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[Experiences using the suction curettage system of Hamann and Pockrand (author's transl)].

All curettages of a 8-week-period were done using the suction system of Hamann and Pockrandt. This test-collective includes 66 patients, their age was between 20 and 78 years; 6 of them had to be excluded: the surgical intervention was begun without general anaesthesia but continued with general anaesthesia is required by the patient. The test-collective was divided into 2 groups: in group A (30 patients) all suction-curettages were done in general anaesthesia, in the first 20 patients a conventional curettage with dilation of the cervix were performed additionally, in order to proof the effectiveness of the suction curettage. The histological findings of the materials of the conventional curettages had shown no more informations than that of the materials of the suction curettages. -- In group B (30 patients) the suction curettage were done in diazepampentazocin-analgesia; a third of them had specified no sensations, the others had stated a feeling of pressure or spasms. -- In each group the histological examinations were possible without any problems. The advantages of the suction curettage system are the rare necessity of cervix dilatation (7 of 60 cases), the possibility of the operation without general anaesthesia and the possibility of a quick performance of the curettage.

Abortion, Incomplete

Diagnostic outpatient aspiration curettage.

Outpatient uterine curettage has proved to be an effective diagnostic tool and could replace the need for many hospital curettages. The materials needed to perform an outpatient curettage are described. The method was evaluated on 300 patients who underwent conventional hospital curettage under anesthesia 24 hours after the outpatient curettage. The outpatient curettage was evaluated for safety, reliability, economy, effectiveness, and patient acceptance. The results of the two methods compared favorably.

Adult

Some observations on the value of endocervical curettage performed as an integral part of colposcopic examination of patients with abnormal cervical cytology.

A total of 259 patients underwent endocervical curettage as an integral part of colposcopic examination of patients with abnormal cervical cytology. The transformation zone was entirely visualized in 140 patients (54.1 per cent), and, in 8.6 per cent of this group, the endocervical curettings were abnormal. On no occasion did the endocervical curettage harbor the worst lesion when compared to the histology of the ectocervical biopsy, cone biopsy, and hysterectomy specimens. In 117 patients (45.2 per cent), the transformation zone could not be visualized in its entirety, and in 57.3 per cent the endocervical curettings were abnormal. In one patient of this group invasive carcinoma was present in the endocervical curettage, and in another patient invasive carcinoma was present in both the ectocervical biopsy and the endocervical curettage. Thus, when the entire transformation zone is not visualized in its entirety or at all, endocervical curettage appears to be of value since a frank invasive carcinoma may be diagnosed and a cone biopsy avoided.

Biopsy

Critical assessment of dilatation and curettage in 1029 women.

Of 1029 dilatation-and-curettage operations carried out in a 12-month period, more than half were in women aged under 40, and 38% were for menstrual disturbances. The yield of intrauterine disease in these groups was low--curettage for post-menopausal bleeding or discharge in 150 women detected 15 endomettrial carcinomas and a similar number of other endometrial lesions. The complication-rate resulting from curettage was 1.7%--i.e., equivalent to the overall rate of detection of endometrial carcinoma. Selection of patients submitted to uterine curettage could be better, but postmenopausal bleeding remains an indication for mandatory uterine curettage.

Adult

Electron microscopic study of vascular regeneration in rat tracheal mucosa following physical curettage.

Transmission and scanning electron microscopic studies were made of regeneration of the vascular network of rat tracheal mucosa on 30 min to 8 hr after the mechanical curettage. The vascular network casts were made by infusion of Mercox resin through the aortic arch for scanning electron microscopy. At 30 min after curettage, vascular thromboses were observed, and terminal blind branches were formed in the injured blood vessels areas through SEM observation. Diapedesis of leukocytes appeared at 30 min after curettage from intact venules at the wound margins. Recovery from the loss of endothelial cells began at 30 min after curettage. At 3 hr after curettage, vascular indentation (protrusion) and vascular process (bud-like process) were developed from intact venules at the wound margins. It is concluded that the formation of thrombus and terminal blind branch vessels constitute the initial reparative reactions of the injured vascular network and that new vessels then begin to form by outgrowth of protrusions and bud-like processes from intact venules at the wound margins.

Animals

[Hysteroscopic diagnosis in patients with abnormal uterine hemorrhage and previous endometrial curettage].

