Journal of the American College of Surgeons
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Adequate treatment of severe deep pelvic endometriosis requires complete excision of all implants, but formal bowel resection is not generally recommended. The purpose of this study was to describe our experience with planned complete laparoscopic management of deep pelvic endometriosis with bowel involvement. ⋯ Though technically demanding, complete radical laparoscopic excision of endometriotic implants can be accomplished with preservation of the reproductive organs and appropriate use of bowel resection in the majority of patients. The surgeon or gynecologist who plans to perform laparoscopic excision of deep pelvic endometriosis should have the ability or access to expertise for laparoscopic partial or segmental bowel resection or plan to convert to laparotomy when faced with this disease location.
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Comparative Study
Comparative evaluation of duplex-derived parameters in patients with chronic venous insufficiency: correlation with clinical manifestations.
Quantification of venous reflux is still a matter of debate. Our goal was to compare the duplex-derived parameters between patients with early and advanced chronic venous insufficiency (CVI), and to determine indicative parameters reflecting the progression of CVI. ⋯ Superficial venous insufficiency might play a major role in the development of advanced CVI. The peak reflux velocity and peak reflux volume improve discrimination power between early-stage and advanced CVI.
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Experience using radiofrequency ablation (RFA) for treating unresectable hepatic malignancies is expanding, with promising outcomes and fewer complications compared with cryotherapy. ⋯ In contrast to previous reports using cryotherapy, systemic inflammatory responses as measured by increased cytokines were not observed after RFA. The cryotherapy-induced "cryoshock" phenomenon was not observed in patients undergoing RFA in our study. We conclude that RFA ablation is fundamentally different than cryotherapy and apparently does not stimulate Kupffer and other hepatic macrophages to produce proinflammatory cytokines.