Gynecologic Patients Research Articles

Meta-analysis of electrical stimulation promoting recovery of gastrointestinal function after gynecological abdominal surgery

BACKGROUND The effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery was not clear. AIM To systematically evaluate the effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery. METHODS The Cochrane Library, Web of Science, PubMed, ProQuest, and the Chinese biomedical literature databases Wanfang, Weipu, and CNKI were used to search for relevant studies on controlled trials of electrical stimulation in gynecological abdominal surgery patients from self-established databases to May 2024. The RevMan software (version 5.3) was used to analyze the included literature and explore the heterogeneity of each study. RESULTS Seven controlled trials, involving 520 patients, were included. The results of meta-analysis showed that electrical stimulation could shorten the recovery time of intestinal sound after gynecological abdominal surgery [odds ratio (OR): -5.11, 95%CI: -5.84 to -4.38, P < 0.00001] and improve the time of first anal exhaust (OR: -1.19, 95%CI: -1.38 to -0.99, P < 0.00001), improved the time of first anal defecation (OR: -0.98, 95%CI: -1.19 to -0.78, P < 0.00001), The difference is significant. According to the funnel plot, if the scatter is symmetrical, it indicates that the funnel plot is unbiased. CONCLUSION Electrical stimulation can shorten this reduces the length of time it takes for the patient to recover from bowel sounds and also affects the time to first anal voiding and defecation to some extent, thereby promoting gastrointestinal function recovery after gynecological abdominal surgery. The quality of the studies included in this review was poor, which may have affected the final results. It is necessary to conduct a randomized controlled study with higher quality and more samples to further confirm the promoting effect of electrical stimulation on gastrointestinal function recovery to guide clinical treatment.

Holistic approaches to mitigating psychological distress in gynecological cancer patients

This article delves into the psychological impact of gynecological malignancies and suggests pathways to improve the quality of life (QoL) for affected patients. Building on Shang et al 's comprehensive analysis, this piece integrates insights from various studies to highlight the profound influence of psychological and physical symptoms on patients undergoing treatment for gynecological cancers. The study underscores that anxiety and depression significantly exacerbate the disease's toll. Factors such as physical exercise and digital and interactive health interventions show promise in mitigating these adverse effects. The article emphasizes the necessity for a holistic care approach that addresses both physical and emotional needs. Recommendations include enhanced training for healthcare providers, public awareness campaigns, streamlined diagnostic pathways, and improved access to specialist care. These integrated strategies aim to ensure that women facing gynecological cancers can maintain an optimal QoL through comprehensive and multidisciplinary care models.

The experience with Hugo™ robot-assisted surgery on complex gynecological patients in Panama.

The Hugo™ robotic assisted surgery system is a relatively new robotic platform developed by Medtronic. The study objective was to describe the experience of using Hugo™ robotic assisted surgery in gynecological surgeries and compare robotic assisted surgery-related outcomes between complex and non-complex gynecological patients at the Pacifica Salud Hospital. We performed secondary data retrospective analysis of 144 consecutive patients who underwent gynecological surgery with Hugo™ robotic assisted surgery system (Medtronic) at the Pacifica Salud hospital in Panama City from July 19, 2021, to August 3, 2023. Complex patients were defined as those with one or more risk factors for surgery complications. Descriptive analysis of participants' sociodemographic and robotic assisted surgery-related characteristics. Due to the non-normal distribution of the RAS-related numeric variables, we compared these variables between complex and non-complex cases of gynecological patients using Kruskal-Wallis's test. The study found that Hugo™ robotic assisted surgery system was safe for gynecological surgery in patients with and without risk factors for developing major surgery complications. None of the patients experienced any complications, and they had short hospital stays with low blood loss without requiring a blood transfusion. The Hugo™ robotic assisted surgery system was technically sound and did not present technical failures. The results could be a reference for adopting this technology and developing best practices in the Latin American region.

Estimated clinical utility of multi-gene pharmacogenetic testing in a retrospective cohort of gynecology patients.

This study aimed to estimate the clinical utility of performing multi-gene pharmacogenetic testing on patients undergoing gynecologic surgery/procedure by evaluating the prescribing rate of Clinical Pharmacogenetics Implementation Consortium (CPIC) level A medications and frequency of drug-gene interactions (DGIs). The electronic health record was queried for 76 current procedural terminology codes to identify gynecologic surgeries/procedures that occurred between 1 January 2015 to 31 December 2020 in patients with at least one of 152 international classification of disease codes. Prescription data for CPIC level A medications was extracted. Those enrolled in the Penn Medicine Biobank were assessed for DGIs. The cohort consisted of 7798 female patients and 682 were in the biobank. Up to 6 years following their surgery or procedure, 80% were ordered ≥1 CPIC level A medication. Over half (54%) of these medications were ordered within 3 days after their surgery or procedure. The most common CPIC level A medications ordered were ibuprofen (57%) and ondansetron (42%). Overall, 7% of the cohort had ≥1 known or predicted DGI with medications they were prescribed. Multi-gene pharmacogenetic testing may be beneficial to gynecologic surgery/procedure patients by assisting clinicians with prescribing postoperative analgesics and future medications.

