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  1. Article ; Online: Experimental and new investigational drugs for the treatment of uterine fibroids.

    Evangelisti, Giulio / Ferrero, Simone / Perrone, Umberto / Gustavino, Claudio / Volpi, Eugenio / Izzotti, Alberto / Barra, Fabio

    Expert opinion on investigational drugs

    2024  , Page(s) 1–12

    Abstract: Introduction: Uterine fibroids, the most prevalent benign tumors among reproductive-age women, pose treatment challenges that range from surgical interventions to medical therapies for symptom control. Progestins and estroprogestins effectively manage ... ...

    Abstract Introduction: Uterine fibroids, the most prevalent benign tumors among reproductive-age women, pose treatment challenges that range from surgical interventions to medical therapies for symptom control. Progestins and estroprogestins effectively manage uterine bleeding by suppressing dysfunctional endometrium over fibroids. While GnRH agonists represent a crucial milestone in symptom treatment, their prolonged use results in menopausal-like symptoms and irreversible bone mineral density loss. Advancements in understanding fibroid pathophysiology have prompted the exploration of new compounds to overcome current therapy limitations.
    Areas covered: This manuscript offers an updated overview of investigational drugs for symptomatic uterine fibroids.
    Expert opinion: Despite ulipristal acetate's well-established efficacy as a selective progesterone receptor modulator (SPRM) in fibroid treatment, its prescription has declined due to the rare but severe risk of liver damage. Oral GnRH antagonists, like elagolix, relugolix, and linzagolix, with their novel pharmacodynamic properties, are gaining traction in fibroid management, inducing a dose-dependent reduction in circulating sex hormone levels. Ongoing research on natural compounds, such as vitamin D and epigallocatechin gallate (EGCG), presents emerging options for treating uterine fibroids. This evolving landscape reflects the ongoing efforts to improve therapeutic outcomes for individuals with symptomatic uterine fibroids.
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1182884-5
    ISSN 1744-7658 ; 0967-8298 ; 1354-3784
    ISSN (online) 1744-7658
    ISSN 0967-8298 ; 1354-3784
    DOI 10.1080/13543784.2024.2343786
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    Zs.A 3739: Show issues Location:
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  2. Article ; Online: How challenging could be preoperative and intraoperative diagnosis of endometrial cancer?

    Ferrero, Annamaria / Attianese, Daniela / Villa, Michela / Ravarino, Nicoletta / Menato, Guido / Volpi, Eugenio

    Minerva obstetrics and gynecology

    2022  Volume 75, Issue 4, Page(s) 365–370

    Abstract: Background: Aim of this study was to rate the misdiagnosis of histological type between preoperative endometrial biopsy and final postoperative pathology focusing on non-endometrioid endometrial cancer (NEEC). Secondary objective is to assess the ... ...

    Abstract Background: Aim of this study was to rate the misdiagnosis of histological type between preoperative endometrial biopsy and final postoperative pathology focusing on non-endometrioid endometrial cancer (NEEC). Secondary objective is to assess the concordance between intraoperative assessment and final pathology in a subgroup of patients.
    Methods: A multicenter retrospective study was conducted in patients with histological diagnosis of endometrial cancer who underwent surgical staging between 2011 and 2016. The concordance rate and the Kappa Cohen coefficient were calculated to assess the correlation concerning the histological type between endometrial biopsy and final pathology, and between intraoperative assessment and final pathology in a subgroup of patients.
    Results: Two hundred ninety-five patients were enrolled, 226 were endometrioid carcinomas and 61 NEEC at final pathology. The concordance rate between pre-operative and final pathology for NEEC and the Kappa Cohen coefficient were 81.4% and 0.41 (CI 95% 0.3059-0.5122), respectively. 26 out of 61 (42.6%) NEEC were preoperatively misdiagnosed. The frozen section was performed in a subgroup of 86 patients (29.15%): the concordance rate between frozen section and final pathology for NEEC was 80% and the Kappa Cohen coefficient was 0.28 (CI 95% 0.212-0.347).
    Conclusions: Preoperative pathological histotype assessment predicts final pathology with a moderate grade of accuracy and the identification of NEEC could be challenging. Efforts should be directed toward molecular characterization of diagnostic samples in order to improve diagnostic accuracy and guide therapeutic decisions.
    MeSH term(s) Female ; Humans ; Retrospective Studies ; Neoplasm Staging ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/pathology ; Carcinoma, Endometrioid/pathology ; Carcinoma, Endometrioid/surgery ; Endometrium/pathology
    Language English
    Publishing date 2022-02-22
    Publishing country Italy
    Document type Multicenter Study ; Journal Article
    ZDB-ID 3062815-5
    ISSN 2724-6450
    ISSN (online) 2724-6450
    DOI 10.23736/S2724-606X.22.05037-0
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  3. Article ; Online: The retrograde and retroperitoneal totally laparoscopic hysterectomy for endometrial cancer.

