patients with intermediate and high risk endometrial cancer stages I were subjected to staging laparotomy with intraoperative detection of SLN and subsequent completion of the pelvic and paraaortic lymphadenectomy. Harvested SLN was routinely examined by classical haematoxilin eosin staining and in case of negativity, immunohistochemistry with antikeratine antibodies AE1/AE3 was applied....
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Evaluation of postoperative lymphoedema after differently radical surgery for vulvar and cervical carcinoma
Nováčková, Marta ; Halaška, Michael (advisor) ; Špaček, Jiří (referee) ; Mlynček, Miloš (referee) ; Kučera, Eduard (referee)
The aim of this study was a prospective detection of postoperative lymphedema of the lower limbs in patients after the surgery for cervical and vulvar cancer using different methods of examination and their comparison and monitoring of postoperative complications and quality of life. Totally 78 women were followed after the surgery for cervical cancer and 36 for carcinoma of the vulva. Due to the radicality of the surgery the patients were divided into the conservative and radical groups. Lower limbs lymphedema were evaluated preoperatively and 3, 6 and 12 months after the surgery by the measurement of the lower limbs circumference, multifrequency bioelectrical impedance analysis (MFBIA) and subjective feeling. Quality of life using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires was evaluated before and 6 and 12 month after the surgery. 12 months after the cervical cancer surgery 35.9 % of patients reported subjective lymphedema, 37.18 % lymphedema were objectively diagnosed by the measurement of lower limb circuits and in 52.56 % of cases the increase of amount of extracellular fluid was detected by the MFBIA Ri/R0 method. The prevalence of lymphedema after the surgery for vulvar cancer reached 19.44% by the subjective assessment, 38.89 % by the measurement of...
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Prevention of complications endoscopis surgery
Müller, Radek ; Kučera, Eduard (advisor)
This theme is dealing with historical development of the endoscopic methods in his opening part. Then this theme focuses on the identification of occurrence of complications in the endoscopic gynecology. First of all it focuses on laparoscopically assisted vaginal hysterectomy (LAVH). This theme speculates about the possibilities of prevention except of the complications. This theme was created by using the file of 487 patients who were operated by the LAVH method in the Institution for care about mother and child in Prague - Podolí in the interval of 2005 - 2008. The results of analysis are: 396 (81,3 %) patients were cured without any complication. Peroperational or postoperational complications were occured in 91 (18,7 %) cases. The patients with complications (91 cases) had in 58 (11,9 %) cases the less severe complications (fever or subfever at least 3 postoperation days, vaginal infiltration or the combination both of this complications. The group of 33 patients was affected by one or more severe complications. The theme compares getting results with National register of complications in gynecology laparoscopy. The summary says us that LAVH method belongs to the modern procedure in therapy of great group of gynecological pathology. There is very low occurrence of complications by using necessary...
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A laparoscopic approach to the prevention of complications in female endometrial cancer
Demo, Pavel ; Kučera, Eduard (advisor)
In this thesis I present a retrospective analytical study , which evaluates the results laparoscopically assisted vaginal hysterectomy (LAVH ) in the treatment of endometrial cancer and compare them with the results of similar studies in the professional press . This work will also basis for extensive retrospective study that will compare laparoscopically assisted vaginal hysterectomy and abdominal open surgical technique in the treatment of endometrial cancer . The aim of the thesis is to verify : Whether the laparoscopic approach yields fewer complications than the abdominal approach . What is the length of hospitalization using laparoscopic techniques . Compare the length of laparoscopic surgery of the file with a length of operations other workplaces. At the beginning of the thesis is devoted to the issue of endometrial cancer laparoscopic operations generally focus on a laparoscopically assisted vaginal hysterectomy (LAVH ) and its use in the treatment of endometrial cancer . Information for creating a group of patients who underwent LAVH in the diagnosis endometrial cancer , I have gained from operating books of the year 2001 - 2005 from the Institute for Mother and Child in Prague - Podolí. I also used a computerized database archive , also courtesy of Institute for the Care of Mother and Child...
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Prevention of complications in pregnancy after laparoscopic myomectomy
David, Martin ; Kučera, Eduard (advisor)
Gynecology and obstetrics monitor many clinical areas, which are very complex and not only medical side of things. Uterine myomatóza between such areas undoubtedly belongs. In the last time monitor several important phenomena occurring at the same time, giving rise to many questions. In recent years we have witnessed not only the rising birth rate but also shift to higher fertility age groups. According to data from 2007 significantly increased the number of pregnancies after twenty-fifthyear of age (> 70%) and rapidly increases the fertility of women between 30 and 34year (35%) [1]. In this age group is also a high incidence of uterine fibroids. We speak a very frequent clinical finding - fibroid is the most commongynecological tumor. It is therefore of considerable morbidity originator. So there is a growing group of women in roughly the same age, at where there is a fibroid, which are planning pregnancy andpregnant more often not. Symptomatic myoma is obviously an indication for its removal through various treatment modalities including surgical therapy. The result is a subgroup of patients who need to predict subsequent course of pregnancy, including mode of delivery, to analyze
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