1
|
Alsaadi A, Artibani M, Hu Z, Wietek N, Morotti M, Gonzalez LS, Alazzam M, Jiang J, Abdul B, Soleymani Majd H, Blazer LL, Adams J, Silvestri F, Sidhu SS, Brugge JS, Ahmed AA. Single-cell transcriptomics identifies a WNT7A-FZD5 signaling axis that maintains fallopian tube stem cells in patient-derived organoids. Cell Rep 2023; 42:113354. [PMID: 37917586 DOI: 10.1016/j.celrep.2023.113354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/31/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023] Open
Abstract
The study of fallopian tube (FT) function in health and disease has been hampered by limited knowledge of FT stem cells and lack of in vitro models of stem cell renewal and differentiation. Using optimized organoid culture conditions to address these limitations, we find that FT stem cell renewal is highly dependent on WNT/β-catenin signaling and engineer endogenous WNT/β-catenin signaling reporter organoids to biomark, isolate, and characterize these cells. Using functional approaches, as well as bulk and single-cell transcriptomics analyses, we show that an endogenous hormonally regulated WNT7A-FZD5 signaling axis is critical for stem cell renewal and that WNT/β-catenin pathway-activated cells form a distinct transcriptomic cluster of FT cells enriched in extracellular matrix (ECM) remodeling and integrin signaling pathways. Overall, we provide a deep characterization of FT stem cells and their molecular requirements for self-renewal, paving the way for mechanistic work investigating the role of stem cells in FT health and disease.
Collapse
Affiliation(s)
- Abdulkhaliq Alsaadi
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
| | - Mara Artibani
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; Gene Regulatory Networks in Development and Disease Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK
| | - Zhiyuan Hu
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; Gene Regulatory Networks in Development and Disease Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK
| | - Nina Wietek
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Matteo Morotti
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Laura Santana Gonzalez
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
| | - Moiad Alazzam
- Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Jason Jiang
- Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Beena Abdul
- Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK
| | - Hooman Soleymani Majd
- Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Levi L Blazer
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Jarret Adams
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | | | - Sachdev S Sidhu
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Joan S Brugge
- Department of Cell Biology, Harvard Medical School, Boston, MA 02115, USA; Ludwig Center at Harvard, Boston, MA, USA
| | - Ahmed Ashour Ahmed
- Ovarian Cancer Cell Laboratory, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; Department of Gynecological Oncology, Churchill Hospital, Oxford University Hospitals, Oxford OX3 7LE, UK.
| |
Collapse
|
2
|
Alazzam M, Khalifa MA, Al-Ani A. The transverse-vertical incision (Alazzam hybrid incision). Langenbecks Arch Surg 2022; 407:1303-1309. [PMID: 35226178 PMCID: PMC9151581 DOI: 10.1007/s00423-021-02404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/03/2021] [Indexed: 11/26/2022]
Abstract
Abstract
Open abdominal surgery evolved around two incisions, vertical and transverse incisions. Transverse incisions are associated with less postoperative morbidities but offer limited access. Vertical incisions offer better access but are associated with more complications. We describe here a hybrid incision, transverse-vertical incision that offers adequate exposure for complex lower abdominopelvic surgery while overcoming the limitations and morbidities associated with midline and transverse incisions.
Collapse
Affiliation(s)
- Moiad Alazzam
- Consultant Gynaecological Oncology Surgeon, Department of Gynaecological Oncology, Churchill Hospital-Oxford University Hospitals, Old Road, Oxford, Headington OX3 7LN, UK.