    Volpi, Eugenio / Bernardini, Luca / Ferrero, Anna Maria

    International journal of surgical oncology

    2012  Volume 2012, Page(s) 263850

    Abstract: Introduction. We retrospectively report our experience with the utilization of an original procedure for total laparoscopic hysterectomy based on completely retrograde and retroperitoneal technique for surgical staging and treatment of the endometrial ... ...

    Abstract Introduction. We retrospectively report our experience with the utilization of an original procedure for total laparoscopic hysterectomy based on completely retrograde and retroperitoneal technique for surgical staging and treatment of the endometrial cancer. The surgical, financial, and oncological advantages are here discussed. Methods. The technique used here has been based on a combination of a retroperitoneal approach with a retrograde and lateral dissection of the bladder and retrograde culdotomy with variable resection of parametrium. No disposable instruments and no uterine manipulator were utilized. Results. Intraoperative and postoperative complications were observed in 10% of the cases overall. Operative time length and mean haemoglobin drop value results were 129 min and 125 mL, respectively. Most patients were dismissed on days 3-5 from the hospital. Seventy-eight percent of the patients were alive with no evidence of disease at mean followup of 49 months. Conclusions. Our original laparoscopic technique is based on a retroperitoneal approach in order to rapidly control main uterine vessels coagulation, constantly check the ureter, and eventually decide type and site of lymph nodes removal. This procedure has important cost saving implications and the avoidance of uterine manipulator is of matter in case such as these of uterine malignancy.
    Language English
    Publishing date 2012-07-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2584964-5
    ISSN 2090-1410 ; 2090-1402
    ISSN (online) 2090-1410
    ISSN 2090-1402
    DOI 10.1155/2012/263850
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  4. Article ; Online: Retroperitoneal and retrograde total laparoscopic hysterectomy as a standard treatment in a community hospital.

    Volpi, Eugenio / Bernardini, Luca / Angeloni, Moira / Cosma, Stefano / Mannella, Paolo

    European journal of obstetrics, gynecology, and reproductive biology

    2014  Volume 172, Page(s) 97–101

    Abstract: Objective: To report our experience with a modified procedure for total laparoscopic hysterectomy based on a retrograde and retroperitoneal technique. This surgical approach is analyzed on a consecutive series of patients in a community hospital and ... ...

    Abstract Objective: To report our experience with a modified procedure for total laparoscopic hysterectomy based on a retrograde and retroperitoneal technique. This surgical approach is analyzed on a consecutive series of patients in a community hospital and theoretical educational advantages are proposed.
    Study design: All patients undergoing hysterectomy from January 2012 to April 2013 were included in the study. A detailed description of the technique is given. As main outcome measures we evaluated: the number and rate of patients excluded from laparoscopic approach, the rate of late complications need readmission, the rate of transfusions, the rate of conversion to laparotomy and the number of minor complications. The main concern of the study was ureteral complications.
    Results: Overall 174 patients underwent hysterectomy in our unit. The rate of patients submitted to laparoscopic hysterectomy was 97.5%. The number of complications needing re-admission was three (2%). The rate of conversion was 2.7%. In the study period, two (1.2%) ureteral complications were observed (late fistulae). There were four bladder lesions but the patients were released on the same day as the patients with no lesion.
    Conclusions: Opening the retroperitoneum allows rapid control of the main uterine vessels by coagulation, and constant checks on the ureter. Difficult benign situations can be managed. Even in a non-referral center about 94% of hysterectomies can be performed by laparoscopic surgery. This approach is helpful and may be reproducible in gynecological procedures.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical/statistics & numerical data ; Blood Transfusion/utilization ; Cervical Intraepithelial Neoplasia/surgery ; Cohort Studies ; Conversion to Open Surgery/statistics & numerical data ; Endometrial Hyperplasia/surgery ; Endometrial Neoplasms/surgery ; Endometriosis/surgery ; Female ; Hospitals, Community ; Humans ; Hysterectomy/methods ; Laparoscopy/methods ; Leiomyoma/surgery ; Metrorrhagia/surgery ; Middle Aged ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Retroperitoneal Space/surgery ; Ureteral Diseases/epidemiology ; Uterine Cervical Neoplasms/surgery ; Uterine Diseases/surgery ; Uterine Neoplasms/surgery
    Keywords covid19
    Language English
    Publishing date 2014-01
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2013.10.013
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    Zs.A 837: Show issues Location:
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  5. Article ; Online: Laparoscopic bipolar coagulation of hypogastric artery in postpartum haemorrhage: a case report.

