单孔腹腔镜手术治疗妊娠早期子宫圆韧带肌瘤一例

doi:10.3877/cma.j.issn.1674-6899.2021.02.011

中华腔镜外科杂志(电子版) ›› 2021, Vol. 14 ›› Issue (02) : 116 -118. doi: 10.3877/cma.j.issn.1674-6899.2021.02.011

新技术新方法

单孔腹腔镜手术治疗妊娠早期子宫圆韧带肌瘤一例

王永鹏¹, 孙大为²^,^†(

)

^1. 110042　沈阳，中国医科大学肿瘤医院/辽宁省肿瘤医院妇科
^2. 100730　北京，中国医学科学院北京协和医院妇科

收稿日期:2021-02-27 出版日期:2021-04-30
通信作者: 孙大为

Treatment of uterine round ligament myoma in early pregnancy by TU-LESS: a case report

Yongpeng Wang¹, Dawei Sun²^,^†()

^1. Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110042, China
^2. Department of Gynecology, Peking Union Medical College Hospital, Beijing 100730, China

Received:2021-02-27 Published:2021-04-30
Corresponding author: Dawei Sun

全文 ( ) 下载PDF ( ) 导出引用

目的

探讨妊娠早期子宫圆韧带肌瘤的临床特点、诊断及治疗方法，以期提高妇产科医师对该疾病的认识和了解，同时应重视单孔腹腔镜在该类疾病中的应用价值。

方法

选取中国医学科学院北京协和医院收治的1例妊娠早期合并子宫圆韧带肌瘤的病例，阐述诊治过程及临床结局，并结合文献复习总结该病的特点及诊疗策略。

结果

患者在确诊子宫圆韧带肌瘤之前终止妊娠，二期应用单孔腹腔镜探查最终确诊并将肿瘤切除，手术顺利。术后随访1个月，恢复良好，无并发症。

结论

子宫圆韧带肌瘤非常少见，尤其妊娠期合并子宫圆韧带肌瘤更是罕见。该疾病容易误诊，核磁共振检查可能有助于正确诊断。单孔腹腔镜技术在该病诊断和治疗中发挥着重要的作用。

关键词: 妊娠, 子宫圆韧带肌瘤, 经脐单孔腹腔镜

Objective

To investigate the clinical characteristics, diagnosis and treatment of uterine round ligament myoma in early pregnancy, so as to improve the understanding of gynecologists and obstetricians, and pay attention to the application of laparoendoscopic single-site surgery.

Methods

A case of early pregnancy complicated with uterine round ligament myoma in Peking Union Medical College Hospital was selected, describing the process of diagnosis and treatment, also clinical outcome. The characteristics and diagnosis and treatment strategy of the disease were summarized combined with literature review.

Results

The pregnancy was terminated before the diagnosis of round ligament leiomyoma. The second stage of UM-LESS exploration was used, and the tumor was finally diagnosed and removed. The operation was successful. The patients were followed up for 1 month and recovered well without any complications.

Conclusions

Uterine round ligament myoma is very rare, especially during pregnancy. It is easy to be misdiagnosed and MRI may be helpful for the correct diagnosis. UM-LESS plays an important role in the diagnosis and treatment of the disease.

Key words: Pregnancy, Uterine round ligament myoma, Transumbilical laparoendoscopic single-site surgery

