Ovarian Cyst

This trial investigates different surgical methods for treating endometriomas, which are ovarian cysts larger than 2 cm, in adult women aged 18 to 43 who have symptoms like pelvic pain or fertility issues. The study aims to compare pregnancy rates within 24 months after surgery, along with birth rates, types of pregnancies, recurrence of cysts, complications, and changes in pain levels. Researchers seek to find which surgical approach yields better pregnancy outcomes and fewer problems. Participants are randomly assigned to one of three surgical treatments: cystectomy, where the cyst wall is gently removed from the ovary; plasma vaporization, which destroys the cyst wall using plasma energy; or ethanol sclerotherapy, which uses alcohol to destroy the cyst lining. After surgery, women will have follow-up visits at 3 months and 24 months to monitor their recovery and pregnancy progress. During the study, participants will be evaluated through medical imaging, symptom questionnaires, and monitoring of pregnancy outcomes including natural and assisted pregnancies. Researchers will track recurrence of cysts over 24 months and assess pain using a standardized scale. Safety and complications will be recorded during the first 3 months post-surgery. The total participation spans from surgery through two years of follow-up evaluations.

Researchers are evaluating the combination of adebrelimab and fuzuloparib in people with recurrent platinum-resistant ovarian cancer who have not received previous systemic antitumor therapy for this cancer. This exploratory, single-arm Phase 2 study focuses on assessing the effectiveness and safety of this drug combination in women with this condition. The study is led by Fujian Cancer Hospital and aims to measure outcomes over a 3-year period. Participants receive adebrelimab at 20 mg/kg intravenously every three weeks and take fuzuloparib orally at 100 mg twice daily. The study does not include a comparator group and follows a single treatment approach. Treatment continues under medical supervision while researchers monitor the participants' response and safety. During the study, participants undergo regular evaluations including scans to measure tumor response using RECIST1.1 criteria, blood tests, and physical assessments. Researchers track the primary outcome of objective response rate over three years, along with secondary outcomes like overall survival, progression-free survival, and disease control rate. Safety monitoring and adherence to study procedures are maintained throughout the study, with participation lasting up to three years.

Pancreatic ductal adenocarcinoma (PDAC) is a serious cancer with low 5-year survival rates, mainly due to late-stage diagnosis. Researchers are studying an AI-powered screening system that uses non-contrast computed tomography (NCCT) scans taken during routine medical visits or health check-ups. This observational, multi-center study aims to improve early detection of PDAC and its precursor lesions, potentially leading to better patient outcomes and wider access, especially in underserved areas. The study will use a deep learning AI model to automatically detect abnormalities in the pancreas from NCCT images. Cases flagged by the AI will be reviewed by two independent radiologists. If the radiologists suspect cancer or precursor lesions, participants will undergo further testing such as blood tests and advanced imaging. Those diagnosed with PDAC or precursor lesions will receive specialized treatment and consultation, while those without a diagnosis will be followed clinically for at least one year. Participants will be involved through routine CT scans without additional imaging initially. The study will measure the AI system's accuracy by tracking detection rates, recall rates for further testing, and positive predictive value over three years. Secondary outcomes include the proportion of early-stage PDAC detected and survival time over five years. The study involves multiple hospitals and technical support, with ongoing monitoring and clinical follow-up for confirmed or negative cases.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer with a low 5-year survival rate, making early diagnosis vital to improving outcomes. Current screening methods are limited and often miss early-stage disease, especially for the general public. Researchers are evaluating the use of an Artificial Intelligence (AI) system called PANDA combined with low-dose computed tomography (LDCT) to enhance pancreatic cancer screening in a prospective, multicenter, observational cohort, aiming to improve early detection and reduce unnecessary procedures. Participants will undergo annual LDCT scans analyzed by the PANDA AI system. Abnormal findings identified by the AI are reviewed by a multidisciplinary team (MDT) to decide next steps: suspected pancreatic cancer or precursor lesions lead to hospital examinations; benign lesions receive personalized monitoring; and cases confirmed as normal by MDT will have at least one year of follow-up. If abnormalities appear during follow-up, participants will be managed accordingly. This approach focuses on evaluating detection rates, predictive values, consensus, and recall rates over two years. During the study, participants will complete LDCT exams and consent to follow-up assessments based on AI and MDT findings. Researchers will monitor pancreatic cancer detection rates, early-stage cancer proportions, and safety indicators like false positives and unnecessary invasive procedures. Follow-up will continue for at least one year for some participants, with ongoing monitoring to assess the effectiveness and safety of AI-assisted LDCT screening in a health check-up population.

