Mario Palumbo

and 8 more

Objective: The study aimed to assess the effect of the human papillomavirus 9-valent (9vHPV) vaccine after surgical excision through loop electrosurgical excision procedure (LEEP) or laser ablation in women with cervical intraepithelial neoplasia compared to ablation procedures alone. Methods: We enrolled 326 women in our single-center, retrospective, observational, study. The selected patients aged 18 to 65 years old and underwent surgical treatment of LEEP/laser ablation for CIN1/CIN2-3 between 2020 and 2024 were divided into two groups: vaccinated (V) and non-vaccinated (NV) patients with either low-grade (CIN1) or high-grade (CIN2-3) HPV-related cervical lesions, to assess the effects of vaccination 6-15 months after treatment. HPV test result and colposcopy data were analyzed to assess the effect of adjuvant HPV vaccination. Results: The vaccinated group (V) included 222 women (68%), while the unvaccinated group (NV) 104 (32%). The HPV infection rate (%) in the low-risk (CIN1) group was 38% in the NV group compared to 18% in the V group (p = 0.0169). In the high-risk group (CIN2-3), the infection rate was 18% in the NV group while 8% in the V group (p = 0.0353). The HPV infection rate (%) was higher in the NV groups, and therefore, vaccination had a statistically significant effect (p = 0.05) on the infections (%) in our follow-up. Conclusion: Human papillomavirus 9-valent vaccine presetend a significant role in viral clearance of women treated for HPV cervical lesions: in our cohort, vaccination had been a positive factor for the reduction of HPV infections compared to NV groups.

Pierluigi Giampaolino

and 10 more

Objective: To assess the feasibility and the perioperative outcomes of laparoscopic gynecological surgery in regional anesthesia (RA) from the point of view of the surgeon, anesthesiologist and patient. Design: Prospective cohort study Setting: University Hospital Federico II of Naples Population: Women planned to undergo gynecologic laparoscopy surgery for benign pathology. Methods: Women were assigned, according to their preference, to either RA (Group A) or general anesthesia (GA)(Group B). Surgical, anesthesiological and postoperative recovery data were recorded. Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. Main outcome mesure: The primary outcome measure was postoperative pain. Secondary outcomes included mobilization, length of hospital stay, global surgeons and patient satisfaction, intraoperative pain assessment in Group A. Results: Immediate postoperative pain was significantly lower in Group A 0 vs 2 (p<0.001), also at 6 h 1.5 vs 3 (p =0.004), with no significant differences at 24 h. The secondary outcome demonstrated early patient’s mobilization (p<0.001) as well as early discharge (p<0.001) and greater patient’s satisfaction for the Group A. A maximum pain score of 3 points out of 5 was recored through the entire surgery. Conclusion: RA showed to decrease the impact of surgical stress and to guarantee a quicker recovery without compromising surgical results. As well as different surgical approaches can be selected to treat different pathologies, RA technique could be a viable option for patients. Keywords: gynecological surgery; regional analgesia; postoperative pain.