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巨大的带蒂子宫肌瘤经宫颈脱出：一项手术挑战。

Enormous Myoma Pedunculated Through the Cervix: A Surgical Challenge.

作者信息

Futcher F, George P, Habib N, Von Theobald P, Birsan-Frances A

机构信息

Department of Obstetrics and Gynecology, North University Hospital of Reunion Island, Saint-Denis, France.

Department of Obstetrics and Gynecology, Hôpitaux du Pays du Mont-Blanc, Sallanches, France.

出版信息

Case Rep Obstet Gynecol. 2025 Jul 31;2025:8044836. doi: 10.1155/crog/8044836. eCollection 2025.

DOI:10.1155/crog/8044836
PMID:40777066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12331403/
Abstract

We report the case of a 57-year-old woman who presented to the gynecological emergency department with an enormous 18 cm submucosal leiomyoma pedunculated through the cervix. She was anemic due to bleeding over the past 2 months. The aim of this study was to highlight the challenges of managing such an unusual clinical scenario. We also describe the preoperative and intraoperative methods that can be used to minimize intraoperative blood loss and improve the safety and feasibility of this kind of surgical procedure. In our case, we decided to perform a vaginal myomectomy after a tourniquet on the pedicle to reduce bleeding.

摘要

我们报告了一例57岁女性病例，该患者因一个巨大的、通过宫颈的18厘米带蒂黏膜下平滑肌瘤而就诊于妇科急诊科。由于过去两个月的出血，她出现了贫血。本研究的目的是强调处理这种不寻常临床情况的挑战。我们还描述了可用于尽量减少术中失血并提高此类手术安全性和可行性的术前和术中方法。在我们的病例中，我们决定在对蒂部使用止血带后进行经阴道子宫肌瘤切除术以减少出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/769694029c77/CRIOG2025-8044836.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/b64f756b252e/CRIOG2025-8044836.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/f0b07c7c25dc/CRIOG2025-8044836.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/9d0635fbee5a/CRIOG2025-8044836.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/769694029c77/CRIOG2025-8044836.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/b64f756b252e/CRIOG2025-8044836.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/f0b07c7c25dc/CRIOG2025-8044836.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/9d0635fbee5a/CRIOG2025-8044836.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f459/12331403/769694029c77/CRIOG2025-8044836.004.jpg

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本文引用的文献

1
Intrauterine Tamponade Balloon for Management of Severe Postpartum Haemorrhage: Does Early Insertion Change the Outcome? A Retrospective Study on Blood Loss.用于治疗严重产后出血的宫腔填塞球囊：早期置入会改变结局吗？一项关于失血情况的回顾性研究
J Clin Med. 2023 Aug 22;12(17):5439. doi: 10.3390/jcm12175439.
2
Vaginal prolapse of a large uterine cervical leiomyoma complicated with cervical inversion: A case report of an extremely rare entity with review of the literature.巨大子宫颈平滑肌瘤合并宫颈内翻的阴道脱垂：1例极其罕见病例报告并文献复习
SAGE Open Med Case Rep. 2022 Nov 1;10:2050313X221135596. doi: 10.1177/2050313X221135596. eCollection 2022.
3
MRI Evaluation of Uterine Masses for Risk of Leiomyosarcoma: A Consensus Statement.
MRI 评估子宫肿块发生平滑肌肉瘤的风险：共识声明。
Radiology. 2023 Feb;306(2):e211658. doi: 10.1148/radiol.211658. Epub 2022 Oct 4.
4
A hybrid technique for the removal of a large prolapsed pedunculated submucous leiomyoma.一种用于切除巨大脱垂带蒂黏膜下平滑肌瘤的混合技术。
J Gynecol Obstet Hum Reprod. 2022 May;51(5):102365. doi: 10.1016/j.jogoh.2022.102365. Epub 2022 Apr 8.
5
Advanced Interventional Procedures after Intrauterine Tamponade Balloon Insertion in a Tertiary Care Center.三级医疗中心宫腔内球囊填塞术后的高级介入性操作。
J Invest Surg. 2021 Apr;34(4):373-379. doi: 10.1080/08941939.2019.1637976. Epub 2019 Jul 19.
6
A review on recent advances in chitosan based composite for hemostatic dressings.壳聚糖基复合材料在止血敷料方面的最新进展综述。
Int J Biol Macromol. 2019 Mar 1;124:138-147. doi: 10.1016/j.ijbiomac.2018.11.045. Epub 2018 Nov 14.
7
Application of chitosan-covered gauze in combination with intrauterine balloon tamponade for postpartum hemorrhage treatment - Case report of a novel "uterine sandwich" approach.壳聚糖覆盖纱布联合宫腔球囊填塞在产后出血治疗中的应用——一种新型“子宫三明治”方法的病例报告
Int J Surg Case Rep. 2018;48:101-103. doi: 10.1016/j.ijscr.2018.05.006. Epub 2018 May 26.
8
Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids.区分子宫肉瘤和平滑肌瘤的临床特征
JSLS. 2018 Jan-Mar;22(1). doi: 10.4293/JSLS.2017.00066.
9
Uterine fibroid therapy using interventional radiology mini-invasive treatments: current perspective.使用介入放射学微创治疗的子宫肌瘤疗法：当前观点
Med Oncol. 2017 Apr;34(4):52. doi: 10.1007/s12032-017-0906-5. Epub 2017 Feb 24.
10
Epidemiology of Uterine Fibroids: From Menarche to Menopause.子宫肌瘤的流行病学：从初潮到绝经
Clin Obstet Gynecol. 2016 Mar;59(1):2-24. doi: 10.1097/GRF.0000000000000164.