| | | | | |
Collapse
|
3
|
Sadeghi N, Addley S, Alazzam M, Traill Z, Johnson CA, McCole M, Soleymani Majd H. Intravascular leiomyomatosis; mimicking low grade endometrial sarcoma. J OBSTET GYNAECOL 2021; 42:1564-1568. [PMID: 34749572 DOI: 10.1080/01443615.2021.1963220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Negin Sadeghi
- Obstetrics and Gynaecology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Susan Addley
- Gynaecology Oncology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Moiad Alazzam
- Gynaecology Oncology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Zoe Traill
- Radiology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Catherine A Johnson
- Radiology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Mark McCole
- Pathology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Hooman Soleymani Majd
- Gynaecology Oncology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
4
|
Smyth S, Addley S, Alazzam M, Soleymani Majd H. Adamantinoma: metastatic disease masquerading as a gynaecological malignancy. BMJ Case Rep 2021; 14:e241615. [PMID: 34083182 PMCID: PMC8183221 DOI: 10.1136/bcr-2021-241615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/03/2022] Open
Abstract
Adamantinoma is a rare low-grade malignancy of the appendicular skeleton with unclear histogenesis. We present the case of a 65-year-old woman with known recurrent and metastatic right tibial disease despite clear resection margins. On further investigation, a positron emission tomography-CT scan identified a primary breast lesion and an 11 cm mass in the right iliac fossa of suspected ovarian malignancy amenable to surgical resection. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and resection of a retroperitoneal mass arising from the pelvic sidewall encompassing the iliac vasculature. The patient made an uneventful recovery with histology confirming disease metastasising to the pelvis. Currently, clinical management guidelines are not available. We present an overview of adamantinoma and highlight a previously undocumented gynaecological oncology surgical approach to this novel disease location. Regarding metastases, we acknowledge the challenges of investigation pertaining to disease site and origin as well as a paucity of recommendations for surveillance and follow-up.
Collapse
Affiliation(s)
- Sarah Smyth
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Susan Addley
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Moiad Alazzam
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Hooman Soleymani Majd
- Department of Gynaecological Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| |
Collapse
|
5
|
Addley S, Alazzam M, Johnson C, Soleymani Majd H. Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum. BMJ Case Rep 2021; 14:14/3/e237669. [PMID: 33685909 PMCID: PMC7942270 DOI: 10.1136/bcr-2020-237669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.
Collapse
Affiliation(s)
- Susan Addley
- Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Moiad Alazzam
- Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Catherine Johnson
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Hooman Soleymani Majd
- Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| |
Collapse
|
6
|
Addley S, Majd HS, Jackson E, Alazzam M. A Novel Technique to Facilitate Fertility-Sparing Laparoscopic Ovarian Cystectomy for a 27 Centimetre Ovarian Cyst. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Abstract
High-grade endometrial cancers (ECs) are an aggressive subset of ECs accounting for 70-80% of EC-related deaths. Currently, staging surgery, together with chemotherapy or radiotherapy, is the primary treatment strategy for these cancers. The widespread use of next-generation sequencing has led to a refined understanding of EC's genomics with important information for diagnosis and therapy for individual patients (precision medicine). However, advances in the genomics assessment of high-grade tumors have been slower due to their lower incidence than low-grade EC. This article will briefly introduce the current state of knowledge of the genomics of G3 endometrioid EC, serous uterine cancer, clear cell uterine carcinoma and uterine carcinosarcoma and discuss its implications for diagnosis and targeted therapy.
