Melgrati Luigi, Damiani Alfredo, Franzoni Gianalfredo, Marziali Massimiliano, Sesti Francesco
Unit of Gynecology and Obstetrics, International School of Gynecological Endoscopy, S. Pio X Hospital, Milan, Italy.
J Minim Invasive Gynecol. 2005 Jul-Aug;12(4):379-81. doi: 10.1016/j.jmig.2005.05.012.
We report on the first case of an isobaric (gasless) laparoscopic myomectomy during the second trimester of pregnancy. Our patient had acute abdominal pain that did not respond to medical management. The procedure was performed under spinal anesthesia with conscious sedation. The remainder of the pregnancy was unremarkable. We believe that surgical management of uterine leiomyoma during pregnancy may be successfully performed in carefully selected patients. Laparotomy can be avoided, and pregnant patients can be managed safely by operative laparoscopy. With isobaric laparoscopy, the adverse effects and potential risks of CO2 insufflation are eliminated. The procedure can be performed under loco-regional anesthesia. The uterine closure can be performed safely and quickly as in laparotomy.
我们报告了首例妊娠中期等压（无气腹）腹腔镜子宫肌瘤切除术。我们的患者出现急性腹痛，药物治疗无效。该手术在脊髓麻醉加清醒镇静下进行。妊娠的其余过程无异常。我们认为，对于经过精心挑选的患者，孕期子宫平滑肌瘤的手术治疗可以成功实施。可以避免开腹手术，通过手术腹腔镜可以安全地处理妊娠患者。采用等压腹腔镜技术，可消除二氧化碳气腹的不良反应和潜在风险。该手术可在局部区域麻醉下进行。子宫缝合可像开腹手术一样安全、快速地完成。
