Journal of Yeungnam Medical Science

Review article

Classification of endometriosis: Soo-Young Lee, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2021;38(1):10-18. Published online August 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00444

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Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

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Original articles

Clinical outcomes of hysterectomy for benign diseases in the female genital tract: 6 years’ experience in a single institute: Hyo-Shin Kim, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2020;37(4):308-313. Published online April 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00185

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Abstract PDF

Background
Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital.
Methods
We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients’ demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes.
Results
A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%–38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%).
Conclusion
Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

Citations

Citations to this article as recorded by

Analysis of Different Routes of Hysterectomy Based on a Prospective Algorithm and Their Complications in a Tertiary Care Institute
Subrat Panda, Ananya Das, Rituparna Das, Nalini Sharma, Wansalan Shullai, Vinayak Jante, Anusuya Sharma, Kaushiki Singh, Prateeti Baruah, Ruksana Makakmayum, Imtiaz Wani
Minimally Invasive Surgery.2022; 2022: 1. CrossRef

Clinical and histopathologic analysis of gynecological cancer: a single institute experience over 7 years: Soo-Young Lee, Eunbyeol Kim, Hyo-Shin Kim, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2020;37(3):179-185. Published online March 5, 2020; DOI: https://doi.org/10.12701/yujm.2019.00451

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Abstract PDF

Background
Approximately 100,000 women are diagnosed with cancer each year in Korea. According to a survey by the Korean central cancer registry in 2016, uterine cervical cancer, uterine corpus cancer, and ovarian cancer were the 5th, 7th, and 8th most prevalent cancers respectively among Korean women. The present study aims to review the clinico-pathologic characteristics of patients who were treated for major gynecological malignancies at Yeungnam University Medical Center.
Methods
Patients with invasive gynecological cancers from January 2012 to February 2019 were retrospectively identified. We analyzed the clinical features, demographic profiles, pathologic data, treatment modality used, adjuvant treatment used, complications, recurrence, and survival outcomes.
Results
A total of 287 patients (cervical cancer 115; corporal cancer 86; and ovarian, tubal, or primary peritoneal cancer 90) were included. Most cervical (82.7%) and corporal cancers (89.5%) were diagnosed in the early stages (stage I or II), while more than half (58.9%) the cases of ovarian, tubal or peritoneal cancers were diagnosed in the advanced stages (stage III or IV). Surgical complications were observed in 12.2% of cervical cancers, 16.3% of uterine corpus cancers, and 11.1% of ovarian, tubal, and peritoneal cancers, respectively. The 5-year overall survival rate was 94.1%, 91.0%, and 77.1% for cervical, corporal, and ovarian, tubal, or peritoneal cancers, respectively.
Conclusion
Surgical treatment was satisfactory in terms of the incidence of complications, and survival outcomes were generally good. Clinicians should be aware of the clinical and histopathological characteristics of patients with gynecological cancers to be able to provide optimal strategies and counseling.

Citations

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Molecular landscape of recurrent cervical cancer
Divya Adiga, Sangavi Eswaran, Deeksha Pandey, Krishna Sharan, Shama Prasada Kabekkodu
Critical Reviews in Oncology/Hematology.2021; 157: 103178. CrossRef
Histopathological Study of Gynecological Cancers in Patients Admitted to Baqiyatallah Hospital in Tehran during 2011-2019
Seyedeh Razieh Hashemi, Mohammad Reza Akbari, Zahra Soleimani
Avicenna Journal of Clinical Medicine.2021; 28(1): 42. CrossRef

Case Report

Puerperal septic shock and necrotizing fasciitis caused by Staphylococcus caprae and Escherichia coli: Yu-Jin Koo; Yeungnam Univ J Med. 2018;35(2):248-252. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.248

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Abstract PDF

Puerperal sepsis is one of the leading causes of maternal morbidity and mortality worldwide. Postpartum pelvic infections can cause various complications, including wound infections and necrotizing fasciitis. Several microorganisms are known to cause such infections; however, no study has reported on Staphylococcus caprae, a coagulase-negative staphylococcus that is isolated frequently from animals and infrequently from human specimens, as a causative agent. Here, we report a rare case of septic shock complicated by necrotizing fasciitis after a cesarean section. This is the first report of a human isolate of S. caprae in association with puerperal sepsis and necrotizing fasciitis.

Citations

Citations to this article as recorded by

Factors Affecting Postpartum Infection: A Systematic Review
Maryam Malmir, Narges Azizi Boroojerdi, Seyedeh Zahra Masoumi, Parisa Parsa
Infectious Disorders - Drug Targets.2022;[Epub] CrossRef

Review Article

Recent advances in minimally invasive surgery for gynecologic indications: Yu-Jin Koo; Yeungnam Univ J Med. 2018;35(2):150-155. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.150

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Abstract PDF

Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic singlesite surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

Citations

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Ngima Yangji Sherpa, Ahmed El Minawi, Ahmed N Askalany, Marwa Abdalla
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Liam Swanepoel, Alexander Przybysz, Pieter Fourie, Jurgen Kosel
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Archives of Gynecology and Obstetrics.2023; 308(5): 1549. CrossRef
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Pei-Chen Chen, Pei-Chen Li, Hsuan Chen, Dah-Ching Ding
Gynecology and Minimally Invasive Therapy.2022; 11(2): 121. CrossRef
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Xiaoping Jia, Jing Zhou, Yanyan Fu, Hui Wang, Cailing Ma
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Liam Swanepoel, Nouf Alsharif, Alexander Przybysz, Pieter Fourie, Pierre Goussard, Mohammad Asadullah Khan, Abdullah Almansouri, Jurgen Kosel
Advanced Materials Technologies.2021;[Epub] CrossRef
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Liliana Mereu, Francesca Dalprà, Saverio Tateo
Journal of Clinical Medicine.2021; 10(10): 2073. CrossRef
Cervicovaginal reconstruction with small intestinal submucosa graft in congenital cervicovaginal atresia: A report of 38 cases
Yan Ding, Xuyin Zhang, Ying Zhang, Fang Shen, Jingxin Ding, Keqin Hua
European Journal of Obstetrics & Gynecology and Reproductive Biology.2021; 267: 49. CrossRef
Benefícios relacionados à cirurgia minimamente invasiva na ginecologia
Isys Holanda Albuquerque de Vasconcelos, Renata Nogueira Andrade, Beatriz Amâncio Rodrigues, Beatriz Leite Assis, Lorenna da Silva Santos, Luana Lemos Alves, Marlon José dos Santos Rosa, Monica Aparecida Miranda Carvalho, Renata Correia Freire, Scanagatt
Revista Científica Multidisciplinar Núcleo do Conhecimento.2020; : 28. CrossRef

Case Report

Successful delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a twin pregnancy: Yu-Jin Koo; Yeungnam Univ J Med. 2018;35(1):135-139. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.135

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Abstract PDF: There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

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