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妊娠期急性附件病变的经脐单孔腹腔镜手术:初步经验

Laparoendoscopic single-site surgery for acute adnexal pathology during pregnancy: preliminary experience.

作者信息

Dursun Polat, Gülümser Cağrı, Cağlar Mete, Araz Coskun, Zeyneloğlu Hulusi, Haberal Ali

机构信息

Department of Obstetrics & Gynecology, School of Medicine, Baskent University, Ankara, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2013 Sep;26(13):1282-6. doi: 10.3109/14767058.2013.783799. Epub 2013 Apr 12.

Abstract

OBJECTIVE

To report the feasibility of laparoendoscopic single port surgical approach for the management of huge adnexal cysts and adnexal torsion during pregnancy. To discuss the optimal method of entry into the peritoneal cavity for pregnant patients.

DESIGN

Two case report. METHOD AND PATIENT(S): Two pregnant patients with adnexal mass. First patient, suffering from persistent and progressive abdominal distention and pain on her 12th week of pregnancy, was diagnosed with an ovarian cyst in 18 cm diameter on left ovary. The other patient had IVF twin pregnancy and presented with left adnexal torsion on the 25th week of pregnancy.

INTERVENTION(S): Single-port laparoscopic ovarian cystectomy on the 12th week of pregnancy in patient one and single-port left adnexectomy in a twin pregnancy on the 25th week of pregnancy in patient two.

MAIN OUTCOME MEASURE(S): Feasibility of single port laparoscopic intervention during pregnancy for adnexal mass.

RESULT(S): Complete resolution of the symptoms for both pregnant women after the surgeries. No fetal and maternal complication was diagnosed during both pregnancies.

CONCLUSION(S): Single port laparoscopy with open-entry technique is feasible and might be a better surgical option for the pregnant patients with adnexal pathology. However, further studies with larger sample size are needed to reach clear conclusion.

摘要

目的

报告经脐单孔腹腔镜手术治疗妊娠合并巨大附件囊肿及附件扭转的可行性。探讨妊娠患者进入腹腔的最佳方法。

设计

两例病例报告。方法与患者:两名妊娠合并附件肿物患者。首例患者,孕12周时出现持续性进行性腹胀及腹痛,诊断为左侧卵巢直径18cm的囊肿。另一例患者为体外受精双胎妊娠,孕25周时出现左侧附件扭转。

干预措施

首例患者在孕12周时行经脐单孔腹腔镜卵巢囊肿切除术,第二例患者在孕25周双胎妊娠时行经脐单孔左侧附件切除术。

主要观察指标

妊娠期间经脐单孔腹腔镜干预治疗附件肿物的可行性。

结果

两名孕妇术后症状均完全缓解。两次妊娠期间均未诊断出胎儿及母体并发症。

结论

采用开放式入路技术的经脐单孔腹腔镜手术是可行的,对于有附件病变的妊娠患者可能是一种更好的手术选择。然而,需要更大样本量的进一步研究才能得出明确结论。

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