Researchers are evaluating the impact of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) compared to conventional abdominal laparoscopy (CAL) for benign adnexal surgery in women aged 18 to 70. The study aims to confirm that vNOTES does not negatively affect women's sexual function after surgery, addressing concerns about vaginal scarring and its effects on sexual activity. Secondary goals include assessing vNOTES efficiency, complications, and the quality of histological analysis of surgical specimens. Participants will be randomly assigned to receive either the vNOTES or CAL surgical technique for procedures such as cystectomy, oophorectomy, salpingectomy, or tubal sterilization. Both approaches involve minimally invasive surgery, with vNOTES using the vaginal route and CAL using abdominal laparoscopy. The study also examines pain, hospital stay length, patient satisfaction, and surgical complications during and up to 30 days after surgery. Women in the study will complete questionnaires before surgery and at 3 and 6 months afterward to assess sexual function, couple satisfaction, and pain during sex. Medical and general data will be collected at enrollment, during hospitalization, and one month post-surgery. The main outcomes measured include quality of sexual life and postoperative recovery, while monitoring safety and the effectiveness of both surgical methods throughout the study period.

Researchers are studying women with ovarian masses that cannot be clearly identified by ultrasound. The study focuses on evaluating the use of pelvic MRI scans that include special imaging techniques called diffusion- and perfusion-weighted sequences. The goal is to see how well these MRI findings match with tissue analysis or follow-up over two years. Participants will undergo pelvic MRI scans as the main observation in this study. These scans use advanced imaging methods to better characterize the ovarian masses that remain unclear after ultrasound examination. The study mainly involves women who have such undetermined adnexal masses and does not include treatment or placebo groups. During the study, participants will have their MRI results compared with either tissue samples from surgery or clinical follow-up lasting up to two years. Researchers will collect and analyze this information to better understand the diagnostic value of MRI in these cases. The total observation period for each participant may last up to two years to confirm the nature of the ovarian mass.

Ovarian cysts are common in women during childbearing period. Most cysts are normal functional cysts that typically resolve spontaneously and need no treatment. However, pathologic cysts such as endometriomas and dermoid may require surgical intervention.( For women of childbearing age with symptomatic ovarian cysts, laparoscopic cystectomy is the first-line surgical treatment for ovarian cysts because it has many advantages, including the benefits of ovarian-sparing surgery (with continued hormonal support and preservation of future fertility) and of minimally invasive surgery (including small incisions, quick recovery, and less pain). Laparoscopic ovarian cystectomy is the treatment of choice for benign ovarian tumors in the young, including mature cystic teratomas, endometriomas, and serous or mucinous cystadenomas. One of the greatest challenge during the surgery is stopping bleeding from the rest ovarian tissue. Electrosurgical energy is a commonly used technique to cut off bleeding from the remaining ovarian tissue during laparoscopic ovarian cystectomy, but it can increase time of operation , increase the risk of complications, and if used excessively, it can damage the soft tissues of the ovaries, and interfere with fertility . Electrosurgical units can be divided into two major types: monopolar and bipolar, monopolar system refers to current flow from one active electrode through the patient, who is entirely included in the circuit, and exists via dispersive electrode to the generator, but its usage can cause collateral injuries and thermal necrosis at the point of contact. In bipolar units, both active and return electrodes are housed within the same instrument; so, the current flows only through the tissue between the two blades of the electrode and return to the generator without passing through the whole body. Bipolar energy is safer than monopolar energy in terms of the risk of postoperative adhesions and the risk of over treatment that can lead to ovarian failure and also provide a significant postoperative resumption of the spontaneous ovulation and pregnancy. On the other hand, other hemostatic strategies have been investigated such as hemostatic sealants, which create a seal when applied to bleeding tissues. This process causes platelets to clump together and initiates the clotting cascade, obstructing blood flow. Other studies, including randomized controlled trials, have consistently demonstrated that hemostatic sealants are effective in stopping bleeding and reducing blood loss at many surgical sites. This empirical evidence demonstrates the potential of a hemostatic sealant as an effective alternative to electrosurgical energy, particularly in surgical situations that require strong hemostasis, such as laparoscopic ovarian cystectomy. Ovarian reserve is defined as the size and number of the ovarian follicle pools at any given time. Alternatively, it can be defined as the total ovarian follicle pool which is equal to the quiescent (primordial) follicles plus growing follicles. This reproductive potential is determined by the quiescent primordial follicles that can develop into primary, antral, and ovulating follicles. It can be estimated by several methods and the level of serum anti-Mullerian hormone (AMH) is considered one of the best endocrine markers . AMH is formed by the granulosa cells of active follicles (primary follicles, preantral follicles and small antral follicles) but not by quiescent primordial follicles. AMH regulates the process of follicle formation by controlling the number of primordial follicles that initiate the maturation process, thus preventing the exhaustion of the quiescent follicles.