    Panuccio, Enrico / Volpi, Eugenio / Ferrero, Annamaria / Sismondi, Piero

    Case reports in obstetrics and gynecology

    2011  Volume 2011, Page(s) 250325

    Abstract: Background. Postpartum haemorrhage (PPH) is a significant contributor to worldwide maternal morbidity and mortality. When PPH continues despite aggressive medical treatment, early consideration should be given to surgical intervention. Various surgical ... ...

    Abstract Background. Postpartum haemorrhage (PPH) is a significant contributor to worldwide maternal morbidity and mortality. When PPH continues despite aggressive medical treatment, early consideration should be given to surgical intervention. Various surgical interventions may be used but conservative interventions are recommended primarily. Case. This case report describes laparoscopic coagulation of hypogastric artery technique in a patient with PPH. Conclusions. Laparoscopic ligature of the hypogastric artery for PPH treatment can be a valid alternative to laparotomy in patients with vaginal delivery.
    Language English
    Publishing date 2011-09-06
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627654-9
    ISSN 2090-6692 ; 2090-6684
    ISSN (online) 2090-6692
    ISSN 2090-6684
    DOI 10.1155/2011/250325
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  6. Article ; Online: Ovarian lymphoma and hydronephrosis.

    Volpi, Eugenio / Bernardini, Luca / Angeloni, Moira / Gogna, Paolo / Intersimone, Donatella / Fedeli, Franco

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2014  Volume 17, Issue 4, Page(s) 668–671

    Abstract: Introduction: Ovarian lymphoma is a rare entity, and hydronephrosis from lymphoma is even rarer. Most reports describe a laparoscopic approach to the disease, but we report a case of hydroureteronephrosis associated with ovarian lymphoma managed ... ...

    Abstract Introduction: Ovarian lymphoma is a rare entity, and hydronephrosis from lymphoma is even rarer. Most reports describe a laparoscopic approach to the disease, but we report a case of hydroureteronephrosis associated with ovarian lymphoma managed completely by miniinvasive techniques.
    Case report: A 51-year-old woman was referred to us for back pain and renal colic and computed tomography scan findings of right hydroureteronephrosis and a mass in the right mesorectum and uterosacral ligament. After magnetic resonance imaging was performed, the patient underwent laparoscopic adnexectomy and ureterolysis after ureteroscopy and stenting. Histology results showed diffuse B-cell lymphoma of the ovary occluding the ureter without infiltration. The patient has undergone 6 cycles of chemotherapy.
    Discussion: This is the first report to describe ovarian lymphoma and hydroureteronephrosis managed completely by laparoscopic surgery and endoscopy. Frequency in clinical practice, differential diagnosis, and endoscopic approach are discussed. The advantages of a multidisciplinary endoscopic team are underlined.
    MeSH term(s) Combined Modality Therapy ; Female ; Humans ; Hydronephrosis/etiology ; Laparoscopy ; Lymphoma, B-Cell/complications ; Lymphoma, B-Cell/drug therapy ; Lymphoma, B-Cell/surgery ; Middle Aged ; Ovarian Neoplasms/complications ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/surgery ; Ureteral Neoplasms/complications ; Ureteral Neoplasms/drug therapy ; Ureteral Neoplasms/surgery
    Language English
    Publishing date 2014-01-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
    DOI 10.4293/108680813X13654754534918
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    Zs.A 5183: Show issues Location:
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    Zs.MO 310: Show issues

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  7. Article ; Online: Suspecting malignancy in endometrial polyps: value of hysteroscopy.

    Daniele, Alberto / Ferrero, Annamaria / Maggiorotto, Furio / Perrini, Gaetano / Volpi, Eugenio / Sismondi, Piero

    Tumori

    2013  Volume 99, Issue 2, Page(s) 204–209

    Abstract: Aims and background: Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women ... ...

