Terada Yukihiro, Arai-Kikuch Maiko, Ugajin Tomohisa, Yokomizo Rei, Kikuchi Hiroyuki, Yaegashi Nobuo
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
J Reprod Med. 2009 Oct;54(10):655-8.
Laparoscopy has been successfully used following renal transplantation for many procedures, including native kidney nephrectomy, revision of transplant ureters and cholecystectomy. Laparoscopic surgery has also been used recently to treat pelvic disorders in patients after renal transplantation, such as removal of endometriotic cyst and hysterectomy. In such cases, we must pay special attention to the anatomy of the renal graft transplanted into the pelvic cavity.
A woman received a kidney transplant at 7 years old, with her mother as the donor. At 19 years old, she was diagnosed with pure gonadal dysgenesis and began hormone replacement therapy and monitoring of tumor markers. At 23 years old, laparoscopic gonadectomy was performed under general anesthesia. Bilateral atrophic gonads were removed without any complications. The renal graft in the right hemipelvis did not obstruct the operation.
To our knowledge, this case is the first published report of laparoscopic castration in a patient with a sexual differentiation disorder and prior renal transplantation.
腹腔镜技术已成功应用于肾移植后的多种手术，包括切除自体肾、修复移植输尿管以及胆囊切除术。腹腔镜手术最近也被用于治疗肾移植术后患者的盆腔疾病，如切除子宫内膜异位囊肿和子宫切除术。在这类病例中，我们必须特别关注移植到盆腔内的肾移植物的解剖结构。
一名女性7岁时接受了肾移植，供体为其母亲。19岁时，她被诊断为单纯性腺发育不全，并开始接受激素替代治疗及肿瘤标志物监测。23岁时，在全身麻醉下进行了腹腔镜性腺切除术。双侧萎缩性腺被切除，未出现任何并发症。右半盆腔的肾移植物未妨碍手术操作。
据我们所知，该病例是首例关于患有性分化障碍且既往有肾移植史患者行腹腔镜去势术的报道。
