Tanaka M, Sagawa T, Hashimoto M, Mizumoto Y, Yoshimoto H, Yamazaki R, Kasai T, Inoue M
Department of Obstetrics and Gynecology, School of Medicine, Kanazawa University, Japan.
Ultrasound Obstet Gynecol. 2008 Mar;31(3):342-5. doi: 10.1002/uog.5272.
To evaluate the feasibility and utility of performing ultrasound-guided culdotomy using a renal balloon dilator catheter for transvaginal ovarian cystectomies.
Culdotomy using transvaginal sonography and a Nephromax balloon dilator catheter was performed in 16 patients for the vaginal removal of benign ovarian cysts located in the cul-de-sac. Each ovarian cyst was punctured under transvaginal ultrasound guidance and the punctured site on the vaginal wall was enlarged with a dilator. The cyst was then enucleated through this vaginal wound. Preoperative characteristics of the patients, outcome, operating time, blood loss and complications of each culdotomy, and the histology of the cysts, were recorded and examined.
We used this method on 14 patients with unilateral ovarian cysts and two with bilateral cysts. Culdotomy was performed successfully in 15 cases (94%). The mean +/- SD operating time for culdotomy was 22 +/- 11 min, and blood loss during the procedure was less than 10 mL in all cases. There were no complications including rectal injury or febrile morbidity.
Culdotomy assisted by ultrasound imaging and a dilator is a safe, reliable and effective method for removal of benign ovarian cysts via a vaginal approach.
评估使用肾球囊扩张导管进行超声引导下阴道后穹窿切开术用于经阴道卵巢囊肿切除术的可行性和实用性。
对16例患者进行经阴道超声检查及使用肾球囊扩张导管的阴道后穹窿切开术，以经阴道方式切除位于阴道后穹窿的良性卵巢囊肿。在经阴道超声引导下对每个卵巢囊肿进行穿刺，并用扩张器扩大阴道壁上的穿刺部位。然后通过该阴道伤口摘除囊肿。记录并检查患者的术前特征、手术结果、每次阴道后穹窿切开术的手术时间、失血量和并发症，以及囊肿的组织学情况。
我们对14例单侧卵巢囊肿患者和2例双侧卵巢囊肿患者使用了该方法。15例（94%）成功进行了阴道后穹窿切开术。阴道后穹窿切开术的平均手术时间为22±11分钟，所有病例术中失血量均少于10毫升。未发生包括直肠损伤或发热性疾病在内的并发症。
超声成像和扩张器辅助的阴道后穹窿切开术是一种通过阴道途径切除良性卵巢囊肿的安全、可靠且有效的方法。
