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[妊娠期盆腔肿块的腹腔镜治疗]

[Laparoscopic management of pelvic mass in pregnancy].

作者信息

Purnichescu V, Cheret-Benoist A, Von Theobald P, Mayaud A, Herlicoviez M, Dreyfus M

机构信息

Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, avenue Georges-Clemenceau, 14033 Caen Cedex.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2006 Jun;35(4):388-95. doi: 10.1016/s0368-2315(06)76410-9.

Abstract

OBJECTIVES

To determine the feasibility, safety and limiting factors of laparoscopic management of pelvic mass in pregnancy.

MATERIAL

and methods. During a 10-year period, 21 laparoscopic procedures were performed in patients with pelvic masses in pregnancy after exclusion of appendicitis and ectopic pregnancy. Laparoscopic surgery was done during the first trimester of pregnancy in 8 cases, the second trimester in 12 cases and the third trimester in one case. All the procedures were performed with general anesthesia and the laparoscopic cystectomies were performed with the intraperitoneal technique.

RESULTS

The indications were: persistent or sonographically abnormal ovarian cyst (12 cases), torsion of ovarian cyst (5 cases), and symptomatic pelvic mass (4 cases: 2 painful cysts and 2 infarction of fibroma). One borderline tumor were discovered. The laparoscopic procedure could not be performed in two cases due to difficulty of access to the lesion. No patient encountered complications during the intra- and post-operative periods. The mean hospital stay was 4.5 days. The outcome of the pregnancy was normal in all cases.

CONCLUSION

Laparoscopic management of pelvic masses in pregnancy by an experienced team, is a safe and effective procedure.

摘要

目的

确定妊娠期盆腔肿物腹腔镜治疗的可行性、安全性及限制因素。

材料与方法

在10年期间,对排除阑尾炎和异位妊娠后的妊娠期盆腔肿物患者进行了21例腹腔镜手术。8例在妊娠早期进行腹腔镜手术,12例在妊娠中期进行,1例在妊娠晚期进行。所有手术均采用全身麻醉,腹腔镜囊肿切除术采用腹腔内技术。

结果

手术指征为:持续性或超声检查异常的卵巢囊肿(12例)、卵巢囊肿扭转(5例)及有症状的盆腔肿物(4例:2例疼痛性囊肿和2例纤维瘤梗死)。发现1例交界性肿瘤。2例因病变部位难以暴露而无法进行腹腔镜手术。所有患者在术中及术后均未出现并发症。平均住院时间为4.5天。所有病例妊娠结局均正常。

结论

由经验丰富的团队对妊娠期盆腔肿物进行腹腔镜治疗是一种安全有效的方法。

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