Spiritual Care Experiences of Nurses Caring for Gynecologic Cancer Patients in Türkiye: A Qualitative Research.

The study aimed to examine the spiritual care experiences of nurses caring for gynecologic cancer patients. The study was conducted using a phenomenological design, one of the qualitative research methods. Nurses caring for gynecologic cancer patients were included in the study. In sample selection, the criterion sampling method, one of the purposeful sampling methods, was used, and the sample size was ten nurses. A semi-structured interview guide was used to collect the data. Content analysis was performed using the MAXQDA package program. The study was written based on the COREQ checklist. The nurses' statements determined themes, sub-themes, and codes in line with the research findings. Accordingly, four themes were identified as "spiritual care practices," "emotional effects of spiritual care," "factors affecting spiritual care," and "recommendations to improve spiritual care".In line with the findings obtained, it is recommended that in-service training should be provided to nurses caring for gynecologic cancer patients to provide spiritual care at a professional level. Moreover, the excessive workload caused by working conditions should be reduced, and regulations and institutional policies should be established to increase the number of nurses.

Venous thromboembolism among gynecologic cancer patients in Zaria

Cancer is one of the most important acquired risk factors for Venous Thromboembolism (VTE) including Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Patients with active malignancy have up to six-fold increased risk of symptomatic VTE than the general population. The risk of VTE in patients with gynecologic malignancy is especially high because of the nature of the tumor, its pelvic location, associated comorbidities, and systemic chemotherapy. The objective of this study was to determine other risk factors, incidence, clinical presentation, and immediate outcome of treatment of thromboembolism in patients with gynecologic cancers in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. It was a retrospective cross-sectional descriptive study of gynecologic cancer cases that were diagnosed with VTE while on admission from 2007-2016 in ABUTH. The overall prevalence of clinical VTE was 2.8% in gynaecologic malignancy. All were DVT. Most cases of DVT were present in ovarian cancers with left-sided preponderance. There is a need for the provision of modern imaging equipment to facilitate timely and highly sensitive diagnosis of VTE in low-resource settings. The main limitation of this study was the inability to find any confirmed case of PE.

Sensitive Detection of Gynecological Cancer Recurrence Using Circulating Tumor DNA and Digital PCR: A Comparative Study with Serum Biochemical Markers

Early detection of recurrences in gynecological cancers is crucial for women’s health. Circulating tumor DNA (ctDNA) analysis through liquid biopsy offers a promising approach for monitoring disease progression and identifying relapses. This study investigated the utility of digital Polymerase Chain Reaction (dPCR) for ctDNA detection in three gynecological cancer patients with clinically confirmed relapses during a two-year post-surgical follow-up. Patient-specific tumor mutations were identified through whole-exome sequencing (WES) and confirmed via Sanger sequencing. dPCR probes targeting these mutations were used to quantify the ctDNA levels in plasma samples collected throughout the follow-up period, and the findings were compared with standard serum biochemical markers. In two patients, persistent positive dPCR signals for the selected mutations were detected after tumor removal, with ctDNA levels progressively increasing even after post-surgical chemotherapy. Notably, dPCR identified elevated ctDNA levels before an increase in the cancer antigen 125 (CA125) biochemical marker was observed. In the third patient, no ctDNA signals from the two selected mutations were detected despite clinical evidence of recurrence, suggesting the emergence of new mutations. While this study highlights the promise of dPCR for early recurrence detection in gynecological cancers, it also underscores the critical need for comprehensive mutation panels to overcome the inherent challenges posed by tumor heterogeneity and the emergence of new mutations during disease progression.

Increasing trends of laparoscopic procedures in non-obstetric surgery during pregnancy over 17 years at a single center: Retrospective case-control study.

