Document Detail


Histological Characteristics of Vaginal Cuff Tissue from Patients with Vaginal Cuff Dehiscence.
MedLine Citation:
PMID:  24316139     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To describe the histological characteristics of vaginal tissue in patients who presented with vaginal cuff dehiscence (VCD) after robotic hysterectomy and to compare this group to patients who did not dehisce.
STUDY DESIGN: Vaginal cuff tissue was obtained from 7 patients with VCD and 6 without VCD. Tissue was stained with H&E and evaluated for acute and chronic inflammation markers - neutrophils, lymphocytes and plasma cells. Immunohistochemical staining was performed and evaluated using semi-quantitative method for collagen I and III, smooth muscle actin (SMA) and SM-22α (myofibroblast) content. Grading was performed by 4 blinded investigators. Mann-Whitney test was used to evaluate the two groups and correlation coefficients for inter-observer variability. Design Classification: II-3 SETTING: Academic Center PATIENTS: 7 patients with vaginal cuff dehiscence and 6 with out vaginal cuff dehiscence INTERVENTIONS: stains on tissue specimens from each group MEASUREMENTS AND MAIN RESULTS: VCD group demonstrated significantly higher amounts of neutrophils (1.71 vs. 1, p=0.036), lymphocytes (2.85 vs. 1.33, p=0.002), and plasma cells (2.2 vs. 1, p=0.001) compared to non-VCD group. There was no statistical difference between the groups in amounts of collagen I (1.71 vs 1.27, p=0.09) and collagen III (1.66 vs. 1.38, p=0.37), SMA (1.23 vs. 1.33, p=0.65) and SM22α (1.85 vs. 1.27, p=0.09). Inter-observer variability was low (k = 0.86, p =0.76).
CONCLUSION: Patients with VCD had significantly higher levels of acute and chronic inflammatory cells compared to the control group. Findings suggest that a prolonged inflammatory phase may be delaying normal progression to reparation in patients with dehiscence.
Authors:
Jennifer Klauschie; Yan Wen; Bertha Chen; Lu Zhou; Raphael Nunez-Nateras; Idris T Ocal; Dora Lam-Himlin; Rosanne Kho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-3
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  -     ISSN:  1553-4669     ISO Abbreviation:  J Minim Invasive Gynecol     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Gynecologic Surgery, Mayo Clinic AZ, Phoenix AZ. Electronic address: Jennifer@academic-urology.com.
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