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腹腔镜单孔线性输卵管造口术治疗异位妊娠:一例报告

Laparoscopic single-site linear salpingostomy for the management of heterotopic pregnancy: a case report.

作者信息

Bedaiwy Mohamed A, Volsky Jessica, Lazebnik Noam, Liu James

出版信息

J Reprod Med. 2014 Sep-Oct;59(9-10):522-4.

Abstract

BACKGROUND

The laparoscopic management of tubal pregnancy component of a heterotopic pregnancy was conducted via multiport approach. In this report we describe a new technique using a single port approach with long-term follow-up.

CASE

A 27-year-old woman, G4P1031, presented with a heterotopic pregnancy after 2 years of infertility treatment. She underwent multiple surgeries to excise left ovarian cysts, lysis of adhesions, and recanalization of the right fallopian tube. During this time she also experienced a left-sided ectopic pregnancy and was treated with a traditional operative laparoscopy. Upon diagnosis of a heterotopic pregnancy, the decision was made to perform a laparoendoscopic single-site (LESS) procedure for treatment of a right ectopic pregnancy via a salpingostomy to preserve her potential for future spontaneous conception. A linear salpingostomy procedure was performed without complications, and the patient was able to carry her intrauterine pregnancy to term.

CONCLUSION

The LESS procedure is effective in resolving an ectopic pregnancy without affecting a coexisting intrauterine pregnancy, and preserving the potential for future spontaneous pregnancies. This approach should be considered for eligible patients with a heterotopic pregnancy who desire preservation of tubal function. (J Reprod Med 2014;

摘要

背景

异位妊娠中输卵管妊娠部分的腹腔镜处理是通过多端口入路进行的。在本报告中,我们描述了一种采用单端口入路并进行长期随访的新技术。

病例

一名27岁女性,孕4产1,有3次流产史,在接受2年不孕治疗后出现异位妊娠。她接受了多次手术,切除左侧卵巢囊肿、松解粘连以及右侧输卵管再通术。在此期间,她还经历了一次左侧异位妊娠,并接受了传统的手术腹腔镜治疗。诊断为异位妊娠后,决定通过输卵管造口术采用单孔腹腔镜手术(LESS)治疗右侧异位妊娠,以保留她未来自然受孕的可能性。进行了线性输卵管造口术,无并发症发生,患者能够将宫内妊娠维持至足月。

结论

LESS手术可有效解决异位妊娠,同时不影响并存的宫内妊娠,并保留未来自然妊娠的可能性。对于希望保留输卵管功能的异位妊娠合格患者,应考虑采用这种方法。(《生殖医学杂志》2014年;

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