子宫次全切除术后五年盆腔平滑肌瘤和子宫内膜异位症的切除
Removal of pelvic leiomyomata and endometriosis five years after supracervical hysterectomy.
作者信息
Hilger Wesley S, Magrina Javier F
机构信息
Division of Gynecologic Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA.
出版信息
Obstet Gynecol. 2006 Sep;108(3 Pt 2):772-4. doi: 10.1097/01.AOG.0000209187.90019.d3.
BACKGROUND
The number of laparoscopic supracervical hysterectomies performed has increased, yet the benefits and consequences are not well understood.
CASE
The patient presented 5 years after a laparoscopic supracervical hysterectomy with pelvic pain, an elevated CA 125 level, and a pelvic mass. Surgical exploration revealed multiple leiomyomata with adenomyosis and endometriosis.
CONCLUSION
After a laparoscopic supracervical hysterectomy, pelvic seeding of morcellated uterine tissue may lead to symptomatic pelvic leiomyomata and endometriosis requiring further surgery. Surgeons performing laparoscopic supracervical hysterectomies should take measures to prevent pelvic seeding at the time of morcellation and recognize the complication when it occurs.
背景
腹腔镜次全子宫切除术的实施数量有所增加，但其益处和后果尚未得到充分了解。
病例
该患者在腹腔镜次全子宫切除术后5年出现盆腔疼痛、CA 125水平升高及盆腔肿块。手术探查发现多个平滑肌瘤伴子宫腺肌病和子宫内膜异位症。
结论
腹腔镜次全子宫切除术后，粉碎的子宫组织盆腔播散可能导致有症状的盆腔平滑肌瘤和子宫内膜异位症，需要进一步手术。实施腹腔镜次全子宫切除术的外科医生应在粉碎操作时采取措施预防盆腔播散，并在并发症发生时予以识别。
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