    Abstract Aims and background: Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors.
    Methods and study design: This was a retrospective study. We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed.
    Results: The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7%). Hysteroscopy correctly excluded (negative predictive value: 100%) and accurately predicted (positive predictive value: 85.7%) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5% of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold ( P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps.
    Conclusions: Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.
    MeSH term(s) Adenocarcinoma/diagnosis ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Aged ; Diagnosis, Differential ; Endometrial Hyperplasia/diagnosis ; Endometrial Hyperplasia/pathology ; Endometrial Hyperplasia/surgery ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/surgery ; Female ; Humans ; Hysteroscopy ; Middle Aged ; Polyps/diagnosis ; Polyps/pathology ; Polyps/surgery ; Precancerous Conditions/diagnosis ; Precancerous Conditions/pathology ; Precancerous Conditions/surgery ; Predictive Value of Tests ; Retrospective Studies ; Uterine Diseases/diagnosis
    Language English
    Publishing date 2013-06-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 280962-x
    ISSN 2038-2529 ; 0300-8916
    ISSN (online) 2038-2529
    ISSN 0300-8916
    DOI 10.1700/1283.14193
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    Ud II Zs.43: Show issues Location:
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    Zs.MO 287: Show issues

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  8. Article ; Online: Complications after the treatment of endometrial cancer: a prospective study using the French-Italian glossary.

    Piovano, Elisa / Fuso, Luca / Poma, Cinzia Baima / Ferrero, Annamaria / Perotto, Stefania / Tripodi, Elisa / Volpi, Eugenio / Zanfagnin, Valentina / Zola, Paolo

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2014  Volume 24, Issue 3, Page(s) 418–426

    Abstract: Introduction: The evaluation of treatment complications is crucial in modern oncology because they heavily influence the every day life of patients. Several authors confirmed the reproducibility of the French-Italian glossary to score the complications ... ...

    Abstract Introduction: The evaluation of treatment complications is crucial in modern oncology because they heavily influence the every day life of patients. Several authors confirmed the reproducibility of the French-Italian glossary to score the complications in patients with endometrial cancer after radiotherapy (RT), but the treatment of endometrial carcinoma is primarily surgical and chemotherapy is often used for high-risk disease.
    Objectives: This study aimed to analyze the incidence of complications in our patients treated for endometrial cancer and to verify whether the glossary is a suitable instrument in the description of complications after surgery, RT, and chemotherapy.
    Methods: The data of patients affected by endometrial cancer treated in the Gynecology and Obstetrics Academic Department, Azienda Ospedaliera Mauriziano Umberto I in Turin from 2000 to 2009 (with surgery alone or integrated treatments) were prospectively collected, and complications were described using the glossary. Every patient included in the analyses had a minimum of 18 months follow-up.
    Results: Of the 271 patients, 68 (25%) experienced at least 1 complication with 87 overall complications. Most of the complications were mild (63%) and were found in the urinary (30%) or cutaneous systems (30%). Forty-four (50%) complications appeared within 1 year after treatment, but 9 (10%) complications appeared after 60 months of follow-up. Patients who were submitted to both surgery and RT showed a trend of higher rate of at least 1 complication (19/58 [32.7%]) if compared with surgery alone (36/135 [26.6%]), even if the difference was not statistically significant (P = 0.09). The incidence of complications in patients treated or not with lymphadenectomy was not statistically different (P = 0.088), whereas patients treated with laparotomy had a higher rate of cutaneous complications if compared with the laparoscopic approach (P = 0.018). The glossary included all observed complications.
    Conclusions: One every 4 women treated for endometrial cancer develops a complication. Clinicians should check for complications especially after integrated treatments maintaining surveillance even in the long term. The glossary is a comprehensive instrument to describe the complications of endometrial cancer, regardless of the type of treatment delivered.
    MeSH term(s) Antineoplastic Agents/adverse effects ; Carcinoma/therapy ; Endometrial Neoplasms/therapy ; Female ; Humans ; Incidence ; Italy/epidemiology ; Middle Aged ; Outcome Assessment (Health Care) ; Postoperative Complications/epidemiology ; Prospective Studies ; Skin Diseases/epidemiology ; Skin Diseases/etiology ; Terminology as Topic ; Urinary Bladder Diseases/epidemiology ; Urinary Bladder Diseases/etiology
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2014-01-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1097/IGC.0000000000000094
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    Zs.A 3198: Show issues Location:
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  9. Article: Laparoscopic neurolysis of the pelvic sciatic nerve in a case of catamenial footdrop.

