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Adnexal mass protocol From: Zach Newton (zbnewton@atl.mindspring.com) Sat Jul 19 09:12:30 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Cheri Van Hoover: "Re: drug screening" Previous message: jay kulkin: "Re: Your chance to make me look good.." Next in thread: Bernard Cristalli: "Re: Adnexal mass protocol" Maybe reply: Bernard Cristalli: "Re: Adnexal mass protocol" Maybe reply: Myer S. Bornstein: "Re: Adnexal mass protocol" This exchange reflects why the protocol that Geff is developing would best be directed toward addressing indications for surgery vs. continued non-surgical management of adnexal masses. The vagaries of patient particulars, surgical judgement and experience, and immediate resources available are too broad to address with a protocol applicable to a standardized approach. It is best not to intermingle indications for surgical intervention with a detailed road map of what to do once surgery has been selected. Currently, the QI and UM functions are in place to monitor and act on surgeons' performances once surgery has been undertaken. A huge step forward will have been accomplished by putting in place a rational protocol for surgical vs. non-surgical management. This will include the eventuality of surgery for some of those initially placed in the non-surgical group with further evaluation recommended. -- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn jay kulkin wrote: > > This is an interesting question and appropriate for the time. > > If I can get the patient to be pain free with a unilateral S&O done > laparoscopically as an outpatient in a 30 minute case at minimal > expenditure, why subject her to a riskier and more costly procedure? Good > chance I'll get her to menopause without the hysterectomy. In my > experience, if the rest of her pelvis and other adnexa look good, I will > succeed in 90% (anecdotal #) of the cases. This may also be definitive > treatment. > > Jay > > At 07:27 AM 7/19/97 -0500, you wrote: > > > >> > >>Each rules has it's exceptions. I agree with you for the S & O in the > >>case of endometrioma at 46 YO. > >> > >>-- > >>Bernard Cristalli MD CNGOF > >Why not TAH BSO? Isn't that definitive treatment for endometriosis? > > > >Robert Brenner MD FACOG Next message: Cheri Van Hoover: "Re: drug screening" Previous message: jay kulkin: "Re: Your chance to make me look good.." Next in thread: Bernard Cristalli: "Re: Adnexal mass protocol" Maybe reply: Bernard Cristalli: "Re: Adnexal mass protocol" Maybe reply: Myer S. Bornstein: "Re: Adnexal mass protocol"

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