Le Xin, Dogan Nasuh Utku, Favero Giovanni, Köhler Christhardt
Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Department of Special Operative and Oncologic Gynecology, Asklepios Hospital Altona, Germany.
J Int Med Res. 2021 Jun;49(6):3000605211020697. doi: 10.1177/03000605211020697.
Persistent bleeding from the remaining cervix after laparoscopic supracervical hysterectomy (LSH) is normally related to the presence of residual functioning endometrial tissue. However, postoperative significant vaginal hemorrhage caused by cervical necrosis following LSH is relatively rare. A 39-year-old nulligravida was admitted to the emergency department with hypovolemic shock after LSH performed in another hospital for treatment of uterine fibroids 18 days previously. Following hemodynamic stabilization and mechanical tamponade of the bleeding uterine cervix, laparoscopic simple trachelectomy was carried out and antibiotics were administered. The patient developed no surgical or clinical complications and was discharged 4 days after surgery. Histologic examination revealed extensive areas of tissue necrosis and no signs of malignancy. Stump necrosis and accompanying bleeding are rare but serious complications of LSH. Infection is an important component of this entity and should be treated. Endoscopic management of this condition appears to be feasible and safe.
腹腔镜次全子宫切除术后（LSH）残端宫颈持续出血通常与残留的有功能的子宫内膜组织有关。然而，LSH术后因宫颈坏死导致的术后严重阴道出血相对少见。一名39岁未孕女性，18天前在另一家医院因子宫肌瘤行LSH术后，因低血容量性休克被收入急诊科。在血流动力学稳定及对出血的宫颈进行机械压迫止血后，实施了腹腔镜单纯宫颈切除术并给予抗生素治疗。患者未出现手术或临床并发症，术后4天出院。组织学检查显示广泛的组织坏死区域，未发现恶性征象。残端坏死及伴随的出血是LSH罕见但严重的并发症。感染是该病症的重要组成部分，应进行治疗。内镜处理这种情况似乎是可行且安全的。