Thirty-four patients, with a history of persistent abnormal uterine bleeding and dilatation and curettage or suction curettage performed within the previous year, were evaluated by office hysteroscopy and biopsy. For 16 patients (47%) the hysteroscopic diagnosis was in agreement with the curettage. Hysteroscopy revealed more information in 18 patients (53%): 8 had polyps, 6 had submucous or pedunculated myoma, 2 had endometrial neoplasia, 1 had myoma and polyp, 2 had endometrial neoplasia and 1 had synechia. Moreover in 3 patients with diagnosis of suspected myoma by curettage, hysteroscopy revealed a normal cavity. The high incidence of missed diagnosis of pathologic conditions by "blind" curettage supports the opinion that diagnostic hysteroscopy is the method of choice in the evaluation of abnormal uterine bleeding.

Dilatation and Curettage

[A comparative study of the suction and customary curettage methods in the termination of pregnancy (author's transl)].

90 hysteroscopies using CO2 were performed to evaluate differences in effectiveness between the customary curettage and the suction methods in terminating pregnancy during the first trimenon. Following suction, the uterine cavity was nearly always thoroughly evacuated. Very seldom is there any residual tissue seen. On the contrary, the uterine cavity following termination by customary curettage was almost never completely evacuated. Very often rest tissue of decidua, usually chorionic, in some cases with villous structures, were found. Tissue remnants following termination by either method were removed by target biopsy or curettage and examined histologically. Having made the above observations and comparison, it must be concluded that the suction method is clearly the more advantageous. If applied correctly, it becomes unnecessary to perform curettage right after the suction.

Abortion, Legal

Diagnostic suction curettage without anesthesia. An investigation into the practical usefulness of the Vabra aspirator.

The purpose of this work is: 1) to answer the question whether the procedure of the Vabra aspiration curettage without anesthesia is well tolerated by the patients; 2) to assess the reliability of the Vabra curettage and to compare it with the conventional curettage in the diagnosis of various endometrial disorder. 262 patients were submitted to the procedure of fractional suctioncurettage without anesthesia; the method succeeded in 261 cases. In 205 cases the histological diagnosis was compared to the diagnosis from a conventional curettage or from a hysterectomy specimen. The method gives histologically reliable results. The tolerance by the patients was good. There were no complications.

Adult

Role of endocervical curettage in colposcopy.

A series of 1,850 patients with atypical Papanicolaou smears referred to the Colposcopy Clinic at Cook County Hospital were evaluated. There were 2,000 colposcopic examinations with or without directed biopsy and 495 endocervical curettements. Records of 126 patients who had definitive diagnoses were reviewed. Of 126 patients, 41 had diagnostic conization following colposcopy-directed biopsy and endocervical curettage; 85 had only colposcopy-directed biopsy and endocervical curettage. There were two instances in which an invasive cancer was missed prior to therapy, one in the group of 41 patients (incidence of 2.4 per cent), the other in the group of 85 patients (incidence of 1.1 per cent). Cone biopsy contributed very little to establishing the diagnosis of invasive cancer following colposcopy-directed biopsy and endocervical curettage. Safety measures for endocervical curettage performed during pregnancy are presented. The management of patients evaluated by colposcopy-directed biopsy and endocervical curettement requires careful correlation of histo- and cytopathology.

Biopsy

Giant cell tumor of bone treated by curettage, cementation, and bone grafting.

Giant cell tumor, a relatively rare, occasionally malignant tumor of bone, remains a difficult therapeutic problem for the orthopedic surgeon. Various treatment options, including curettage alone, curettage with bone grafting, radiation, and curettage with acrylic cementation have been utilized and reported. Therapeutic complications such as infection, recurrence, and loss of support of the articular surface have continued to plague the treatment of giant cell tumors. This article reports the results of 10 consecutive cases of giant cell tumor of bone treated by curettage and methyl methacrylate cementation, followed by bone grafting of the surface of the lesion with demineralized bone matrix to reconstitute the cortex at the site of the tumor. At an average follow up of 36 months, eight patients had an excellent functional result and two had a fair result as scored on the Musculoskeletal Tumor Society rating system. To date, there have been no tumor recurrences or metastases, and all patients have radiographic evidence of healing of the weight bearing cortical surface.