Collapse
Affiliation(s)
- Matteo Morotti
- Department of Gynecological Oncology, Oxford University Hospital NHS Foundation Trust, Oxford, UK -
| | - Hooman Soleymani Majd
- Department of Gynecological Oncology, Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - Jvan Casarin
- Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy
| | - Moiad Alazzam
- Department of Gynecological Oncology, Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - Stephen Damato
- Department of Cellular Pathology, Oxford University Hospitals, Oxford, UK
| |
Collapse
|
8
|
Addley S, Jackson E, Kuntal S, Alazzam M, Soleymani Majd H. A case of Bartholin's gland malignancy: A rare diagnosis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Addley S, Jackson E, Kuntal S, Soleymani Majd H, Alazzam M. Vaginal melanoma: A case managed by laparoscopic type III pelvic exenteration achieving tumour-free margins and preserving organ structure and function. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
Pinelli C, Morotti M, Casarin J, Tozzi R, Ghezzi F, Mavroeidis VK, Alazzam M, Soleymani Majd H. Interval Debulking Surgery for Advanced Ovarian Cancer in Elderly Patients (≥70 y): Does the Age Matter? J INVEST SURG 2020; 34:1023-1030. [PMID: 32148117 DOI: 10.1080/08941939.2020.1733146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Elderly ovarian cancer (OC) patients are more likely to be managed suboptimally, with worse clinical outcomes as a result. Strategies to decrease morbidity are lacking.Methodology: Consecutive patients with advanced stage OC (IIIC-IV) who were managed in our center between January 2016 and July 2018 were retrospectively analyzed. All patients underwent neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) according to our institution protocol. We divided patients into two groups: Group 1 (age ≥ 70 years) and Group 2 (age < 70 years). The primary outcome of the study was assessment of peri-operative morbidity amongst two groups. RESULTS A total of 153 patients were referred during the study period. 114 patients underwent IDS after NACT (74.5%), 46 in Group 1 and 68 in Group 2. Elderly patients were more likely to receive more than three cycles of NACT prior to IDS compared to younger patients (39% vs. 19%, p = 0.03). Elderly patients were more frequently subjected to Cardiopulmonary Exercise Testing (CPET) as pre-operative assessment (63% vs. 27%, p = 0.002). Optimal/complete resection was achieved in all patients in Group 1 (100%) and in 97% of patients in Group 2. With the exception of higher postoperative cardiac arrhythmias in Group 1 (11% vs. 1%, p = 0.04), no significant differences in 30-day morbidity were observed. No 90-day death in both groups was registered. CONCLUSION Older age should not preclude clinicians from offering ultra-radical resection to patients with advanced OC after NACT. In our series, elderly patients received the same treatment with similar outcomes to the younger group. Clinicians should be encouraged to use CPET for patients' selection following NACT.
Collapse
Affiliation(s)
- Ciro Pinelli
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.,Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
| | - Matteo Morotti
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Jvan Casarin
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.,Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
| | - Roberto Tozzi
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Fabio Ghezzi
- Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy
| | - Vasileios K Mavroeidis
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
| | - Moiad Alazzam
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Hooman Soleymani Majd
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| |
Collapse
|
11
|
Pinelli C, Morotti M, Casarin J, Tozzi R, Alazzam M, Mavroeidis VK, Soleymani Majd H. The Feasibility of Cardiophrenic Lymphnode Assessment and Removal in Patients Requiring Diaphragmatic Resection During Interval Debulking Surgery for Ovarian Cancer. J INVEST SURG 2019; 34:756-762. [PMID: 31809609 DOI: 10.1080/08941939.2019.1690077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Several studies have demonstrated the feasibility and role of bulky cardiophrenic lymph nodes (CPLNs) resection during primary debulking surgery (PDS) for stage IV ovarian cancer (OC). However, no studies, to date, investigated the accuracy and feasibility of CPLNs assessment and removal during interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT). MATERIAL AND METHODS A retrospective analysis of consecutive stage IV OC patients who underwent NACT followed by IDS with CPLNs assessment and/or resection from July 2017 to June 2018. Bulky CPLNs were considered for excision when a full-thickness diaphragmatic resection was required in order to achieve complete tumour resection. RESULTS A total of 21 ovarian cancer stage IV patients treated with NACT followed by IDS were identified. Seven (33.3%) patients underwent CPLNs resection due to bulky appearance of the CPLNs at the intraoperative palpation. The final histological examination of the CPLNs reported metastatic disease in four (57%) of seven patients. Complete cytoreduction without residual disease was achieved in five cases (71.4%) while in two case (28.6%) optimal cytoreduction was performed. Intra-operative surgical complications occurred in one patient. One patient had a major postoperative complication (Clavien-Dindo 3). Two cases of postoperative cardiac arrhythmia were observed. CONCLUSIONS CPLNs intraoperative assessment is less accurate during IDS compared to previous PDS studies. CPLNs removal during IDS after NACT for stage IV OC could be safely performed to achieve a complete resection.