图1 盆腔彩色多普勒超声：宫内妊娠囊4.1 cm×4.3 cm×2.3 cm，胎芽长2.9 cm,

图2 子宫左侧可见不均质低回声，大小约5.9 cm×4.2 cm×4.3 cm，形态规则，边界清

图3 子宫左侧低回声周围及内部见极为丰富的血流信号,

图4 术中见肿物发源于子宫圆韧带，有宽蒂与其相连，距离宫角较近

1	孙大为．中国大陆妇科单孔腹腔镜手术的现状和展望[J]. 中国临床新医学，2020, 13(8): 752-755.
2	Aya, Mochimaru, Kayo, et al. Laparoscopic management of a leiomyoma of the round ligament of the uterus misdiagnosed as an ovarian tumor: a case report [J]. Jap J Gynecol Obstet Endo, 2019, 35(1): 169-174.
3	Breen JL, Neubecker RD. Tumors of the round ligament a review of the literature and a report of 25 cases[J]. Obstetrics and Gynecology, 1962, 19(6): 771-780.
4	张柯，张怡. 巨大子宫圆韧带肌瘤1例[J]. 中国现代医学杂志，2003, 13(16): 157-157.
5	丁国霞. 输卵管妊娠合并子宫圆韧带肌瘤一例[J]. 河南肿瘤学杂志，1999, 12(4): 56-56.
6	汪志辉，生秀杰．妊娠期附件包块的诊断策略[J]. 中国实用妇科与产科杂志，2020, 36(12): 1145-1148.
7	Bon GG, Kenemans P, Verstraeten AA, et al. Maternal serum CA125 and CA15-3 antigen levels in normal and pathological pregnancy[J]. Fetal Diagnosis & Therapy, 2001, 16(3): 166-172.
8	Stenman UH, Tiitinen A, Alfthan H，et al. The classification，functions and clinical use of different isoforms of HCG[J]．Hum Reprod Update, 2006, 12(6): 769-784.
9	Dealmeida GR, Santossimes RD, AntonioSilvinato, et al. Ultrasound in the first trimester of pregnancy [J]. Revista da Associao Médica Brasileira, 2020, 66(11): 1472-1472.
10	Hand JW, Li Y, Thomas EL, et al. Prediction of specific absorption rate in mother and fetus associated with MRI examinations during pregnancy [J]. Magnetic Resonance in Medicine, 2010, 55(4): 883-893.
11	彭萍，朱兰，郎景和，等. 中孕期腹腔镜卵巢手术30例临床特点[J]. 协和医学杂志，2015, 6(3): 202-205.
12	林文雯，赵仁峰. 经脐单孔腹腔镜手术在妊娠合并巨大卵巢囊肿治疗中的研究及应用现状[J/CD]. 中华腔镜外科杂志(电子版), 2019, 12(4): 253-256.

[1]	李钱梅, 何冠南, 赵婧, 陈曦, 唐玉英, 马丽琼, 梁蓉, 袁桃, 李明星. 早孕期低危妊娠和高危妊娠胎盘微血流成像特征及预后分析[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(07): 726-732.
[2]	刘涵, 刘晓菲, 陈翰翰, 陈延君, 张雁. 妊娠期肉芽肿性乳腺炎一例[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(04): 253-254.
[3]	张舒沁, 陈练. 产后宫腔内妊娠物残留的诊断和临床处理[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 493-497.
[4]	刘子洋, 崔俭俭, 赵茵. 产科弥散性血管内凝血及其评分系统的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 511-518.
[5]	谢江燕, 王亚菲, 贺芳. 妊娠合并血栓性血小板减少性紫癜2例并文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 556-563.
[6]	张静, 刘畅, 华成舸. 妊娠期患者口腔诊疗进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 340-344.
[7]	徐敬云, 丁波, 蒋宇慧, 沈杨. 妊娠期单孔腹腔镜手术实施行与思[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 262-266.
[8]	鲁珊, 姚蕴珊, 廖色坭, 陈子恩, 张一剑, 蓝健皓, 魏薇, 刘艳杨, 陈艳红, 陈敦金. 妊娠合并急性阑尾炎100例临床研究[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 214-219.
[9]	汪文雁, 郑剑兰, 朱丽慈. 体外受精-胚胎移植术后妊娠患者孕产期风险的临床研究[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 220-226.
[10]	傅新露, 李之岳, 卢丹. 妊娠合并结肠癌穿孔致脓毒症休克一例并文献复习[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 227-231.
[11]	朱丽慈, 郑剑兰, 刘士璇, 张文蕾, 胡群, 陈丽旋. 妊娠期子宫嵌顿一例并文献复习[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 232-236.
[12]	俞慧慧, 尹宗智. 妊娠期胃穿孔[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 209-213.
[13]	胡小靖, 张华. 妊娠期卵巢囊肿蒂扭转的诊断与治疗[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 197-201.
[14]	黎璞, 生秀杰. 妊娠合并子宫颈癌的管理[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 202-208.
[15]	杭中霞, 王朝霞, 孙琴, 李妮. 血清Irisin、TSH 及Hcy 在妊娠期甲状腺功能减退症诊断中的应用[J/OL]. 中华诊断学电子杂志, 2024, 12(04): 265-269.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Treatment of uterine round ligament myoma in early pregnancy by TU-LESS: a case report

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Treatment of uterine round ligament myoma in early pregnancy by TU-LESS: a case report