Kwon Yong-Soon, Cho Yoo Mi, Im Kyong Shil, Yoo Su Bin, Hyung Sung Woo
Department of Obstetrics and Gynecology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Korea.
JSLS. 2019 Jan-Mar;23(1). doi: 10.4293/JSLS.2018.00072.
Uterine-conservative surgery via laparoscopy is a challengeable and high risk because of heavy intra-operative bleeding events in reproductive women with highly vascular uterine benign disease. There are three reported cases of women with highly vascular uterine benign diseases and high risk of intra-operative heavy bleeding, but were treated successfully to control intra-operative heavy bleeding risk by transient occlusion of the uterine artery (TOUA) through laparoscopy and resulted in safe conservation of the uterus.
The cases of women with high risk of heavy bleeding during therapeutic procedure included cesarean scar pregnancy, hydatid form mole on cesarean scar, and cervical pregnancy. All these women had the strong desire to presere their fertility and uterus. In all the three cases, we used the method of TOUA and performed therapeutic surgeries successfully, with less bleeding and safe conservation of the uterus through laparoscopy.
Laparoscopic TOUA could be a therapeutic option to manage heavy intra-operative bleeding during conservative uterine surgeries associated with the risk of heavy bleeding.
对于患有高血管性子宫良性疾病的生殖期女性,由于腹腔镜下子宫保留手术术中出血量大,该手术具有挑战性且风险高。有三例报告称,患有高血管性子宫良性疾病且术中大出血风险高的女性,通过腹腔镜下子宫动脉临时阻断术(TOUA)成功控制了术中大出血风险,并成功保留了子宫。
治疗过程中出血风险高的女性病例包括剖宫产瘢痕妊娠、剖宫产瘢痕部位葡萄胎和宫颈妊娠。所有这些女性都强烈希望保留生育能力和子宫。在所有三例病例中,我们使用了TOUA方法,成功进行了治疗性手术,术中出血较少,并通过腹腔镜安全地保留了子宫。
腹腔镜下TOUA可能是一种治疗选择,用于处理与大出血风险相关的保守性子宫手术术中的大出血情况。