Collapse
Affiliation(s)
- Ciro Pinelli
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.,Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | - Matteo Morotti
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Jvan Casarin
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.,Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | - Roberto Tozzi
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Moiad Alazzam
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Vasileios K Mavroeidis
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| | - Hooman Soleymani Majd
- Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK
| |
Collapse
|
12
|
Tozzi R, Casarin J, Baysal A, Pinelli C, Matak L, Ghanbarzadeh N, Alazzam M, Garruto-Campanile R, Majd HS, Kilic Y, Morotti M. Morbidity of multiple bowel resection compared to single bowel resection after debulking surgery for ovarian cancer. Eur J Obstet Gynecol Reprod Biol 2019; 240:215-219. [PMID: 31326636 DOI: 10.1016/j.ejogrb.2019.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/21/2019] [Accepted: 07/08/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To assess the impact of multiple bowel resections on postoperative outcomes in stage IIIC-IV ovarian cancer (OC). METHODS From the Oxford OC database we retrieved consecutive patients who underwent bowel resection between January 2009 and November 2017. Patients were divided into two groups: single bowel resection (SBR) and MBR (≥2 bowel resections). The following outcomes were compared between the two groups: 30-day related and not related morbidity to bowel surgery, bowel diversion rate and time to start/restart adjuvant chemotherapy. RESULTS Thirty-five patients were in the MBR and 146 in the SBR group. The 30-day overall surgical-related complication and bowel specific complications rate was higher in MBR group than SBR group (54.3% vs. 23.9%, p < 0.001) and (25.7% vs. 10.5%, p = 0.035), respectively. The rate of bowel diversion was 97.7% in MBR vs. 26.7% in the SBR group (p = 0.021). Trend analysis showed a significant reduction in the rate of MBR after the introduction of NACT (p- for trend <0.001). CONCLUSIONS Our data show that MBR during OC surgery is associated with a higher rate of overall and bowel specific complication compared to SBR. The introduction of NACT is associated with a reduced rate of MBR.
Collapse
Affiliation(s)
- Roberto Tozzi
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK.
| | - Jvan Casarin
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK; Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | - Ahmet Baysal
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK
| | - Ciro Pinelli
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK; Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy
| | - Luka Matak
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK; Department of Obstetrics and Gynaecology, General Hospital Zadar, Croatia
| | - Nahid Ghanbarzadeh
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK; Department of Obstetrics and Gynaecology, Birjand University of Medical Sciences, Iran
| | - Moiad Alazzam
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK
| | | | - Hooman Soleymani Majd
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK
| | - Yakup Kilic
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK
| | - Matteo Morotti
- Department of Gynaecologic Oncology, Division of Women's and Children, Churchill Hospital, Oxford, UK
| |
Collapse
|
13
|
Alabdrabalnabi A, Al Fareed N, Matouq A, Alazzam M, Al Ajrafi R, Al-zahrani A. Pattern of scrotal examination by physicians in the Eastern Province of Saudi Arabia. HAMDAN MEDICAL JOURNAL 2015. [DOI: 10.7707/hmj.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
14
|
Matouq A, Alabdrabalnabi A, Al Fareed N, Alazzam M, Al Ajrafi R, Al-Zahrani A. Scrotal pathology evaluation among primary health care physicians. HAMDAN MEDICAL JOURNAL 2015. [DOI: 10.7707/hmj.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
15
|
Dhulkotia JS, Alazzam M, Galimberti A. Tisseel for management of traumatic postpartum haemorrhage. Arch Gynecol Obstet 2008; 279:437-9. [DOI: 10.1007/s00404-008-0824-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 10/13/2008] [Indexed: 11/25/2022]
|