Publications by authors named "Roya Padmehr"

3 Publications

  • Page 1 of 1

Laparoscopic excision of deeply infiltrating endometriosis: a prospective observational study assessing perioperative complications in 244 patients.

Arch Gynecol Obstet 2019 06 5;299(6):1619-1626. Epub 2019 Apr 5.

Centre for Endometriosis and Minimally Invasive Gynaecology (CEMIG), Ashford & St. Peter's Hospital NHS Foundation Trust, Chertsey, UK.

Purpose: To examine peri-operative complications in patients undergoing laparoscopic excision of deeply infiltrating endometriosis (DIE).

Methods: This was a prospective study of a case series of women having laparoscopic excision of deeply infiltrating endometriosis from September 2013 through August 2016 in a tertiary referral center for endometriosis and minimally invasive gynaecological surgery in Iran. Data collected included demographics, baseline characteristics, intraoperative and postoperative data up to 1 month following surgery.

Results: We analysed data from 244 consecutive patients, who underwent radical laparoscopic excision of all visible DIE. Major postoperative complications occurred in 3 (1.2%) and minor complications in 27 (11.1%) of patients. 80.3% of our patient group had Stage IV endometriosis. Segmental bowel resection was performed in 34 (13.9%), disc resection in 7 (2.9%), rectal shave in 53 (21.7%). Joint operating between a gynaecologist and colorectal and/or urological colleague was required in 29.6% of cases. The mean operating time was 223.8 min (± 80.7 standard deviation, range 60-440 min) and mean hospital stay was 2.9 days (± 1.5 standard deviation, range 1-11). The conversion to laparotomy rate was 1.6%.

Conclusions: A combination of different laparoscopic surgical techniques to completely excise all visible DIE, within the context of a tertiary referral center offering multi-disciplinary approach, produces safe outcomes with low complication rates.
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June 2019

Fertility outcome after laparoscopic treatment of advanced endometriosis in two groups of infertile patients with and without ovarian endometrioma.

Eur J Obstet Gynecol Reprod Biol 2016 Jun 12;201:46-50. Epub 2016 Mar 12.

Independent Research Consultant, FACOG, Iran; Avicenna Research Institute, ACECR, Reproductive Biotechnology Research Center, Tehran, Iran.

Objective: To evaluate the result of laparoscopic endometrioma excision in fertility outcome of advanced endometriosis patients.

Study Design: The study was designated as historical cohort, in a private referral center of advance laparoscopy. 111 infertile patients, diagnosed as endometriosis, were divided in two groups: DIE (deep infiltrative endometriosis) and endometrioma (case group), and patients with only DIE (without endometrioma ((control group). All patients underwent global laparoscopic resection of DIE lesion (both groups) and laparoscopic excisional cystectomy of endometrioma (case groups). Patients were followed for fertility outcomes and data were analyzed by Kaplan-Meier test and COX regression using SPSS software.

Results: After adjusting covariates, the Kaplan-Meier analysis of cumulative pregnancy rates (CPR) did not show any statistical significance between cases (35.6%) and controls (39.5%) (Log-rank P-value=0.959). The COX regression analysis of covariates showed there is no significant relationship between cystectomy and fertility outcome. It showed statistical significance effect of age (hazard ratio [HR]=0.772), years of infertility (HR=0.224), and previous endometrioma surgery (HR=0.180), on fertility chance.

Conclusion: In advanced endometriosis with DIE and infertility, fine excision and stripping of the endometrioma along with radical resection of DIE improves fecundity without any significant adverse effect in comparison with patients with intact ovaries.
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June 2016

Oral clonidine premedication reduces nausea and vomiting in children after appendectomy.

Iran J Pediatr 2012 Sep;22(3):399-403

Department of Anesthesiology and Intensive Care, AJA University of Medical Sciences, Tehran, Iran ; Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Clonidine is an α2-agonist which is used as a sedative premedication in children. There are conflicting results in the published literature about the effect of clonidine on the incidence of post operative nausea and vomiting (PONV). We therefore decided to evaluate the effect of oral clonidine given preoperatively on the incidence of PONV in children after appendectomy.

Methods: Sixty children, 5-12 years old, classified as American Society of Anesthesiologists physical status I and II, who were scheduled for appendecectomy were enrolled in this randomized double blinded clinical trial. Patients were randomly assigned into two groups of 30 patients. Patients in clonidine group were given 4 µ -1 clonidine in 20 cc of apple juice and patients in control group were given only 20 cc of apple juice 1 hour before transporting to operating room. The protocol of general anesthesia and postoperative analgesia was the same for two groups. Incidence of PONV and antiemetic usage of patients were assessed during 0-24 hours after anesthesia.

Findings: The patients' characteristics were similar in two groups. Patients who had received clonidine had significantly less episodes of PONV and also less rescue antiemetic usage than patients in control group.

Conclusion: We showed that oral clonidine at a dose of 4 µ -1 administered preoperatively is associated with a reduced incidence of postoperative vomiting in children who have undergone appendectomy.
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September 2012