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The management of pseudomyxoma peritonei
Mann, W J; Wagner, J; Chumas, J; Chalas, E
The management of nine patients with pseudomyxoma peritonei was reviewed. Aggressive surgical resection of tumor is the standard of treatment, with many patients requiring multiple laparotomies. Chemotherapy, including the use of cisplatin is not effective. Long-term nutritional support provides a better quality of survival for select patients.
PMID: 2208015
ISSN: 0008-543x
CID: 3460062
Stapler resection of Meckel's diverticulum during gynecologic cancer surgery
Patsner, B; Chalas, E; Orr, J W; Mann, W J
Stapler resection of Meckel's diverticulum was performed on 16 patients with known or presumed gynecologic malignancy at the time of extended abdominal surgery. All diverticulectomies were done quickly and without morbidity. Heterotropic gastric epithelium was found in one diverticulum, and one other patient with stage III ovarian adenocarcinoma had metastases to the serosa of her Meckel's diverticulum.
PMID: 2387536
ISSN: 0090-8258
CID: 3460122
Intestinal complications associated with use of the Dexon mesh sling in gynecologic oncology patients [Case Report]
Patsner, B; Mann, W J; Chalas, E; Orr, J W
Three cases of postoperative enterocutaneous fistula formation following use of the Dexon mesh sling are reported from two gynecologic oncology services. Two patients had intestinal trauma or bowel resection at the time of mesh placement. Postoperative submesh abscess formation was noted in only one patient. Factors which might predispose to fistula formation after mesh placement, particularly in previously radiated patients, and techniques which might be used to avoid this complication are discussed.
PMID: 2354820
ISSN: 0090-8258
CID: 3460102
Morbidity and mortality of stapled anastomoses on a gynecologic oncology service: a retrospective review
Chalas, E; Mann, W J; Westermann, C P; Patsner, B
The Gynecologic Oncology Division performed 167 operations requiring intestinal resection during the period July 1, 1980 to May 30, 1989. Stapling instruments were utilized in 155 procedures and resulted in 204 anastomoses. Major morbidity occurred in 36 (23%) patients, including 17 (11%) deaths and (4.5%) fistulas. Minor morbidity, such as ileus and atelectasis, occurred in 46 (30%) patients. Intestinal surgery is required in approximately 10% of gynecologic oncology procedures, and is associated with significant major and minor morbidity, particularly in obstructed patients.
PMID: 2323618
ISSN: 0090-8258
CID: 3460092
Ovarian carcinoma arising in atypical endometriosis [Case Report]
Moll, U M; Chumas, J C; Chalas, E; Mann, W J
Malignant transformation is a rare but recognized complication of gonadal and extragonadal endometriosis. Morphologic documentation of the continuous transition from benign endometrioid epithelium through epithelial atypia to invasive carcinoma within the same organ is necessary to prove that the cancer arose from endometriosis. This stringent criterion, put forward by Scott, has rarely been fulfilled. We report a case with a chronologic association between ovarian endometriosis showing foci of atypia and a subsequent large clear-cell carcinoma arising in the same ovary 3 years later. We recommend close scrutiny of cellular atypia in endometriosis to define lesions that may be preneoplastic and require an extended surgical approach.
PMID: 2304731
ISSN: 0029-7844
CID: 3460082
ROLE OF NUTRITIONAL-STATUS IN NATURAL-KILLER CELL-ACTIVITY IN PATIENTS WITH OVARIAN-CANCER
BAKER, DA; CREAN, JM; MANN, W; MILCH, PO; SALVATORE, W; KAELBER, A; PATSNER, B; CHALAS, E
ISI:A1989CA25500004
ISSN: 0722-219x
CID: 3460742
Temporal arteritis and intestinal perforation. Report of three cases [Case Report]
Patsner, B; Pitzele, S; Mann, W J; Chalas, E
PMID: 2779884
ISSN: 0028-7628
CID: 3460212
Management of lymphocysts after radical gynecologic surgery [Case Report]
Mann, W J; Vogel, F; Patsner, B; Chalas, E
Pelvic lymphocysts developed in 3 of 124 patients undergoing radical surgery for cervical cancer. All were managed by percutaneous aspiration under local anesthesia in an outpatient setting. Sclerosis was required in one patient. This management plan is superior to laparotomy in being less morbid and equally effective.
PMID: 2703185
ISSN: 0090-8258
CID: 3460172
The value of CT scanning in the management of patients with gynecologic malignancies
Mann, W J; Baim, R; Patsner, B; Chalas, E; Taylor, A; Westermann, C; Loesch, M; Chumas, J
The management of gynecologic malignancies is exceedingly complex, requiring thoughtful coordination of surgery, radiation therapy and chemotherapy. Despite the fact that the natural history and clinical course of these cancers are generally well understood, the scarring caused by surgery and/or radiation, and the marked limitations of pelvic examination make clinical staging and evaluation of limited value and known inaccuracy in following women with ovarian, cervical, uterine, vulvar and vaginal cancers. Understandably, the development of computerized axial tomography (CT), and its ability to visualize the abdomen and pelvis, lead to rapid acceptance of CT scans in defining extent of cancer and following patient response to various therapeutic interventions (Chen et al. 1980; Feigen et al. 1987; Photopoulos et al. 1977). Authors have compared the accuracy of CT findings with physical examination, surgical findings, lymphography, conventional radiography or ultrasound (Clarke-Pearson et al. 1986; Vercamb et al. 1987; Amendola 1981; Kerr-Wilson et al. 1984). However, little has been written on the effect of CT scanning on patient management. If we define and accept the accuracy of CT scanning in detecting pelvic and abdominal disease, can we show a benefit in patient management? Or, does CT scanning provide us with expensive information, or misinformation, which fails to translate into better patient care. Do complex imaging modalities compliment thorough examination and experienced clinical judgement, or only duplicate findings and provide extraneous information? To answer these questions, eighty-one months experience in using CT scanning in managing patients with gynecologic malignancies was reviewed.
PMID: 2673071
ISSN: 0932-0067
CID: 3460162
Predictive value of CA 125 for ovarian carcinoma in patients presenting with pelvic masses [Letter]
Patsner, B; Mann, W J; Chalas, E
PMID: 3163416
ISSN: 0029-7844
CID: 3460282