The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Charles F Levenback - One of the best experts on this subject based on the ideXlab platform.
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lymphatic mapping and sentinel node biopsy in women with high risk endometrial cancer
Gynecologic Oncology, 2007Co-Authors: Michael Frumovitz, Diane C Bodurka, Russell Broaddus, Robert L Coleman, Anil K Sood, David M Gershenson, Thomas W Burke, Charles F LevenbackAbstract:Objective. To evaluate fundal injection of blue dye and radiocolloid for lymphatic mapping and sentinel node identification in women with high-risk endometrial cancer. Methods. At laparotomy, 18 women with high-risk endometrial cancer had isosulfan blue and technitium-99 radiocolloid injected into the Uterine Fundus subserosally. Sentinel nodes were then identified either by direct observation of blue dye, by radioactive counts using a handheld gamma counter, or by a combination of both methods. The number and location of sentinel node(s) were recorded and compared with the final lymph node specimens after hysterectomy and selective lymphadenectomy. Results. A sentinel node was identified in only 8 (45%) of the cases. Four patients had sentinel nodes only in the pelvis, 2 had sentinel nodes in the pelvis and above the bifurcation of the aorta, and 2 patients had sentinel nodes above the bifurcation of the aorta only. Seven (88%) patients had unilateral drainage of dye and the radiocolloid; the other patient had bilateral drainage. No patients had metastatic disease to sentinel or nonsentinel lymph nodes. Conclusions. Subserosal fundal injection of blue dye and the radiocolloid is a poor technique for identifying sentinel lymph nodes in patients with high-risk endometrial cancer.
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intraabdominal lymphatic mapping to direct selective pelvic and paraaortic lymphadenectomy in women with high risk endometrial cancer results of a pilot study
Gynecologic Oncology, 1996Co-Authors: Thomas W Burke, Charles F Levenback, Carmen Tornos, Mitchell Morris, Taylor J Wharton, David M GershensonAbstract:Abstract Objective: To determine the feasibility of intraperitoneal lymphatic mapping of the Uterine Fundus as a means of identifying target sites for lymph node biopsy during staging laparotomy and to develop preliminary experience with the technique. Methods: Fifteen women with high-risk endometrial tumors were entered on this Institutional Review Board-approved pilot study. At laparotomy, isosulfan blue dye (1.0 ml) was injected into the subserosal myometrium at three sites: the superior midpoint of the Fundus, 2 cm inferiorly on the anterior wall, and 2 cm inferiorly on the posterior wall. Dye uptake into lymphatic channels was observed for 10 min. The retroperitoneal spaces were opened. Blue lymphatic channels and nodes within the pelvic and paraaortic regions were identified. Nodes demonstrating dye uptake were biopsied as separate specimens: the locations of these nodes were carefully recorded. Hysterectomy and selective lymphadenectomy were then performed as usual. Results: Lymphatic channels coursing into the broad ligament and along the ovarian vessels were identified from all uteri injected. Deposition of dye into grossly identifiable lymph nodes was seen in 10 of 15 cases (67%). A total of 31 nodes demonstrated dye uptake. The locations of these nodes included paraaortic sites in 12, common iliac in 6, and pelvic in 13. No dye-containing paraaortic nodes were seen below the origin of the inferior mesenteric artery. Lymphatic channels coursing above the renal vessels were seen routinely. Microscopic nodal metastases to sentinel nodes were identified in 2 of 4 women with proven lymphatic spread. Conclusions: Lymphatic mapping of the Uterine Fundus is feasible and can identify targets for selective nodal biopsy in some women. Preliminary observations confirm that the lymphatic network draining the uterus is complex and involves both pelvic and paraaortic nodes. Lymphatic channels that parallel the ovarian vessels were not observed to enter nodes until reaching the level of the midabdomen. Further experience and refinement of techniques may lead to the development of a selective lymphadenectomy based upon direct visualization of the lymphatic drainage of the uterus rather than the current random sampling.
Kathryn F Mcgonigle - One of the best experts on this subject based on the ideXlab platform.
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retained Uterine Fundus after vaginal hysterectomy
European Journal of Radiology Extra, 2008Co-Authors: Matthew E Brown, Eugene C Lin, Kathryn F McgonigleAbstract:Abstract We report a case of a 53-year-old female with a retained Uterine Fundus, presenting 2 years following a vaginal hysterectomy. It is important for imagers to be aware that morcellation techniques can result in retained portions of the uterus following vaginal hysterectomy.
