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子宫动脉栓塞术后子宫肌瘤:袋内切碎避免剖腹手术。

Pyomyoma After Uterine Artery Embolization: Laparotomy Avoided by In-Bag Morcellation.

机构信息

Department of Gynecology, Centre Hospitalier Universitaire Laval, Québec, Canada.

Department of Gynecology, Centre Hospitalier Universitaire Laval, Québec, Canada.

出版信息

J Minim Invasive Gynecol. 2019 Jan;26(1):175-177. doi: 10.1016/j.jmig.2018.07.022. Epub 2018 Aug 9.

Abstract

We report a case of a pyomyoma in which in-bag morcellation allowed for a total laparoscopic hysterectomy instead of laparotomy, which has been recognized as the standard of care to avoid the spread of infection from morcellation. A 45-year-old multiparous woman presented with sepsis, pelvic pain, and leukocytosis at 1 month after undergoing uterine artery embolization for symptomatic uterine leiomyoma. Pelvic computed tomography scan revealed a 9-cm suspected pyomyoma. A total hysterectomy was performed using a laparoscopic approach with in-bag morcellation. The intervention was successful, and the postoperative course was uneventful. The patient was discharged on postoperative day 1 and was well at 2 months after surgery.

摘要

我们报告了一例子宫肌瘤脓肿病例,其中袋内切碎术使得全腹腔镜子宫切除术成为可能,而不是开腹手术,这已被认为是避免切碎术引起感染扩散的标准治疗方法。一名 45 岁的多产妇在行子宫动脉栓塞术治疗症状性子宫肌瘤 1 个月后出现脓毒症、盆腔痛和白细胞增多。盆腔 CT 扫描显示 9cm 大小疑似子宫肌瘤脓肿。采用腹腔镜入路和袋内切碎术进行全子宫切除术。该干预措施取得成功,术后过程无并发症。患者术后第 1 天出院,术后 2 个月恢复良好。

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