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Biomedical subjects

V Gomel

Publications and source records attributed to V Gomel.

90 records · Page 5Linked to original sources
PubMed1978

Profile of women requesting reversal of sterilization.

One hundred consecutive patients requesting reversal of sterilization have been analyzed. At the time of sterilization 52% were 25 years old or under and 89% were 30 years old or under. Fifty-three patients were not in a stable marital relationship. The mean number of children per patient was 2.39. Two-thirds of the 47 patients who underwent pueperal sterilization regretted their decision within the 1st year. Twenty-six percent of the patients felt psychologically adversely affected by the procedure. The reason for requesting reversal of sterilization in the majority (63%) was a change in marital status. Other reasons were crib death (17%), desire for more children (10%), psychologic factors (6%) accidental tragedies (4%).

Adult↗
PubMed1977

Tubal reanastomosis by microsurgery.

The enormous increase in the number of sterilizations performed in young women is creating a demand for reversal of this procedure. The author's experience with tubal reanastomosis using a microsurgical technique is presented. The traditional approach to cornual occlusion of the tubes has been tubouterine implantation. The demonstration that in such cases the intramural portion of the tube is often patent and that the occlusion site is located in the proximal isthmus has allowed, instead, resection and end-to-end anastomosis at the cornua. Including both tubouterine anastomosis for cornual occlusion and end-to-end anastomosis after previous sterilization, tubal reanastomosis was performed in 31 patients. The postoperative patency rate was 87%, and 64% have had intrauterine pregnancies. In the group subjected to tubal reanastomosis following a previous sterilization, 72.7% of those attempting a pregnancy and having more than 6 months' follow-up have had intrauterine gestations.

Adult↗
PubMed1976

Laparoscopy in general surgery.

In the last seven years laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist. Other specialities have been relatively slow in recognizing its value. Laparoscopy has wide applications in general surgery. It is a useful tool in blunt abdominal trauma and often prevents laparotomy. In patients with acute abdominal conditions, when findings are atypical, uncertainty in diagnosis may be resolved by laparoscopy. In patients with malignant disease it permits assessment of the extent of the lesion and enables accurate selection of the mode of therapy. Numerous procedures per laparoscopy, including biopsies, division of adhesions, cholangiography and collection of samples for bacteriologic studies, may be carried out simultaneously. Complication associated with the procedure are few but may be severe. These can be avoided by careful adherence to proper technic.

Abdomen, Acute↗
PubMed1975

Laparoscopic tubal surgery in infertility.

Besides its diagnostic value, laparoscopy is a useful operative tool in the treatment of infertility. We have used dilatation of phimotic tubal ostia and salpingolysis by laparoscopy as our primary approach. In the total series of 33 cases a pregnancy rate of 42.1 percent was obtained.

Fallopian Tubes↗
PubMed1974

Laparoscopy.

In the last five years, laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist and its use in this field has largely supplanted culdoscopy. Other specialties, nevertheless, have been slower in recognizing its value.The procedure has wide applications in gynecology. In pediatrics, laparoscopy proves useful in elucidation of amenorrhea, intersex and precocious puberty. In general surgery, laparoscopy has been recognized as a useful tool in the patient with multiple trauma, and in establishing the diagnosis of many intra-abdominal conditions.Numerous perlaparoscopic operative procedures which include biopsies and tubal sterilizations may be carried out by an experienced operator. Complications associated with the procedure are few, but may be severe. These can be avoided by careful adherence to proper technique.

Amenorrhea↗
PubMedDate not supplied

Is routine amniocentesis for advanced maternal age still indicated?

OBJECTIVE: To evaluate a policy of selective rather than routine use of amniocentesis for advanced maternal age. METHOD: A consecutive series of 359 pregnant women aged 38-47 underwent nuchal translucency measurement (NTM) at 10-14 weeks, maternal serum screening (MSS) by alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) at 15-17 weeks, and second trimester ultrasound at 21-23 weeks. Women with NTM <3 mm, MSS-derived risk <1/250, and a normal second trimester sonography were considered at low risk and were suggested not to have an amniocentesis. RESULTS: Either the NTM or MSS test was positive in 130 women; 105 (81%) of them elected to have an amniocentesis, versus 122 (53%) of 229 in whom both tests were negative (p < 0.001). Nineteen (5%) of 359 patients had NTM > or =3 mm; all 7 cases of Down's syndrome were in this group; 122 (34%) of 359 patients had a MSS-derived risk > or =1/250; 6 of the 7 cases of Down's syndrome were in this group: Ten patients had an abnormal second trimester ultrasound, 1 of which had trisomy 18. Of the 219 patients with MSS-derived risk <1/250, a NTM <3 mm, and a normal second trimester ultrasound, none had a baby with a chromosomal abnormality (95% confidence interval: 0-1.4%). CONCLUSION: Amniocentesis may be offered on a selective rather than routine basis in women over 38, based upon the results of noninvasive screening tests.

Adult↗
PubMedDate not supplied

Fertility outcome following tubal pregnancy.

This study was undertaken to analyze the factors associated with fertility outcome following tubal pregnancy. Eighty-six patients were analyzed in this regard. The chances of a favourable outcome (intrauterine pregnancy) decreased and an unfavorable outcome (repeated tubal pregnancy or no pregnancy) increased with a history of previous tubal pregnancy and also with an absent or diseased contralateral tube at the time of surgery. History of infertility, prior reconstructive tubal surgery, status of the ipsilateral tube at the time of surgery, the treatment modality (laparoscopy vs laparotomy) or the surgical approach (conservative vs radical) did not significantly affect fertility outcome.

Adult↗
PubMedDate not supplied

A comparative study on the suppression of peritoneal adhesion formation in the rat.

The importance of periadnexal adhesions as cause in female infertility is widely recognized. The incidence of salpingo-ovariolysis (in the absence of tubal obstruction) has been reported as being 35% of the surgical procedures to promote fertility. In addition, one of the important causes of failure of reconstructive fertility surgery is related to postoperative adhesions (either reformed of formed de novo). Adhesions may encapsulate the ovary and/or the terminal end of the oviduct; they may disturb the physiologic spatial, relationship between the fimbriae and ovary and thus impair ovum pick up. Adhesions may also disturb ovarian function decreasing the number of ovulations. The importance of postoperative adhesions is evident also by the vast numbers of studies, published on this subject in the last decade.

Animals↗