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Bloodless Outpatient Surgical Treatment of Rectocele and Cystocele under Local Anesthesia
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作者 Octacílio Figueirêdo Netto Priscila Garcia Figueirêdo +1 位作者 Eduardo Garcia Figueirêdo Wildecir Barros 《Open Journal of Obstetrics and Gynecology》 2021年第5期569-577,共9页
<strong>Background:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Surgical treatment of r... <strong>Background:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Surgical treatment of rectocele and cystocele is usually performed in a hospital setting under regional (spinal or epidural) or general anesthesia, and patients commonly have to stay in the hospital for at least one or two days. The possibility of performing the surgery under local anesthesia, as an outpatient procedure with minimal bleeding and pain, no surgical assistants, with immediate discharge and, most importantly, without compromising postoperative results, is appealing. To our knowledge, no studies ha</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ve</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> evaluated whether performing rectocele and/or cystocele rectocele repair under local infiltration anesthesia and without separation of the vaginal mucosa from the underlying fascia achieves these goals.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> The aim of this study is to describe a new surgical technique for outpatient treatment of cystocele and rectocele under local anesthesia, and our initial results. </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Forty women underwent outpatient surgical repair of rectocele and/or cystocele between April and September 2020 at the ambulatory procedure room of the authors’ clinics. The technique consists of a triangular-shaped CO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> laser vaporization</span><span style="color:red;"> </span><span style="font-family:Verdana;">or electrocauterization of the posterior and/or anterior vaginal epithelium, followed by plication of the edges of the triangle with 0 polygalactin suture. A perineorrhaphy was always performed concomitantly with rectocele repair, and a transobturator sling was performed in women presenting with concomitant stress urinary incontinence. Postoperative evaluation included POP-Q measurement for each patient six months after the procedure, and resolution of prolapse was considered when anterior and/or posterior vaginal wall presented as stage 0 or 1. Pre and postoperative POP-Q measurements were analyzed using Wilcoxon signed-rank test.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The mean operating time was 21 minutes (range: 14</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">38 minutes). All patients tolerated the procedure well and were discharged immediately afterwards. There were no intraoperative or postoperative complications, and all patients had satisfactory healing of the vaginal mucosa. Bleeding from the rectocele and/or cystocele repair was minimal, and nobody required extra-anesthesia or transfer to a hospital surgical theater. At six month follow-up, pre and postoperative POP-Q measurement</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> of points Ap, Bp, Aa and Ba were all statistical</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">y significant (Ap 1.6 ± 1.2 × -2.4 ± 0.9, Bp 2.6 ± 1.6 × -2.7 ± 1.4, Aa 1.4 ± 1.1 × -2.3 ± 0.8, and Ba 2.4 ± 1.5 × -2.5 ± 1.2) respectively, revealing satisfactory resolution of both rectocele and cystocele.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">: Our initial results suggest that rectocele and cystocele may be safely and effectively treated under local anesthesia in an outpatient setting using this new technique.</span></span></span> 展开更多
关键词 RECTOCELE CYSTOCELE Pelvic Organ Prolapse Repair Local Anesthesia
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Repairing Organs with the Touch of a Nanochip
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《Chinese Journal of Biomedical Engineering(English Edition)》 2018年第2期92-92,共1页
This new device changes the function of cells by injecting them with synthetic DNA.Researchers developed a way to change cells inside the body from one type to another—with just one touch from a nanochip.This new tec... This new device changes the function of cells by injecting them with synthetic DNA.Researchers developed a way to change cells inside the body from one type to another—with just one touch from a nanochip.This new technology,called'tissue nanotransfection,'could be used to repair and regenerate body tissues,including organs,in a way that is non-invasive and painless. 展开更多
关键词 repairing Organs with the Touch of a Nanochip
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