Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
J Minim Invasive Gynecol. 2013 Nov-Dec;20(6):864-70. doi: 10.1016/j.jmig.2013.06.002. Epub 2013 Jul 11.
To evaluate the safety and feasibility of single-port laparoscopic adnexal surgery during pregnancy.
A retrospective study (Canadian Task Force Classification III).
A university hospital.
A total of 14 women with intrauterine pregnancy who underwent single-port laparoscopic surgery (SPLS).
We retrospectively reviewed the medical records of 14 women with intrauterine pregnancy who underwent SPLS between November 2009 and September 2012 for the treatment of an adnexal mass.
Factors investigated included the duration of surgery, differences between preoperative and postoperative hemoglobin, the size of the mass as measured by ultrasonography, major intraoperative or postoperative complications, conversion to multiport laparoscopy, and pregnancy outcomes. Single-port laparoscopic adnexal surgery was successfully performed in all 14 pregnant patients with an adnexal mass. The median gestational age at operation was 9 weeks (range, 4 weeks-17 weeks 4 days). Procedures included ovarian cystectomy with or without detorsion (n = 9), cyst aspiration with detorsion (n = 2), salpingectomy (n = 2), and salpingostomy (n = 1). The median duration of surgery was 59 minutes (range, 36-84 minutes). No major intraoperative or postoperative complications were encountered, and there was no need for conversion to multiport laparoscopic surgery. Five women had spontaneous vaginal delivery, and 5 women underwent cesarean delivery at term. One woman had preterm delivery at a gestational age of 24 weeks 5 days. In 1 case, abortion occurred 2 weeks after the operation.
Based on these initial findings, SPLS appears to be a safe and technically feasible treatment for an adnexal mass during pregnancy.
评估单孔腹腔镜附件手术在妊娠期间的安全性和可行性。
回顾性研究（加拿大工作队分类 III）。
一所大学医院。
14 名患有宫内妊娠并接受单孔腹腔镜手术（SPLS）的妇女。
我们回顾性地审查了 2009 年 11 月至 2012 年 9 月期间因附件肿块接受 SPLS 治疗的 14 名宫内妊娠妇女的病历。
调查的因素包括手术时间、术前和术后血红蛋白差异、超声测量的肿块大小、主要术中或术后并发症、转为多孔腹腔镜检查以及妊娠结局。14 名患有附件肿块的孕妇均成功完成了单孔腹腔镜附件手术。手术时的中位妊娠周数为 9 周（范围为 4 周-17 周 4 天）。手术包括卵巢囊肿切除术伴或不伴扭转复位（n=9）、囊肿抽吸伴扭转复位（n=2）、输卵管切除术（n=2）和输卵管造口术（n=1）。手术的中位时间为 59 分钟（范围为 36-84 分钟）。没有发生主要的术中或术后并发症，也不需要转为多孔腹腔镜手术。5 名妇女自然阴道分娩，5 名妇女足月剖宫产。1 名妇女在 24 周 5 天的妊娠时早产。1 例在手术后 2 周发生流产。
根据这些初步发现，SPLS 似乎是治疗妊娠期间附件肿块的一种安全且技术可行的方法。
