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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 上一篇    下一篇

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. 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 Wang 1, Dawei Sun 2 , ( )   

  1. 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
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。

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.

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
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