David M Gershenson - One of the best experts on this subject based on the ideXlab platform.
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lymphatic mapping and sentinel node biopsy in women with high risk endometrial cancer
Gynecologic Oncology, 2007Co-Authors: Michael Frumovitz, Diane C Bodurka, Russell Broaddus, Robert L Coleman, Anil K Sood, David M Gershenson, Thomas W Burke, Charles F LevenbackAbstract:Objective. To evaluate fundal injection of blue dye and radiocolloid for lymphatic mapping and sentinel node identification in women with high-risk endometrial cancer. Methods. At laparotomy, 18 women with high-risk endometrial cancer had isosulfan blue and technitium-99 radiocolloid injected into the Uterine Fundus subserosally. Sentinel nodes were then identified either by direct observation of blue dye, by radioactive counts using a handheld gamma counter, or by a combination of both methods. The number and location of sentinel node(s) were recorded and compared with the final lymph node specimens after hysterectomy and selective lymphadenectomy. Results. A sentinel node was identified in only 8 (45%) of the cases. Four patients had sentinel nodes only in the pelvis, 2 had sentinel nodes in the pelvis and above the bifurcation of the aorta, and 2 patients had sentinel nodes above the bifurcation of the aorta only. Seven (88%) patients had unilateral drainage of dye and the radiocolloid; the other patient had bilateral drainage. No patients had metastatic disease to sentinel or nonsentinel lymph nodes. Conclusions. Subserosal fundal injection of blue dye and the radiocolloid is a poor technique for identifying sentinel lymph nodes in patients with high-risk endometrial cancer.
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intraabdominal lymphatic mapping to direct selective pelvic and paraaortic lymphadenectomy in women with high risk endometrial cancer results of a pilot study
Gynecologic Oncology, 1996Co-Authors: Thomas W Burke, Charles F Levenback, Carmen Tornos, Mitchell Morris, Taylor J Wharton, David M GershensonAbstract:Abstract Objective: To determine the feasibility of intraperitoneal lymphatic mapping of the Uterine Fundus as a means of identifying target sites for lymph node biopsy during staging laparotomy and to develop preliminary experience with the technique. Methods: Fifteen women with high-risk endometrial tumors were entered on this Institutional Review Board-approved pilot study. At laparotomy, isosulfan blue dye (1.0 ml) was injected into the subserosal myometrium at three sites: the superior midpoint of the Fundus, 2 cm inferiorly on the anterior wall, and 2 cm inferiorly on the posterior wall. Dye uptake into lymphatic channels was observed for 10 min. The retroperitoneal spaces were opened. Blue lymphatic channels and nodes within the pelvic and paraaortic regions were identified. Nodes demonstrating dye uptake were biopsied as separate specimens: the locations of these nodes were carefully recorded. Hysterectomy and selective lymphadenectomy were then performed as usual. Results: Lymphatic channels coursing into the broad ligament and along the ovarian vessels were identified from all uteri injected. Deposition of dye into grossly identifiable lymph nodes was seen in 10 of 15 cases (67%). A total of 31 nodes demonstrated dye uptake. The locations of these nodes included paraaortic sites in 12, common iliac in 6, and pelvic in 13. No dye-containing paraaortic nodes were seen below the origin of the inferior mesenteric artery. Lymphatic channels coursing above the renal vessels were seen routinely. Microscopic nodal metastases to sentinel nodes were identified in 2 of 4 women with proven lymphatic spread. Conclusions: Lymphatic mapping of the Uterine Fundus is feasible and can identify targets for selective nodal biopsy in some women. Preliminary observations confirm that the lymphatic network draining the uterus is complex and involves both pelvic and paraaortic nodes. Lymphatic channels that parallel the ovarian vessels were not observed to enter nodes until reaching the level of the midabdomen. Further experience and refinement of techniques may lead to the development of a selective lymphadenectomy based upon direct visualization of the lymphatic drainage of the uterus rather than the current random sampling.
Thomas W Burke - One of the best experts on this subject based on the ideXlab platform.
