PubMed Health⌕ Search

Biomedical subjects

Sergio Podgaec

Publications and source records attributed to Sergio Podgaec.

5 recordsLinked to original sources
PubMed2006

Deeply infiltrating endometriosis affecting the rectum and lymph nodes.

OBJECTIVE: To analyze morphologic aspects of bowel endometriosis. DESIGN: Prospective study of 35 consecutive cases of bowel endometriosis. SETTING: Multidisciplinary group practice and teaching hospital. PATIENT(S): Thirty-five patients with bowel endometriosis were assessed between September 2003 and June 2005. INTERVENTION(S): Histologic analysis of 35 tissue samples removed at laparoscopic rectosigmoidectomy. MAIN OUTCOME MEASURE(S): We performed an evaluation of lesion size, number of lesions present in the bowel, intestinal wall layers affected by the endometriotic lesion, circumference of the intestinal loop affected by the endometriotic lesion, and presence of lymph nodes with foci of endometriosis. RESULT(S): Analysis of the surgical samples revealed lymph nodes in the pericolic adipose tissue of 19 (54%), cases and in 5 of these cases (26.3%), endometriosis had affected the lymph nodes. When the thickness of the endometriotic lesion reached 1.75 cm, lymph nodes of all patients were affected, and all patients in whom more than 80% of the circumference of the intestinal loop was affected by endometriosis presented with positive lymph nodes. CONCLUSION(S): This study raises doubts about whether this form of the disease can still be considered a clinically benign disease.

Adult↗
PubMed2005

Randomized clinical trial of a levonorgestrel-releasing intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women with endometriosis.

BACKGROUND: The objective of this multicentre randomized, controlled clinical trial was to compare the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) and a depot-GnRH-analogue in the control of endometriosis-related pain over a period of six months. METHODS: Eighty-two women, 18 to 40 years of age (mean 30 years), with endometriosis, dysmenorrhoea and/or CPP, were randomized using a computer-generated system of sealed envelopes into either LNG-IUS (n = 39) or GnRH analogue (n = 43) treatment groups at three university centres. Daily scores of endometriosis-associated CPP were evaluated using the Visual Analogue Scale (VAS), daily bleeding score was calculated from bleeding calendars, and improvement in quality of life was evaluated using the Psychological General Well-Being Index Questionnaire (PGWBI). The pain score diary was based on the VAS in which women recorded the occurrence and intensity of pain on a daily basis. A monthly score was calculated from the result of the sum of the daily scores divided by the number of days in each observation period. RESULTS: CPP decreased significantly from the first month throughout the six months of therapy with both forms of treatment and there was no difference between the groups (P > 0.999). In both treatment groups, women with stage III and IV endometriosis showed a more rapid improvement in the VAS pain score than women with stage I and II of the disease (P < 0.002). LNG-IUS users had a higher bleeding score than GnRH-analogue users at all time points of observation with 34% and 71% of patients in the LNG-IUS and GnRH-analogue groups, respectively, reporting no bleeding during the first treatment month, and 70% and 98% reporting no bleeding during the sixth month. No difference was observed between groups with reference to improvement in quality of life. CONCLUSIONS: Both, the LNG-IUS and the GnRH-analogue were effective in the treatment of CPP-associated endometriosis, although no differences were observed between the two treatments. Among the additional advantages of the LNG-IUS is the fact that it does not provoke hypoestrogenism and that it requires only one medical intervention for its introduction every 5 years. This device could therefore become the treatment of choice for CPP-associated endometriosis in women who do not wish to conceive.

Adolescent↗
PubMed2005

Microlaparoscopy vs. conventional laparoscopy for the management of early-stage pelvic endometriosis: a comparison.

OBJECTIVE: To evaluate the advantages and disadvantages of microlaparoscopy vs. conventional laparoscopy in the management of patients with early-stage pelvic endometriosis. STUDY DESIGN: In this prospective, randomized study we evaluated 54 patients with a clinical diagnosis of stage I and II pelvic endometriosis according to the classification of the American Society for Reproductive Medicine, revised in 1996. The patients were divided into 3 groups and underwent, respectively, microlaparoscopy under sedation, microlaparoscopy under general anesthesia and conventional laparoscopy for definitive diagnosis and treatment of the disease. RESULTS: Microlaparoscopy caused less pain, required lower consumption of analgesics and permitted a faster return to daily activities. Sedation decreased the incidence of nausea, vomiting and oropharyngeal pain. Microlaparoscopy under sedation led to a shorter hospital stay and reduced cost. CONCLUSION: Microlaparoscopy under sedation is a viable alternative for the management of patients with suspected early-stage pelvic endometriosis.

Adult↗