Effect of Two-Port Laparoscopic Surgery on Pregnancy Outcomes of Patients with Concurrent Adnexal Masses.
Effect of Two-Port Laparoscopic Surgery on Pregnancy Outcomes of Patients with Concurrent Adnexal Masses.
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DOI：
10.3390/jcm11164697
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发表时间：
2022-08-11
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
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附件肿块在妊娠中很常见，2-10%的妊娠表现为卵巢肿块，其中约1-6%为恶性肿块。对于疑似恶性肿瘤或有症状的肿块，必须尽早进行手术。我们回顾性研究了2012年至2019年期间双孔腹腔镜手术对并发附件肿块（包括大粘液性肿瘤、大畸胎瘤、浆液性交界性肿瘤和异位妊娠）患者结局的影响。在超声确认宫内妊娠囊伴胎儿心跳后，对孕龄（GA）为21周的27 cm卵巢粘液性肿瘤进行腹腔镜右侧卵巢部分切除术，对GA为10周的18 cm畸胎瘤进行腹腔镜右侧卵巢囊肿切除术，对GA为7周的7 cm浆液性交界性肿瘤进行腹腔镜左侧输卵管卵巢切除术。腹腔镜切除输卵管妊娠进行了异位妊娠在GA的12周大量内出血。腹腔镜手术在妊娠早期进行更容易和安全，因为较小的子宫允许上级可视化。所有这些患者术后恢复良好，足月自然分娩正常。我们讨论了并发附件肿瘤患者的治疗和分娩的几个方面，即治疗选择（期待治疗或手术）、手术时机（早期或晚期妊娠）、手术类型（腹腔镜或剖腹手术）和分娩途径（正常自然分娩或剖宫产）及其对妊娠结局的影响。
Adnexal masses are common in pregnancy, with 2–10% of pregnancies presenting with an ovarian mass and approximately 1–6% of these masses being malignant. For suspected malignancy or masses with symptoms, surgery must be performed as early as possible. We retrospectively investigated the effect of two-port laparoscopic surgery on the outcomes of patients with concurrent adnexal masses between 2012 and 2019 (including large mucinous tumor, large teratoma, serous borderline tumor, and heterotopic pregnancy). Laparoscopic right partial oophorectomy was performed for a 27 cm ovarian mucinous tumor at a gestational age (GA) of 21 weeks, laparoscopic right oophorocystectomy for an 18 cm teratoma at a GA of 10 weeks, and laparoscopic left salpingo-oophorectomy for a 7 cm serous borderline tumor at a GA of 7 weeks after ultrasonographic confirmation of an intrauterine gestational sac with a fetal heartbeat. Laparoscopic excision of a tubal pregnancy was performed in a heterotopic pregnancy at a GA of 12 weeks with massive internal bleeding. Laparoscopic surgery is easier and safe to perform during early pregnancy because a smaller uterus allows for superior visualization. All of these patients had optimal postoperative recovery and normal spontaneous delivery at term. We discussed several aspects of treatment and delivery, namely treatment option (expectant management or surgery), surgery timing (early or advanced pregnancy), surgery type (laparoscopy or laparotomy), and delivery route (normal spontaneous delivery or cesarean section), in patients with concurrent adnexal tumors and their effects on pregnancy outcomes.
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DOI：
10.1111/j.1479-828x.2011.01380.x
发表时间：
2012-02-01
影响因子：
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