This research aims to compare two methods for controlling bleeding during laparoscopic ovarian cystectomy in women with ovarian endometriosis. The study evaluates how well a hemostatic agent versus suturing preserves ovarian function, controls bleeding, and ensures safety during surgery. It focuses on women aged 19 to 45 who are scheduled for this procedure to address benign ovarian cysts caused by endometrioma. Participants will be randomly assigned to one of two groups. In the first group, bleeding is controlled using a hemostatic agent called EVICEL4 Fibrin Sealant, which contains thrombin and coagulating proteins. If bleeding continues, additional methods like electrocoagulation and suturing may be used. The second group uses barbed sutures on the ovarian tissue to stop bleeding, with electrocoagulation as a backup if needed. This approach allows comparison of the hemostatic effectiveness and impact on ovarian tissue. During the study, ovarian function will be assessed before surgery and at 12 and 48 weeks after surgery by measuring Anti-Mullerian Hormone (AMH) levels and ovarian volume. Researchers will also track blood loss, hemoglobin levels, time to achieve hemostasis, adverse events, and hospital stay length. Participants will be monitored closely to evaluate safety and the preservation of ovarian function over nearly one year after surgery.

Researchers are evaluating two surgical techniques for treating endometriomas to determine which better preserves ovarian reserve. The study focuses on women with endometriotic cysts who experience infertility or pain. The trial compares the combined technique and CO2 laser vaporization only, assessing ovarian reserve through Anti-Müllerian Hormone (AMH) serum levels before and after surgery. Two surgical methods are studied: the combined technique involves stripping about 80% of the cyst wall followed by ablation of the remaining 20%, while the CO2 laser vaporization method uses CO2 laser to ablate the entire inner cyst wall after draining and inspecting the cyst. The laser settings are carefully controlled to preserve healthy tissue beneath the cyst surface. Participants will have their AMH levels measured three months after surgery to assess ovarian reserve. The study includes women aged 18 to 40 with specific cyst sizes and requires contraception use before surgery. Researchers monitor outcomes through hormone measurements and clinical follow-up to evaluate the effect of each surgical approach on ovarian function.

Researchers are evaluating the effect of ultrasound-guided alcohol sclerotherapy on pelvic pain and quality of life in women aged 18 to 45 diagnosed with ovarian endometriomas. This clinical trial compares sclerotherapy to expectant management to determine if the procedure reduces pelvic pain and improves quality of life, measured by the Endometriosis Health Profile (EHP-5) score. The study addresses the need for less invasive treatment options for ovarian endometrioma, a common form of endometriosis that affects fertility and causes chronic pain. Participants are randomly assigned to either the sclerotherapy group, which undergoes ultrasound-guided puncture and alcohol sclerotherapy with absolute ethanol for 15 minutes followed by a wash, or the control group receiving expectant management with standard pain treatments as needed. The trial follows patients over time to assess pain, quality of life, fertility markers, pregnancy rates, and any adverse events or recurrence. During the study, participants complete baseline and 6-month assessments of pain and quality of life, provide blood and urine samples for biomarker analysis, and undergo ovarian reserve evaluations including AMH and antral follicle counts. Researchers will monitor fertility outcomes and treatment costs with follow-up continuing for about two years to evaluate pregnancy rates. Data will be analyzed using intention-to-treat and per-protocol methods to compare the two groups.