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评价腹腔镜单孔手术治疗孕妇附件包块。

Evaluation of laparo-endoscopic single-site surgery for adnexal mass in pregnant women.

机构信息

Department of Obstetrics and Gynecology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China.

Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.

出版信息

BMC Pregnancy Childbirth. 2024 Oct 4;24(1):647. doi: 10.1186/s12884-024-06829-w.

Abstract

BACKGROUND

Surgery for adnexal mass does occur in pregnant women and therefore the choice of surgery during pregnancy needs to be carefully considered and studied. This study aimed to evaluate the safety and feasibility of Laparo-endoscopic Single-site Surgery (LESS) for adnexal mass during pregnancy and investigate the perioperative condition, pregnancy complications, and obstetric outcomes of operative women during pregnancy.

METHODS

This study retrospectively collected medical records and surgery videos of 20 pregnant women who underwent LESS for adnexal mass between November 2019 and January 2022. Baseline characteristics, operative-related variables, and pregnancy outcomes were followed up.

RESULTS

LESS for adnexal mass was successfully performed in 20 pregnant women, with very satisfactory surgery outcomes reported in all cases. The average gestational age at operation was 15 weeks (range, 5- 25 weeks). The median operative time was 80.8 min (range, 40 -185 min) and the average operative bleeding was 28.0 ml (range, 10-50 ml). The average VAS of 24 h postoperatively was 1 (range, 0-2), and the average length of hospital stay was 5.15 days (range, 3-7 days). All these women delivered a healthy newborn at full term except 1 woman induced abortion for her own reasons at 16 weeks gestational age (GA). The average GA of delivery was 39 weeks (range, 37-40 weeks), the average birth weight was 3228.95 g (range, 2740-3930 g), and the average Apgar score at 5 min was 9.95 (range, 9-10).

CONCLUSIONS

LESS for adnexal mass is safe and feasible for pregnant women.

摘要

背景

在孕妇中确实会进行附件肿块的手术,因此需要仔细考虑和研究妊娠期间的手术选择。本研究旨在评估腹腔镜单部位手术(LESS)治疗妊娠期间附件肿块的安全性和可行性,并调查手术孕妇的围手术期情况、妊娠并发症和产科结局。

方法

本研究回顾性收集了 2019 年 11 月至 2022 年 1 月期间 20 例因附件肿块接受 LESS 治疗的孕妇的病历和手术录像。随访了基线特征、手术相关变量和妊娠结局。

结果

20 例孕妇均成功完成 LESS 治疗附件肿块,所有病例均报告手术效果非常满意。手术时的平均妊娠周数为 15 周(范围,5-25 周)。中位手术时间为 80.8 分钟(范围,40-185 分钟),平均手术出血量为 28.0 毫升(范围,10-50 毫升)。术后 24 小时平均 VAS 为 1(范围,0-2),平均住院时间为 5.15 天(范围,3-7 天)。除 1 例因自身原因在 16 周妊娠时人工流产外,所有这些孕妇均足月分娩健康新生儿。平均分娩孕周为 39 周(范围,37-40 周),平均出生体重为 3228.95 克(范围,2740-3930 克),平均 5 分钟 Apgar 评分为 9.95(范围,9-10)。

结论

LESS 治疗妊娠期间附件肿块是安全可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09d/11451005/e606d4553407/12884_2024_6829_Fig1_HTML.jpg

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