This study aimed to examine the diseases requiring surgery during pregnancy, the changes in surgical methods over time, and the characteristics of surgeries performed in different trimesters. A retrospective study conducted at Bundang CHA Hospital between 2006 and 2023 analyzed surgeries performed during pregnancy and compared laparoscopic and open approaches across the three trimesters of pregnancy. Additionally, general (appendicitis, cholecystitis) and gynecologic (heterotopic pregnancy, adnexal torsion) cases were compared. Among 36 181 delivery patients, 101 (0.28%) underwent surgery. The most common conditions were appendicitis (44.6%), cholecystitis (1.9%), heterotopic pregnancy (23.8%), adnexal torsion (27.7%), and cancer (1.9%). The laparoscopic group had a shorter operative time (41.5 ± 19.3 vs. 57.9 ± 33.9 min, p = 0.009) and hospital stay (4.9 ± 2.7 vs. 9.0 ± 9.8 days, p = 0.016) than open surgery group. Heterotopic pregnancy (47.1%) and adnexal torsion (39.2%) were common in the first trimester, whereas appendicitis peaked in the second (80%) and third trimesters (66.7%). The increasing use of assisted reproductive technology (ART) has led to a rise in gynecological patients requiring surgery in the first trimester, resulting in more laparoscopic surgeries during this period. Interestingly, an increase in laparoscopic surgery was also observed in general surgery during the second and third trimesters. Perioperative tocolysis was more frequent (51.1% vs. 3.8%, p < 0.001) and of longer duration (4.6 ± 8.8 vs. 0.1 ± 0.6 days, p = 0.001) after general surgical procedures. Laparoscopic surgery during pregnancy offers several advantages such as shorter operative time and hospital stay. Since 2011, laparoscopic surgery for the entire gestational period has been on the rise.

Effectiveness and Safety of Low-flow Sevoflurane Combined with Remifentanil on Anaesthesia of Patients Undergoing Gynaecological Laparoscopic Surgery

Objective: To evaluate the advantages of sevoflurane (low-flow) + remifentanil for patients undergoing gynaecological laparoscopic surgery. Methods: 300 patients admitted for gynaecological laparoscopic surgery between July 2020 and July 2023 were selected and divided equally by random number table, 150 cases were counted in the observation group, and sevoflurane (low-flow) + remifentanil was chosen for maintenance anaesthesia; 150 cases were counted in the reference group, and anaesthesia was maintained only with remifentanil. The anaesthesia indexes, haemodynamics, stress reaction indexes, and adverse reaction rate of the two groups were compared. Results: The anaesthesia indexes of the observation group were better than those of the reference group (P &lt; 0.05). Before 5 min of anaesthesia (T1), there was no difference between the haemodynamics and stress reaction indexes of the two groups (P &gt; 0.05). After 30 min of pneumoperitoneum (T2) and immediately after the end of surgery (T3), the hemodynamic and stress indicators of the observation group were lower than those of the reference group (P &lt; 0.05). The adverse reaction rate of the observation group was lower than that of the reference group (P &lt; 0.05). Conclusion: Sevoflurane (low-flow) + remifentanil can improve the anaesthesia indexes of gynecological laparoscopic surgery patients, stabilize intraoperative haemodynamics, reduce the stress reaction, and the safety of medication is high.

Assessing the readability of online health information regarding treatment modalities for gynecologic cancer patients

Assessing the readability of online health information regarding treatment modalities for gynecologic cancer patients

Financial toxicity among gynecologic oncology surgical patients

Financial toxicity among gynecologic oncology surgical patients

Variables impacting postoperative length of stay for gynecologic cancer patients in the era of same day minimally invasive hysterectomy

Variables impacting postoperative length of stay for gynecologic cancer patients in the era of same day minimally invasive hysterectomy

Venous and arterial thromboembolic events in gynecologic cancer patients receiving treatment with immunotherapy

Venous and arterial thromboembolic events in gynecologic cancer patients receiving treatment with immunotherapy

Safety of apixaban when compared to enoxaparin for postoperative venous thromboembolism prophylaxis among gynecologic cancer patients

Safety of apixaban when compared to enoxaparin for postoperative venous thromboembolism prophylaxis among gynecologic cancer patients

Gynecologic oncology patients with severe mental illness diagnosis are more likely to experience adverse outcomes during hospitalizations for cancer-directed treatment

Gynecologic oncology patients with severe mental illness diagnosis are more likely to experience adverse outcomes during hospitalizations for cancer-directed treatment

Universal distress thermometer screening by a social worker among gynecologic oncology patients improves the rate of distress screening

Universal distress thermometer screening by a social worker among gynecologic oncology patients improves the rate of distress screening

Assessment of endocrine toxicities among gynecologic oncology patients receiving immunotherapy

Assessment of endocrine toxicities among gynecologic oncology patients receiving immunotherapy

Evaluating differences among PRAPARE screening assessments of gynecologic oncology patients based on sociodemographic factors

Evaluating differences among PRAPARE screening assessments of gynecologic oncology patients based on sociodemographic factors

Virtual Care With Remote Automated Monitoring (VRAS) for Gynecologic Post-Operative Patients: A Cohort Study

Virtual Care With Remote Automated Monitoring (VRAS) for Gynecologic Post-Operative Patients: A Cohort Study

Postoperative acute pain trajectories in gynecologic cancer patients undergoing hysterectomy

Postoperative acute pain trajectories in gynecologic cancer patients undergoing hysterectomy