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lymphatic mapping and sentinel node biopsy in women with high risk endometrial cancer
Gynecologic Oncology, 2007Co-Authors: Michael Frumovitz, Diane C Bodurka, Russell Broaddus, Robert L Coleman, Anil K Sood, David M Gershenson, Thomas W Burke, Charles F LevenbackAbstract:Objective. To evaluate fundal injection of blue dye and radiocolloid for lymphatic mapping and sentinel node identification in women with high-risk endometrial cancer. Methods. At laparotomy, 18 women with high-risk endometrial cancer had isosulfan blue and technitium-99 radiocolloid injected into the Uterine Fundus subserosally. Sentinel nodes were then identified either by direct observation of blue dye, by radioactive counts using a handheld gamma counter, or by a combination of both methods. The number and location of sentinel node(s) were recorded and compared with the final lymph node specimens after hysterectomy and selective lymphadenectomy. Results. A sentinel node was identified in only 8 (45%) of the cases. Four patients had sentinel nodes only in the pelvis, 2 had sentinel nodes in the pelvis and above the bifurcation of the aorta, and 2 patients had sentinel nodes above the bifurcation of the aorta only. Seven (88%) patients had unilateral drainage of dye and the radiocolloid; the other patient had bilateral drainage. No patients had metastatic disease to sentinel or nonsentinel lymph nodes. Conclusions. Subserosal fundal injection of blue dye and the radiocolloid is a poor technique for identifying sentinel lymph nodes in patients with high-risk endometrial cancer.
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intraabdominal lymphatic mapping to direct selective pelvic and paraaortic lymphadenectomy in women with high risk endometrial cancer results of a pilot study
Gynecologic Oncology, 1996Co-Authors: Thomas W Burke, Charles F Levenback, Carmen Tornos, Mitchell Morris, Taylor J Wharton, David M GershensonAbstract:Abstract Objective: To determine the feasibility of intraperitoneal lymphatic mapping of the Uterine Fundus as a means of identifying target sites for lymph node biopsy during staging laparotomy and to develop preliminary experience with the technique. Methods: Fifteen women with high-risk endometrial tumors were entered on this Institutional Review Board-approved pilot study. At laparotomy, isosulfan blue dye (1.0 ml) was injected into the subserosal myometrium at three sites: the superior midpoint of the Fundus, 2 cm inferiorly on the anterior wall, and 2 cm inferiorly on the posterior wall. Dye uptake into lymphatic channels was observed for 10 min. The retroperitoneal spaces were opened. Blue lymphatic channels and nodes within the pelvic and paraaortic regions were identified. Nodes demonstrating dye uptake were biopsied as separate specimens: the locations of these nodes were carefully recorded. Hysterectomy and selective lymphadenectomy were then performed as usual. Results: Lymphatic channels coursing into the broad ligament and along the ovarian vessels were identified from all uteri injected. Deposition of dye into grossly identifiable lymph nodes was seen in 10 of 15 cases (67%). A total of 31 nodes demonstrated dye uptake. The locations of these nodes included paraaortic sites in 12, common iliac in 6, and pelvic in 13. No dye-containing paraaortic nodes were seen below the origin of the inferior mesenteric artery. Lymphatic channels coursing above the renal vessels were seen routinely. Microscopic nodal metastases to sentinel nodes were identified in 2 of 4 women with proven lymphatic spread. Conclusions: Lymphatic mapping of the Uterine Fundus is feasible and can identify targets for selective nodal biopsy in some women. Preliminary observations confirm that the lymphatic network draining the uterus is complex and involves both pelvic and paraaortic nodes. Lymphatic channels that parallel the ovarian vessels were not observed to enter nodes until reaching the level of the midabdomen. Further experience and refinement of techniques may lead to the development of a selective lymphadenectomy based upon direct visualization of the lymphatic drainage of the uterus rather than the current random sampling.
James P Neilson - One of the best experts on this subject based on the ideXlab platform.
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symphysis fundal height measurement in pregnancy
Cochrane Database of Systematic Reviews, 1998Co-Authors: James P NeilsonAbstract:Background In many settings, symphysis-fundal height measurement has replaced clinical assessment of fetal size by abdominal palpation because the latter has been reported to perform poorly. Objectives The objective of this review was to assess the effects of routine use of symphysis-fundal height measurements (tape measurement of the distance from the pubic symphysis to the Uterine Fundus) during antenatal care on pregnancy outcome. Search methods Comprehensive electronic search of the Cochrane Pregnancy and Childbirth Group trials register (August 2002). Selection criteria Acceptably controlled trials comparing symphysis-fundal height measurement with assessment by abdominal palpation alone. Data collection and analysis One reviewer assessed trial quality and extracted data. Main results One trial involving 1639 women was included. No obvious differences were detected in any of the outcomes measured. Authors' conclusions There is not enough evidence to evaluate the use of symphysis-fundal height measurements during antenatal care.
