Clapp Mara, Huang Jaou-Chen
Department of Obstetrics and Gynecology, The University of Texas at Houston-Memorial Hermann, 6431 Fannin, Suite 3.214, Houston, TX 77030, USA.
Case Rep Obstet Gynecol. 2013;2013:906825. doi: 10.1155/2013/906825. Epub 2013 May 29.
Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue. Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy. Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.
背景。输卵管异位妊娠的治疗有时需要进行手术。从历史上看,外科医生使用电外科手术来实现止血。局部止血密封剂,如弗洛塞尔(FloSeal),可能会减少对电外科手术的依赖,并减少对组织的热损伤。病例。一名33岁的初产妇(G1P0)因右侧输卵管妊娠接受了甲氨蝶呤治疗。患者六天后出现症状,接受了腹腔镜右侧输卵管切开术。在多次尝试用电凝法止血失败后,使用了弗洛塞尔(FloSeal)并实现了止血。六周后,子宫输卵管造影(HSG)证实输卵管通畅。该患者随后成功宫内妊娠。结论。弗洛塞尔(FloSeal)有助于在腹腔镜输卵管切开术中实现止血并保持输卵管通畅。在输卵管妊娠的手术治疗中,弗洛塞尔(FloSeal)是电外科手术的一种有效替代方法和辅助手段。