Clinical and paraclinical characteristics and results of surgical treatment of ovarian tumors in postmenopausal women at Hanoi Obstetrics and Gynecology Hospital in 2021 - 1

HANOI NATIONAL UNIVERSITY

UNIVERSITY OF MEDICINE AND PHARMACY

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TRAN THI THUY NGAN

CLINICAL AND PARACLINICAL FEATURES AND TREATMENT RESULTS OF OVARIAN TUMOR

SURGICAL MENOPAUSE AT HANOI OBSTETRICS AND GYNECOLOGY HOSPITAL IN 2021

UNIVERSITY THESIS IN GENERAL MEDICINE

HANOI NATIONAL UNIVERSITY

UNIVERSITY OF MEDICINE AND PHARMACY

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Performer: TRAN THI THUY NGAN

CLINICAL AND PARACLINICAL FEATURES AND TREATMENT RESULTS OF OVARIAN TUMOR

SURGICAL MENOPAUSE AT HANOI OBSTETRICS AND GYNECOLOGY HOSPITAL IN 2021

UNIVERSITY THESIS IN GENERAL MEDICINE

Course: QH.2016.Y

Instructor: 1. Associate Professor, Doctor, Doctor VU VAN DU

2. MSc., MD. LE THI NGOC HUONG

ACKNOWLEDGEMENTS

During the process of studying, researching and completing this thesis, I have received much help from teachers and friends. With deep gratitude, I would like to sincerely thank:

Board of Directors, Teachers of Obstetrics and Gynecology Department, University of Medicine and Pharmacy, Vietnam National University, Hanoi.

Board of Directors, General Planning Department - Hanoi Obstetrics and Gynecology Hospital. Has created favorable conditions for me in the process of studying and researching. I would like to thank the General Planning Department, Department of Obstetrics and Gynecology.

- Department of Oncology - Hanoi Obstetrics and Gynecology Hospital created favorable conditions for me in the process of collecting data for research.

I would like to express my respect and gratitude to:

Associate Professor, Dr. Vu Van Du, the teacher who has wholeheartedly guided, helped and guided me throughout my study and research.

MSc. Le Thi Ngoc Huong has always cared, wholeheartedly helped, and kindly instructed me throughout my study and research.

Finally, I would like to express my gratitude to my parents, siblings, and friends who have encouraged and shared with me throughout my studies and scientific research.

Hanoi, date month year 2022

Tran Thi Thuy Ngan

COMMITMENT

I am Tran Thi Thuy Ngan, a student of QH.2016.Y course, majoring in General Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, and hereby declare that:

1. This is a thesis that I directly conducted under the guidance of Associate Professor, Dr. Vu Van Du and Master, Le Thi Ngoc Huong.

2. This work does not overlap with any other research published in Vietnam.

3. The data and information in the study are completely accurate, honest and objective, and have been confirmed and approved by the research facility.

I take full responsibility before the law for these commitments.

Hanoi, date month year 2022

Author

Tran Thi Thuy Ngan

LIST OF ABBREVIATIONS

Symbol/abbreviation: Full text/meaning:

BN: Patient

BVPSHN: Hanoi Obstetrics and Gynecology Hospital

BVPSTW: Central Maternity Hospital

CLVT: Computerized tomography

HE4: Human Epididymis Protein 4

MBH: Histopathology

PP: Appendix

PT: Surgery

PTNS: Laparoscopic surgery

SD: Standard deviation

TCHT: Complete uterus

UBT: Ovarian tumor

UNBT: Ovarian cyst

UTBT: Ovarian cancer

VMC: Old surgical scar

WHO: World Health Organization

LIST OF TABLES

Table 2.1. Research variables 17

Table 2.2. Research variables 18

Table 3.1. Distribution of patients by age group 21

Table 3.2. History of number of children 23

Table 3.3. History of miscarriage 24

Table 3.4. Correlation between history of previous abdominal surgery and type of surgery 24 Table 3.5. History of gynecological diseases 25

Table 3.6. Medical history 25

Table 3.7. Distribution of tumor location clinically, ultrasound and surgically 26

Table 3.8. Distribution of tumor size clinically, ultrasound and surgically .. 27 Table 3.9. Tumor mobility and boundaries 27

Table 3.10. Correlation between clinical tumor mobility and intraoperative tumor adhesion... 28 Table 3.11. Complications of ovarian tumors 28

Table 3.12. Classification of tumor size on ultrasound 29

Table 3.13. Ultrasound echo characteristics 29

Table 3.14. Morphological characteristics on ultrasound 30

Table 3.15. Distribution of ovarian tumors according to preoperative CA-125 levels .. 30 Table 3.16. Pathological results 31

Table 3.17. Timing of surgery 32

Table 3.18. Types of surgery 32

Table 3.19. Relationship between tumor size on ultrasound and type of surgery 33

Table 3.20. Treatment methods 33

Table 3.21. Relationship between tumor adhesion during surgery and treatment method 34

Table 3.22. Surgical time 35

Table 3.23. Postoperative hospital stay 36

Table 4.1. Rate of tumor detection by gynecological examination and ultrasound of some previous studies 40

Table 4.2. Characteristics of ovarian tumor location in some previous studies 41

LIST OF CHARTS

Figure 3.1. Tumor classification 21

Figure 3.2. Distribution of patients by occupation 22

Figure 3.3. Distribution of patients by place of residence 23

Figure 3.4. Circumstances of tumor detection 26

Figure 3.5. Intraoperative and postoperative complications 35

LIST OF IMAGES

Figure 1.1. Female pelvic organs 2

INDEX

PROBLEM STATEMENT 1

Chapter 1 2

OVERVIEW 2

1.1. Anatomy and physiology of the ovary 2

1.1.1. Ovarian anatomy 2

1.1.2. Structural characteristics of the ovary 4

1.1.3. Ovarian physiology 5

1.2. Classification of ovarian tumors 5

1.2.1. Functional cysts 5

1.2.2. Solid tumors 6

1.3. Clinical symptoms 7

1.3.1. Potential energy 7

1.3.2. Physical symptoms 8

1.4. Paraclinical characteristics 8

1.4.1. Ultrasound 8

1.4.2. CA-125 9

1.4.3. Magnetic resonance imaging 9

1.4.4. Laparoscopy 10

1.4.5. Histopathological diagnosis 10

1.5. Clinical staging according to FIGO 10

1.6. Treatment methods for ovarian tumors 10

1.6.1. Open abdominal surgery 10

1.6.2. Endoscopic surgery 11

1.6.3. Chemotherapy 12

1.6.4. Radiotherapy 12

1.7. Menopause age 12

1.7.1. Definition of menopause 12

1.7.2. Diagnosis of menopause 13