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R L De Wilde

Publications and source records attributed to R L De Wilde.

17 recordsLinked to original sources
PubMed2000

Endosalpingiosis in laparoscopy.

STUDY OBJECTIVE: To estimate the laparoscopic frequency of endosalpingiosis versus other causes of peritoneal proliferation. DESIGN: Clinic-based, prospective, nonrandomized study (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: The 1107 consecutive women undergoing laparoscopy over 1 year. INTERVENTION: Peritoneoscopy was performed during laparoscopy. All peritoneal proliferations were excised and examined by histology. MEASUREMENTS AND MAIN RESULTS: In 7.6% of patients there was histologic evidence of endosalpingiosis. The frequency in asymptomatic women undergoing elective sterilization was 8.3%, and in infertile patients it was not significantly higher (11.7%, p = 0.6765). No significant difference was seen between patients with (7.3%) and without (7.9%) lower abdominal pain (p = 0. 7027). CONCLUSION: Endosalpingiosis is the second most common cause of peritoneal proliferation in the lower abdomen, with histologic evidence of the disorder in more than 7% of premenopausal women. In contrast to endometriosis, endosalpingiosis plays only a minor role in the evaluation of infertility and lower abdominal pain. Because of its relationship to serous ovarian neoplasms of low malignant potential, further prospective studies are urgently needed.

Abdominal Pain↗
PubMed1997

[A preoperative diagnostic concept for determining the extent of laparoscopic surgery of the adnexa].

The operative laparoscopic therapy of pre- and postmenopausal adnexal tumors has become more and more important in routine gynecological surgery. Careful evaluation of malignancy criteria by preoperative diagnostics decides whether endosurgical treatment or laparotomy should be performed. Preoperative diagnostic measurements must secure a safe and efficient endosurgery without any negative financial impact due to unnecessary explorations. The proposed diagnostic concept offers maximal security with minimal investigations.

Adult↗
PubMed1994

[Safety and effectiveness of endosurgical management of benign adnexal tumors in the premenopausal period: a prospective study].

Between January 1985 and December 1989, a prospective laparoscopic study was performed in premenopausal women with pelvic cysts growing or persisting for at least three months or evoking acute abdominal complaints. The aim of this prospective study was the investigation of the functional/nonfunctional rate, the relapse and the malignancy rate. 372 women underwent a diagnostic-operative laparoscopy in the absence of irregular solid and cystic parts detectable by preoperative vaginal ultrasonography. The treatment consisted of non-randomised endosurgical ovarian cystostomy, cystectomy or ovarectomy. Histopathological assessment showed functional ovarian cysts in 268 women and non-functional benign ovarian tumours in 104. 2 cases were subsequently found to be malignant. After a mean follow-up-time of at least one year, we found an overall recurrence rate of 4.6% after cystostomy, 2% after cystectomy and 0% after ovarectomy in the group of functional ovarian cysts and a total of 1% after endosurgical therapy of the non-functional ovarian tumours. The diagnostic operative laparoscopy proved to be a safe and efficient treatment of pelvic cysts in women of reproductive age, provided a sufficient preoperative vaginal ultrasound examination had been performed.

Adolescent↗
PubMed1994

[Diagnosis and therapy of adnexal tumors in postmenopause. A prospective study].

The management of postmenopausal adnexal tumours is still controversially discussed. Approximately 30% of all postmenopausal tumours are malignant. The standard operative approach for these adnexal masses is still the exploratory laparotomy although the advantages of laparoscopic procedure are obvious, even in older patients. The aim of this prospective study was to find out to what extent diagnostic-operative laparoscopy is able to replace laparotomy in the therapy of postmenopausal adnexal masses. From January 1990 to August 1992, 169 postmenopausal patients entered the prospective study. After careful preoperative diagnostics, 63 patients underwent a laparotomy (group B) and 106 patients a laparoscopy (group A). 10 of these 106 cases underwent laparotomy after diagnostic laparoscopy (group Ab). The main operative procedure in group Aa was laparoscopic adnexectomy after Semm. Mean operative time and mean postoperative hospital stay were significantly lower in patients, who only underwent laparoscopic operation (group Aa). One case (0.9%) of the laparoscopically operated patients was subsequently found to be malignant (histologic assessment) and immediately treated by laparotomy with hysterectomy and contralateral adnexectomy. The combination of vaginal examination, vaginal/abdominal ultrasonography (tumor marker CA 125) and a sufficient preoperative diagnostic during endosurgery (no proliferations on the ovary or peritoneal surface, no ascites) reduces the risk of operating a malignant tumour by laparoscopy to a minimum. We believe that operative laparoscopy of postmenopausal adnexal masses is a safe and efficient method in carefully selected women.

Aged↗
PubMed1994

[Breast saving or modified radical mastectomy in oncologic breast surgery?].

The bilateral subcutaneous reduction mastectomy is known as one of the methods in breast-saving cancer surgery, useful in patients with a malignant breast tumour showing multifocal lesions or combined with ptosis mammarum. In a retrospective study incorporating 160 patients after modified radical mastectomy or bilateral subcutaneous reduction mastectomy, we compared local recurrence rate, disease-free survival and mortality rate. A significant difference was found in local recurrence showing a higher rate in the non-radical group. The disease-free interval and the late mortality rate showed no statistical differences. The comparable disease-free interval of both groups added to the psychosocial benefits makes the bilateral subcutaneous reduction mastectomy a possible alternative surgical treatment of the breast carcinoma.

Adult↗
PubMed1993

[Management of gynecologic diseases within the scope of surgical pelviscopy].

Following the routine use of the diagnostic-operative laparoscopy in the surgical diagnosis and therapy of the lower abdominal pain, the surgeon is confronted with a plethora of gynecological diseases. Due to the unknown appearance, suboptimal therapy follows. Intra-operative consultation of a gynecologist does not necessarily bring the expected solution as there is a lack of gynecological anamnesis and preoperative examination. To avoid insufficient endosurgical diagnosis, therapeutical failures and iatrogenic infertility, the gynecological diagnosis scheme with subsequent therapy is described. Completing the preoperative diagnostics by a gynecological investigation can improve endosurgical treatment and avoid second-look surgery.

Abdominal Pain↗
PubMed1986

Scanning electron microscopic study of microvascular anastomoses on irradiated vessels: long-term effect of irradiation.

A study was performed to determine the effect of preoperative irradiation on microvascular arterial anastomoses. The study focused on microthrombi and epithelial regeneration. Using scanning electron microscopy (SEM), a clear difference was seen comparing nonirradiated to irradiated vessels. No difference was found between short- and long-term effects of irradiation.

Animals↗