切换至 "中华医学电子期刊资源库"
高级检索
中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01) : 20 -23. doi: 10.3877/cma.j.issn.1674-6899.2018.01.006

所属专题： 经典病例； 文献；

论著

经阴道自然腔道内镜手术在异位妊娠中的应用八例分析
刘海元1, 陈欣1, 孙大为1,†(), 张俊吉1, 冷金花1, 朱兰1, 刘珠凤1, 樊庆泊1, 史宏晖1, 郎景和1   
  1. 1. 100730　北京，中国医学科学院北京协和医院妇产科
  • 收稿日期:2017-11-02 出版日期:2018-02-28
  • 通信作者: 孙大为

Primary study on transvaginal natural orifice transluminal endoscopic surgery for ectopic pregnancy: a series of 8 cases

Haiyuan Liu1, Xin Chen1, Dawei Sun1,†(), Junji Zhang1, Jinhua Leng1, Lan Zhu1, Zhufeng Liu1, Qingbo Fan1, Honghui Shi1, Jinghe Lang1   

  1. 1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China
  • Received:2017-11-02 Published:2018-02-28
  • Corresponding author: Dawei Sun
  • About author:
    Corresponding author: Sun Dawei, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

刘海元, 陈欣, 孙大为, 张俊吉, 冷金花, 朱兰, 刘珠凤, 樊庆泊, 史宏晖, 郎景和. 经阴道自然腔道内镜手术在异位妊娠中的应用八例分析[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(01): 20-23.

Haiyuan Liu, Xin Chen, Dawei Sun, Junji Zhang, Jinhua Leng, Lan Zhu, Zhufeng Liu, Qingbo Fan, Honghui Shi, Jinghe Lang. Primary study on transvaginal natural orifice transluminal endoscopic surgery for ectopic pregnancy: a series of 8 cases[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(01): 20-23.

目的

探索经自然腔道内镜手术(natural orifice transluminal endoscopic surgery，NOTES)在异位妊娠治疗中的可行性、安全性及有效性。

方法

中国医学科学院北京协和医院妇产科于2015年6月至2016年5月共完成8例经阴道NOTES异位妊娠患侧输卵管切除术。记录患者年龄、体质量指数、阴道分娩数、停经时间、血β－HCG(人绒毛膜促性腺激素)、肿物大小、子宫直肠窝积血、手术时间、术中出血量等指标。

结果

8例患者的手术均成功完成，无中转传统腹腔镜手术或开腹手术，无并发症发生。年龄(33 ± 4.8)岁，体质量指数(24.2 ± 1.8)kg/m2，阴道分娩(1.5 ± 0.8)次，停经时间(52.3 ± 4.9)d，术前血β－HCG(10 280 ± 7 948.6)U/ml，肿物大小(2.75 ± 0.5)cm，子宫直肠窝积血(105 ± 98.3)ml，手术时间(41.9 ± 3.7)min，术中出血量(8.4 ± 5.6)ml。术后随访血β－HCG水平下降理想，阴道伤口愈合良好。

结论

经阴道NOTES可安全、有效完成异位妊娠输卵管切除，但需要进一步前瞻性研究来评估其完整临床应用。

关键词: 经自然腔道内镜手术, 异位妊娠, 输卵管切除术
Objective

To analyze the feasibility, safety, and efficacy of natural orifice transluminal endoscopic surgery (NOTES)for ectopic pregnancy.

Methods

Between Jun. 2015 and May 2016, 8 patients diagnosed as ectopic pregnancy underwent transvaginal NOTES to remove fallopian tube in Peking Union Medical College Hospital.

Results

All 8 cases were successfully completed. No one was converted to laparotomy or conventional laparoscopy. No complications occurred during intraoperative and postoperative time. The average age of patients was (33±4.8)y, body mass index was (24.2±1.8)kg/m2, vaginal delivery history was (1.5±0.8)times, length of menopause was (52.3±4.9) days, serum β-HCG was (10 280±7 948.6)U/ml, diameter of adnexal mass was (2.75±0.5) cm, hemoperitoneum was (105±98.3)ml, operation time was (41.9±3.7)min, average blood loss during surgery was (8.4±5.6)ml. During the follow-up period, the serum β-HCG decreased as expected. Vaginal wound healed well.

Conclusions

Transvagnial NOTES is a feasible, safe, and effective management in the treatment of ectopic pregnancy. Further evaluation of NOTES in a prospective randomized trial is required.

