ObjectiveTo compare the feasibility and safety of the laparoscopic management of adnexal masses appearing preoperatively benign with those suspicious for malignancy.MethodsRetrospective study of 694 women that underwent laparoscopic management of an adnexal mass.ResultsLaparoscopic management of an adnexal mass was completed in 678 patients. Six hundred and thirty five patients had benign pathology (91.5%) and 53 (7.6%) had primary ovarian cancers. Sixteen patients (2.3%) were converted to laparotomy; there were 13 intraoperative (1.9%) and 16 postoperative complications (2.3%). Patients divided in 2 groups: benign and borderline/malignant tumors. Patients in the benign group had a higher incidence of ovarian cyst rupture (26% vs. 8.7%, p<0.05). Patients in the borderline/malignant group had a statistically significant higher conversion rate to laparotomy (0.9% vs. 16.9%, p<0.001), postoperative complications (1.9% vs. 12.2%, p<0.05), blood loss, operative time, and duration of hospital stay. The incidence of intraoperative complications was similar between the 2 groups.ConclusionLaparoscopic management of masses that are suspicious for malignancy or borderline pathology is associated with an increased risk in specific intra-operative and post-operative morbidities in comparison to benign masses. Surgeons should tailor the operative risks with their patients according to the preoperative likelihood of the mass being carcinoma or borderline malignancy.
Endometrial hyperplasia is characterized by a proliferation of endometrial glands that may progress to or coexist with endometrial carcinoma. Previous studies proved the presence of endometrial stem cells that may have a role in endometrial regeneration and may be responsible for proliferative disorders as in endometrial hyperplasia and endometrial carcinoma. The presentstudy carried out to evaluate the potentiality of Umbilical cord blood Hematopoietic CD34+ and Mesenchymal stem cells to regress endometrial hyperplastic cells proliferation in vitro under certain condition. The Study carried out on 40 Umbilical cord blood samples collected from term delivering women, mononuclear cell were separated. Endometrial samples from the 40 cases (20normal and 20 cases with endometrial hyperplasia) were collected by dilatation and curettage or by curetting endometrium after hysterectomy operation. Then treatment of the hyperplastic cells with the Mesenchymal stem cells extract and CD34+ Hematopoietic stem cells extract was done. Results showed that both CD34+ Hematopoietic stem cells extract and mesenchymal stem cellsextract both had decreased the rate of growth of endometrial hyperplastic cell culture reaching near to the rate of growth of normal endometrial primary cell culture but the mesenchymal stem cells extract had a higher degree of control making endometrial growth rate nearer to the rate of growth of normal endometrial primary cell culture.
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