    Volpi, Eugenio / Seinera, Piero / Ferrero, Annamaria / Dompè, Daniela

    Journal of minimally invasive gynecology

    2005  Volume 12, Issue 6, Page(s) 525–527

    Abstract: Isolated cases of cyclic sciatica associated with endometriosis have been reported since the 1940s. Surgical intervention, either by laparoscopy for lesions within the pelvis or by open procedures for extrapelvic lesions, has usually been performed. A 37- ...

    Abstract Isolated cases of cyclic sciatica associated with endometriosis have been reported since the 1940s. Surgical intervention, either by laparoscopy for lesions within the pelvis or by open procedures for extrapelvic lesions, has usually been performed. A 37-year-old woman with catamenial footdrop and pain of the right thigh came to our observation. Previously, she underwent laparoscopy for bilateral ovarian endometriomas. In a second laparoscopy, we removed her uterosacral right ligament and recto-vaginal endometriotic nodules. After a temporary improvement, a third surgical procedure was necessary: laparoscopic neurolysis to free the sciatic nerve from fibrotic tissue. Then the patient was treated with gonadotropin-releasing hormone analogs for 6 months, and she is free of symptoms 2 years after last surgery. This is the first described case of laparoscopic neurolysis of the proximal sciatic nerve. The procedure has been successful in treating a patient with endometriosis in whom the cause of the syndrome was probably due to entrapment of the nerve in fibrous tissue.
    MeSH term(s) Adult ; Combined Modality Therapy ; Contraceptives, Oral/therapeutic use ; Endometriosis/complications ; Endometriosis/drug therapy ; Endometriosis/surgery ; Female ; Gait Disorders, Neurologic/etiology ; Gonadotropin-Releasing Hormone/therapeutic use ; Humans ; Laparoscopy ; Menstruation ; Nerve Compression Syndromes/diagnosis ; Nerve Compression Syndromes/etiology ; Nerve Compression Syndromes/surgery ; Sciatic Nerve/surgery
    Chemical Substances Contraceptives, Oral ; Gonadotropin-Releasing Hormone (33515-09-2)
    Language English
    Publishing date 2005-11
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2186934-0
    ISSN 1553-4669 ; 1553-4650
    ISSN (online) 1553-4669
    ISSN 1553-4650
    DOI 10.1016/j.jmig.2005.09.005
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    Zs.A 4205: Show issues Location:
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  10. Article: Genital and peritoneal tuberculosis: potential role of laparoscopy in diagnosis and management.

    Volpi, Eugenio / Calgaro, Marco / Ferrero, Annamaria / Viganò, Luca

    The Journal of the American Association of Gynecologic Laparoscopists

    2004  Volume 11, Issue 2, Page(s) 269–272

    Abstract: Genital and peritoneal tuberculosis are rare in developed countries and can mimic ovarian cancer. We report two different cases that came to our attention, both in a month. The first patient was referred to us for an asymptomatic pelvic mass. The second ... ...

    Abstract Genital and peritoneal tuberculosis are rare in developed countries and can mimic ovarian cancer. We report two different cases that came to our attention, both in a month. The first patient was referred to us for an asymptomatic pelvic mass. The second patient came to us because of weight loss, abdominal swelling, and ascites. Unfortunately, the imaging findings were misleading, and the laboratory analyses were not helpful. Only the laparoscopic approach was useful for final diagnosis. We conclude that the symptoms of abdominal tuberculosis vary greatly, and laparoscopy can be essential for its diagnosis and management.
    MeSH term(s) Adnexal Diseases/diagnosis ; Adnexal Diseases/surgery ; Aged ; Aged, 80 and over ; Endosonography/methods ; Female ; Follow-Up Studies ; Humans ; Laparoscopy/methods ; Middle Aged ; Peritonitis, Tuberculous/diagnosis ; Peritonitis, Tuberculous/surgery ; Risk Assessment ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculosis, Female Genital/diagnosis ; Tuberculosis, Female Genital/surgery
    Language English
    Publishing date 2004-07-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1220649-0
    ISSN 1074-3804
    ISSN 1074-3804
    DOI 10.1016/s1074-3804(05)60213-7
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