Key words: Natural orifice transluminal endoscopic surgery, Ectopic pregnancy, Salpingectomy
图1 经阴道自然腔道内镜手术在异位妊娠中的应用
[1]
Rao GV, Reddy DN, Banerjee R. NOTES: human experience[J]. Gastrointest Endosc Clin N Am, 2008, 18(2): 361-370.
[2]
Rolanda C, Lima E, Pego JM, et al. Third－generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video) [J]. Gastrointest Endosc, 2007, 65(1): 111-117.
[3]
Rattner D, Kalloo A. ASGE/SAGES working group on natural orifice transluminal endoscopic surgery[J]. Surg Endosc, 2006, 20(2): 329-333.
[4]
Santos BF, Hungness ES. Natural orifice translumenal endoscopic surgery: progress in humans since white paper[J]. World J Gastroenterol, 2011, 17 (13): 1655-1665.
[5]
Berg CJ, Atrash HK, Koonin LM, et al. Pregnancy－related morality in the united states, 1987－1990[J]. Obstet Gynecol, 1996, 88(1): 161-164.
[6]
Lee CL, Wu KY, Su H, et al. Transvaginal natural－orifice transluminal endoscopic surgery (NOTES) in adnexal procedures[J]. J Minim Invasive Gynecol, 2012, 19(4): 509-513.
[7]
Baekelandt J, Vercammen J. IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery[J]. Fertility and Sterility, 2017, 107(1): 1-2.
[8]
Xu B, Liu Y, Ying X, et al. Transvaginal endoscopic surgery for tubal ectopic pregnancy[J]. JSLS, 2014, 18(1): 76-82.
[9]
Liu BR, Kong XC, Cui GX, et al. Pure transgastric NOTES in an adnexal procedure: the first human case report[J]. Endoscopy, 2013, 45(2): 290-291.
[10]
Ahn KH, Song JY, Kim SH, et al. Transvaginal single－port natural orifice transluminal endoscopic surgery for benign uterine adnexal pathologies[J]. J Minim Invasive Gynecol, 2012, 19(5): 631-635.
[11]
Yoshiki N, Okawa T, Kubota T. Hybrid transvaginal and transumbilical laparoendoscopic adnexal surgery[J]. J Laparoendosc Adv Surg Tech A, 2012, 22(10): 992-995.
[12]
Lee CL, Wu KY, Su H, et al. Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (NOTES): a series of 137 patients[J]. Minim Invasive Gynecol, 2014, 21(5): 818-824.
[13]
Tolcher MC, Kalogera E, Hopkins MR, et al. Safety of culdotomy as a surgical approach: implications for natural orifice transluminal endoscopic surgery[J]. JSLS, 2012, 16(3): 413-420.
[14]
孙大为．单孔腹腔镜手术在妇科的应用探讨[J/CD]．中华腔镜外科杂志(电子版)，2013，6(1)：5-8.
[15]
孙大为. 正确认识单孔腹腔镜手术在妇科的应用[J/CD]. 中华腔镜外科杂志(电子版)，2012，5(4): 1-4.
[1] 梁志清. 子宫内膜癌微创与个性化治疗的进化与发展[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 621-621.
[2] 何浈, 何翔, 郄明蓉. 输卵管妊娠患者发生持续性异位妊娠危险因素及早期诊断的倾向性评分匹配分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2020, 16(02): 181-187.
[3] 周树林, 姜旖, 邱江南, 吴姗, 罗成燕, 袁琳, 程文俊. 经脐单孔腹腔镜全子宫双输卵管切除术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(01): 58-61.
[4] 王慧慧, 陈继明, 夏百荣, 张文笛, 秦真岳, 鲍明月, 余红霞, 张守枫, 魏炜炜, 施如霞. 经阴道单孔腹腔镜手术在妇科中的应用进展[J/OL]. 中华腔镜外科杂志(电子版), 2022, 15(02): 123-128.
[5] 曲思娆, 赵曼曼, 李全红, 李芳, 马晶晶, 张义男, 景思然, 孙建丽. 无气腹V-NOTES与传统腹腔镜治疗卵巢囊肿临床疗效比较[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(04): 217-220.
[6] 刘娟, 肖媛月, 王倩青, 关振堃, 关小明. 盆腔器官脱垂手术新入路：机器人辅助经阴道腹腔镜阴道骶骨固定术[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(03): 168-171.
[7] 花茂方, 王媛, 姚军. 子宫肌壁间妊娠：宫腔镜及腹腔镜成功诊治一例并文献复习[J/OL]. 中华腔镜外科杂志(电子版), 2019, 12(04): 250-252.
[8] 张俊吉, 戴毅, 孙大为, 刘海元, 王媛, 朱兰, 冷金花, 刘珠凤, 郎景和. 经阴道自然腔道内镜手术全子宫切除12例：可行性和安全性分析[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(03): 153-156.
[9] 臧光辉, 张治国, 贺厚光, 姜波, 周荣升, 李志刚, 庞昆, 马伟明, 韩从辉. 经自然腔道内镜手术内切开引流治疗肾盂旁囊肿[J/OL]. 中华腔镜外科杂志(电子版), 2017, 10(03): 163-165.
[10] 中国医师协会结直肠肿瘤专业委员会NOTES专委会. 经自然腔道内镜手术（NOTES）专家共识[J/OL]. 中华结直肠疾病电子杂志, 2021, 10(04): 337-342.
[11] 王锡山. 结直肠肿瘤NOSES术关键问题的思考与探索[J/OL]. 中华结直肠疾病电子杂志, 2018, 07(04): 315-319.
[12] 中国NOSES联盟, 中国医师协会结直肠肿瘤专业委员会NOSES专委会. 结直肠肿瘤经自然腔道取标本手术专家共识（2017）[J/OL]. 中华结直肠疾病电子杂志, 2017, 06(04): 266-272.
[13] 郑国, 金钊, 齐静怡, 张芸. 输卵管妊娠后慢性输卵管炎的造影分析[J/OL]. 中华介入放射学电子杂志, 2021, 09(01): 75-79.
[14] 张磊, 穆永旭, 闫瑞强, 刘海艳, 金昌, 吴常生, 董宁. 经子宫动脉化疗栓塞治疗异位妊娠35例观察[J/OL]. 中华介入放射学电子杂志, 2015, 03(04): 199-200.
[15] 雷红丹, 章灿辉, 袁运水. 输卵管黏膜容受性变化在输卵管妊娠发病中的作用[J/OL]. 中华诊断学电子杂志, 2019, 07(04): 265-268.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？