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Background: Malignant bowel obstruction (MBO) is a common complication in advanced and recurrent gynecologic malignancies, with limited treatment options and poor prognosis. Self-expanding metallic stent (SEMS) insertion has emerged as an alternative palliative measure, yet data specific to gynecologic malignancies remains scarce., Methods: A retrospective analysis was conducted on 61 patients with gynecologic malignancies and malignant large bowel obstruction who underwent colorectal stenting between January 2002 and December 2023. Data, including demographics, procedural details, clinical outcomes, and complications, were collected from electronic medical records., Results: The mean age of patients was 65.7 years, with ovarian cancer being the most common malignancy (77%). "Technical success" of SEMS insertion was achieved in 91.4% of cases, with a "clinical success" rate of 76.7%. Major complications occurred in 2% and 5% of patients at 30- and 90 days post-procedure, respectively. Overall mortality rates were 4% at 30 days and 28% at 90 days., Conclusion: SEMS for managing MBO is a promising alternative to surgery in patients with advanced or recurrent gynecologic malignancies. It offers high technical and clinical success rates with acceptable complication rates. Further research is needed to delineate optimal patient selection criteria and refine procedural techniques to maximize outcomes in this challenging population., Competing Interests: Declarations. Disclosures: All authors, Eliahu Yonathan Bekhor, Erez Klein, Hila Shmilovich, Gad Marom, Yair Glazer, Genevieve Bouchard-Fortier, Mai Harris, Eran Shlomovitz, have no conflicts of interest or financial ties to disclose., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Gestational trophoblastic diseases (GTD) encompass a spectrum of rare pre-malignant and malignant entities originating from trophoblastic tissue. This updated review will highlight important radiological features, pathology and classification, and provide insight into the clinical management of these uncommon disorders. There is a wide geographic variation with the incidence of hydatidiform mole varying between 0.57 and 2 per 1000 pregnancies. The use of ultrasound (US) in the management of early pregnancy symptoms and complications has positively impacted the earlier detection of these diseases and resulted in diminished morbidity. Additional imaging modalities are reserved for problem solving or assessment of pulmonary manifestations of molar pregnancy. Having an awareness of their pleomorphic sonographic presentation and additional pathology that can mimic GTD is critical to avoiding pitfalls. Histologic and molecular analysis further aids in differential diagnosis. Gestational trophoblastic neoplasia (GTN) is inclusive of all malignant GTDs, and arises after 20% of molar pregnancies but can also be seen with non-molar gestations. Biochemical monitoring with human chorionic gonadotrophin is imperative for ongoing monitoring and surveillance and allows early detection of this entity. Doppler US is used for confirmation of diagnosis with magnetic resonance imaging (MRI) reserved for problem solving or assessment of myometrial invasion. This is of heightened relevance in patients undergoing surgical management. Cross sectional imaging is reserved for patients in the setting of GTN for the purposes of staging, prognostication and in the setting of recurrent disease. This may require a combination of computed tomography, MRI and positron emission tomography. Doppler US can provide insight into chemotherapeutic response/predict resistance in patients with GTN. As our understanding of these disorders evolves, there has been maturation in management options with a shift from traditional chemotherapy to innovative immunotherapy, particularly in the setting of resistant or high-risk disease., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Parastomal hernia (PSH) is the most common complication of stoma formation. The safety and efficiency of prophylactically placing mesh to prevent PSH remain controversial. To address this question, we examined the incidence of clinical and radiological PSH when using parastomal prophylactic mesh (PPM)., Methods: We performed a retrospective, single-center, cohort study that included all patients with permanent stoma creation between 2015 and 2018. Patients were divided into two groups according to the utilization of PPM or not., Results: During the study period, 185 patients had a permanent stoma created, 144 with colostomy and 41 with ileostomy. PPM was placed in 79 patients. There was no difference in the need for early surgical reintervention (p = 0.652) or rehospitalization (p = 0.314) for stoma-related complications in patients with mesh as compared with patients without. Similarly, there was no difference in operative time (p = 0.782) or in length of hospital stay (p = 0.806). No patients experienced infection of the mesh or required prosthesis removal. There was a lower incidence rate of PSH with PPM placement in patients with permanent colostomy [adjusted hazard ratio (HR) 0.50 (95% confidence interval 0.28-0.89); p = 0.018]. In contrast, a higher incidence rate of PSH was observed in patients with ileostomy and PPM [adjusted HR 5.92 (95% confidence interval 1.07-32.65); p = 0.041]., Conclusion: Parastomal prophylactic mesh placement to prevent PSH is a safe and efficient approach to reduce the incidence of PSH in patients requiring a permanent colostomy. However, mesh may increase the rate of PSH after permanent ileostomy., (© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

The follow up of 49 stereotactically operated epileptics is graphically demonstrated and the 79 operations in basic targets within the amygdala and the area of the anterior pole of the thalamus are described. The patients had valuable gaining in 80%; The continued developement of stereotactic methods in the future is urgent, so long as 30% of the epileptics respond poorly to drug therapy and only 5-10% are suitable to the traditional resection methods.