腹腔镜手术治疗巨大黏膜下肌瘤脱垂:一例报告。
Massive prolapsed submucous fibroid treated with laparoscopic surgery: A case report.
作者信息
Yabumoto Kazuya, Ito Fumitake, Matsushima Hiroshi, Mori Taisuke, Kusuki Izumi, Kitawaki Jo
机构信息
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
出版信息
J Obstet Gynaecol Res. 2019 Apr;45(4):942-946. doi: 10.1111/jog.13901. Epub 2019 Jan 25.
Prolapsed uterine fibroids are pedunculated submucous fibroids that prolapse through the cervical canal. Herein, we describe the laparoscopic treatment of massive prolapsed submucous fibroids. A 47-year-old woman had experienced frequent urination and abnormal vaginal bleeding for 7 years. She presented with persistent lower abdominal pain. The uterine fundus was palpable at 3 cm above the umbilicus. Vaginal examination revealed a dark purple and easily bleeding mass in her vagina. Pelvic magnetic resonance imaging revealed a large mass prolapsing from the uterine endometrium, which occupied the cervical canal and vagina, without evidence of malignancy. Under a preoperative diagnosis of uterine fibroids with edematous degeneration, we performed laparoscopic uterine artery cutting, transvaginal removal of the fibroid by twisting, and total laparoscopic hysterectomy. Histopathological examination revealed leiomyoma with partial ischemia. Six days postoperatively, the patient was discharged without complications. This approach may be appropriate for the treatment of massive prolapsed submucous fibroids.
子宫脱垂肌瘤是有蒂的黏膜下肌瘤,可通过宫颈管脱垂。在此,我们描述巨大脱垂黏膜下肌瘤的腹腔镜治疗。一名47岁女性有7年尿频和异常阴道出血史。她出现持续性下腹痛。子宫底在脐上3厘米处可触及。阴道检查发现阴道内有一暗紫色且易出血的肿物。盆腔磁共振成像显示一个从子宫内膜脱垂的大肿物,占据宫颈管和阴道,无恶性证据。术前诊断为子宫肌瘤伴水肿变性,我们进行了腹腔镜子宫动脉切断术、经阴道拧除肌瘤及全腹腔镜子宫切除术。组织病理学检查显示为平滑肌瘤伴部分缺血。术后6天,患者无并发症出院。这种方法可能适用于巨大脱垂黏膜下肌瘤的治疗。