Kedia Bela, Chordiya Nilesh, Ganatra Keya
Fortis Hospital, Mumbai, Maharashtra India.
Guru Nanak Hospital, Mumbai, India.
J Obstet Gynaecol India. 2023 Feb;73(1):83-85. doi: 10.1007/s13224-022-01721-z. Epub 2022 Dec 30.
A 59-year-old post-menopausal female presented with complaints of per vaginal spotting for 3 months. Histopathological examination of contents of dilation and curettage revealed endometrial carcinoma (FIGO stage I), along with benign endocervical polyps. MRI also showed presence of left-sided structure indicative of ectopic pelvic kidney. The patient underwent laparoscopic radical hysterectomy, bilateral salpingo-oophorectomy and bilateral ilio-obturator lymph node dissection. Dissection was started along the left pelvic plane. The left pelvic kidney was seen, and left ureter was located and confirmed below the uterus. The patient withstood the procedure well. Anomalies of pelvic anatomy, such as a malpresentation of the kidney and ureter, may prove as surgical challenges while performing open and laparoscopic surgery. However, in depth preoperative imaging, meticulous intraoperative dissection and proper identification of surrounding structures reduces the risk of such complications.
一名59岁的绝经后女性因阴道点滴出血3个月前来就诊。刮宫术内容物的组织病理学检查显示为子宫内膜癌(国际妇产科联盟分期I期),同时伴有良性宫颈息肉。磁共振成像(MRI)还显示左侧有异位盆腔肾的结构。患者接受了腹腔镜根治性子宫切除术、双侧输卵管卵巢切除术和双侧髂内闭孔淋巴结清扫术。手术从左侧盆腔平面开始。可见左侧盆腔肾,确认左侧输尿管位于子宫下方。患者手术耐受良好。盆腔解剖结构异常,如肾脏和输尿管位置异常,在进行开放手术和腹腔镜手术时可能会带来手术挑战。然而,术前进行深入的影像学检查、术中细致的解剖以及正确识别周围结构可降低此类并发症的风险。