References in periodicals archive ?
They suggested that surgery should be adapted to the structure of endometrioma by adhesiolysis with opening and eversion of the cyst and followed by ablation of the superficial endometriotic tissue lining the cortex and excision of the implants at site of the adherent parametrium or ligaments.
Historically, parametrectomy, also known as radical hysterectomy, has been a key cause of postoperative complications associated with the surgery, and the issue of just how much parametrium to remove during surgery is a matter of debate.
Some study findings underscore the importance of removing the parametrium entirely regardless of tumor size, noting that parametrial metastases occur equally in the lateral and medial parametrium.
In the midst of this debate, it's been routine practice to remove all or at least part of the parametrium for all but microinvasive squamous cell carcinomas.
If so-called modified radical hysterectomy removed only the medial half of the parametrium, approximately 1.
And compared with simple hysterectomy, in which none of the parametrium is removed, the survival benefit of modified radical hysterectomy would be only 0.
For many patients, such an incremental difference probably wouldn't justify the added morbidity associated with removing the parametrium, Dr.
The ultimate goal in the examination of a cancerous hysterectomy specimen should be to confirm the presence of residual tumor after the initial sampling, to sample enough of it for adequate typing and grading, and to determine the extent of spread within the specimen (myometrium, serosa, parametrium, lymphatic/vascular spaces, cervix, and attached uterine adnexa).
The items to be recorded in the surgical pathology report include all of those listed previously for the biopsy or curettage specimen, as well as the presence and depth of myometrial extension in the uterine corpus, the presence or absence of lymphatic/vascular space invasion, and the possible involvement of uterine serosa, parametrium, cervix, and other sites included in the resection that would raise the pathologic stage of the tumor (Table 4).