Adult

Examination of curettage material for the diagnosis of ectopic pregnancy.

The histological characteristics of curettage material are described which raise the suspicion of ectopic pregnancy. In the period 1966 to 1975, 464 surgically removed pregnant uterine tubes and in 143 patients curettage material was also examined. On the basis of the curettage material, the suspicion of ectopic pregnancy arose in 109 cases (76%). In 34 curettage materials (24%) no histological sign referring to ectopic pregnancy was detected. Thus in three-fourth of cases examination of the endometrial specimen was of diagnostic value and indicated the necessity of surgery.

Adult

Suction curettage: therapeutic effectiveness in dysfunctional uterine bleeding.

A group of 60 patients between the ages of 30 and 45 were randomly selected to have either a suction curettage or dilatation and curettage. The criteria used for patient selection was that they had dysfunctional uterine bleeding, a normal gynecologic examination, and were receiving no hormonal therapy. These patients were followed up for at least 3 months. Although the number of patients is relatively small, the results showed that, therapeutically, suction curettage was equal to dilatation and curettage in alleviating dysfunctional uterine bleeding.

Adult

Curettage-electrodesiccation treatment of basal cell carcinomas.

Cure rates after treatment of basal cell carcinomas with curettage-electrodesiccation were compared among three groups: group A, 597 lesions treated in the Skin and Cancer Unit in 1958 to 1962; group B, 91 lesions treated in the Skin and Cancer Unit in 1970; and group C, 210 lesions treated in private practice in 1962 to 1973. The following were the five-year cumulative recurrence rates: group A, 18.8%; group B, 9.6%; and group C, 5.7%. In all three groups, there were high recurrence rates for tumors treated on the nose, paranasal areas, and forehead. Few complications occurred after curettage-electrodesiccation with the exception of hypertrophic scars. The cosmetic results following curettage-electrodesication improved with time. Curettage-electrodesiccation, when performed by experienced physicians, is a very useful modality for the treatment of basal cell carcinomas, with cure rates of over 90%, satisfactory cosmetic results, and few significant complications.

Ambulatory Care

Assessment of diagnostic aspiration curettage as an outpatient procedure.

Aspiration curettage proved acceptable to patients and medical staff when incorporated into a busy outpatient practice. The diagnostic reliability of curettings obtained was shown to be 93.5 per cent accurate. In all patients where mucus only is obtained, where symptoms persist or recur, or when aspiration curettage is too distressing, conventional curettage is mandatory.

Cytodiagnosis

[1st results with a new suction curettage system].

The point is a self-developed Suction-curette-system, consisting of a suction-curette of diametres of 3, 4, 5, 6, 7 und 8 mm, a cervicometer and a filter. Effectivity and histological evidence of 1. Suction-curettage after hysterectomy 2. Suction-curettage before hysterectomy in full-narcosis 3. Suction-curettage without full-narcosis were examined. Advantages of this method are discussed.

Adult

Suction curettage of the endometrium in an ambulatory patient.

A review is presented of patients in whom suction curettage of the endometrium was performed as an office procedure. A total of 978 curettages were performed on 943 patients. In 14 patients (1.1%) the procedure was not completed primarily because of marked cervical stenosis. Fifteen cases of adenocarcinoma of the endometrium and 28 cases of adenomatous hyperplasia and atypical adenomatous hyperplasia of the endometrium were diagnosed. The suction curettage was demonstrated to be a simple, safe, efficient and cost-saving alternative to a hospital D&C.

Adolescent

Curettage of nontuberculous mycobacterial cervical lymphadenitis.

Cervicofacial nontuberculous mycobacterial infections of the head and neck are difficult to treat surgically because of their common location near the branches of the facial nerve. Curettage of these lesions through a small skin incision makes treatment simple without injury to the facial nerve fibers and leaves the patient with an excellent cosmetic result. Most discussions on the topic, however, favor complete surgical excision even though curettage has been reported as a safe and excellent means of treatment. For the past 2 years, the department of otolaryngology-head and neck surgery at the Geisinger Medical Center, Danville, Pa, has used curettage in seven patients as the primary treatment modality for these facial and cervical infections. A review of these cases is presented.

Adolescent