著者

永井 智之 島田 宗昭 湊 敬道 田中 恵子 土岐 麻実 工藤 敬 橋本 千明 星合 哲郎 徳永 英樹 八重樫 伸生

出版者

日本産科婦人科内視鏡学会

雑誌

日本産科婦人科内視鏡学会雑誌 (ISSN:18849938)

巻号頁・発行日

vol.35, no.1, pp.92-97, 2019 (Released:2019-06-08)

参考文献数

11

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Objective: To evaluate the usefulness of diagnostic laparoscopy in patients with advanced ovarian cancer.Methods: We retrospectively analyzed nine patients for whom primary debulking surgery was considered unfeasible. We evaluated whether laparoscopic procedure was adequate in making pathological diagnosis and intraabdominal assessment.Results: Median age was 63 years (range, 47-79 years), and median operation time was 59 minutes (range, 43-103 minutes). All nine patients were pathologically diagnosed with high-grade serous carcinoma and were considered unfit to undergo primary debulking surgery. All patients received chemotherapy. Six patients underwent interval debulking surgery. Only one patient showed mild adhesions between the omentum and the abdominal wall. Conclusion: Diagnostic laparoscopy is safe and feasible in advanced ovarian cancer patients.

著者

上地 秀昭 野原 理

出版者

日本産科婦人科内視鏡学会

雑誌

日本産科婦人科内視鏡学会雑誌 (ISSN:18849938)

巻号頁・発行日

vol.33, no.2, pp.197-201, 2017

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<p>  Interstitial pregnancy is a rare and life-threatening condition. The most important facet of caring for women with interstitial pregnancy is early diagnosis. We report a case of interstitial pregnancy that was indistinguishable from normal intrauterine pregnancy. A 38-year-old woman, gravida 4 para 3, with a history of laparoscopic salpingectomy for ectopic pregnancy, felt a strong lower abdominal pain and visited our emergency department. The pregnancy test result was positive, and transvaginal ultrasonography revealed intrauterine pregnancy of 11 weeks with intrapelvic hemorrhage but without an adnexal mass. Two hours later, she felt severe upper abdominal pain. Urgent ultrasonography revealed increased intra-abdominal hemorrhage. Emergency laparoscopy was performed. We collected 1400 ml of blood in the abdominopelvic cavity and found that she had a left interstitial pregnancy with bleeding. We removed all gestational tissue and performed a cornuostomy. After the surgery, 4 blood units were transfused. Interstitial pregnancy was difficult to diagnose at 11 weeks of pregnancy. However, ultrasonography revealed intrauterine pregnancy with intrapelvic hemorrhage. Concomitant intrauterine and extrauterine pregnancies or interstitial pregnancy should be considered.</p>

著者

長尾 有佳里 鈴木 一弘 新保 暁子 坂堂 美央子 齋藤 愛 廣村 勝彦 安藤 智子

出版者

日本産科婦人科内視鏡学会

雑誌

日本産科婦人科内視鏡学会雑誌 (ISSN:18849938)

巻号頁・発行日

vol.31, no.2, pp.399-405, 2016 (Released:2016-05-17)

参考文献数

10

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Anti-N-methyl-D-aspartate (NMDA)-receptor encephalitis is a paraneoplastic encephalitide that causes various symptoms. It occurs especially in young women, with about 60% of cases being associated with ovarian teratoma.   We report two cases of emergency laparoscopic surgeries for anti-NMDA-receptor encephalitis associated with ovarian teratoma.Case 1: A 17-year-old woman had headache, fever and vomiting. A week later, she also had abnormal behavior and hallucination and entered hospital. CT scan detected left ovarian teratoma. As anti-NMDA-receptor encephalitis was suspected, she underwent laparoscopic left ovarian cystectomy. She needed post-operative respirator management for 2.5 months. Although discharged after 4.5 months, she was sent to a psychiatrist after 7 months because of domestic violence. The pathological diagnosis was an immature teratoma, but there is no sign of recurrence.Case 2: A 26-year-old woman had fever, headache and fatigue. A few days later, she also had memory disorder and entered hospital. CT scan detected right ovarian teratoma. As anti-NMDA-receptor encephalitis was suspected, she underwent single incision laparoscopic right salpingo-oophorectomy. She needed post-operative respirator management for 9 months and left hospital after 1 year. The pathological diagnosis was a mature teratoma.  Antibodies against NMDA-receptor were positive in both cerebrospinal fluids.  Early diagnosis and surgery are important for quick recovery of anti-NMDA-receptor encephalitis associated with ovarian teratoma. Even so, patients don't necessarily recover quickly without aftereffects. We should review operative methods, because the patient is young and cannot agree and immature teratoma prevalence is high. Whether a tumor is benign or malignant, it is important to prevent leakage of tumor contents whenever possible.

著者

奥田 知宏 吉岡 崇 秋山 誠 山下 貞雄

出版者

Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy

雑誌

日本産科婦人科内視鏡学会雑誌 (ISSN:18849938)

巻号頁・発行日

vol.26, no.2, pp.429-434, 2010 (Released:2011-06-02)

参考文献数

17

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Laparoscopic surgery is a valuable tool in the definitive diagnosis and treatment of benign uterine tumors. Here we report two cases diagnosed as benign uterine tumors by laparoscopic surgery: the first is an adenomatoid tumor that was suspected preoperatively as a uterine leiomyoma; the second is a uterine leiomyoma that was suspected preoperatively as an adenomatoid tumor.Cases:   Case 1: A 63 year-old woman presented to our hospital complaining of lumbago. Uterine myoma was suspected and ultrasound and MRI were performed. A cystic uterine tumor suggesting benign uterine leiomyoma was discovered. However, malignancy could not be ruled out, therefore, the patient consented to LAVH (laparoscopic assisted vaginal hysterectomy). Upon removal of the patient's uterus, macroscopic examination of the tumor was strongly suggestive of uterine leiomyoma. The specimen was sent to pathology; microscopic examination and immunohistological testing provided the definitive diagnosis of benign adenomatoid tumor.   Case 2: A 44 year-old woman presented to our hospital for periodic examination of a uterine myoma that she had been diagnosed with several years ago. MRI was performed and myoma nodule was found. To rule out malignancy, a diagnostic and therapeutic laparoscopic assisted myomectomy (LAM) was recommended. LAM was chosen because the tumor surface appeared as a usual myoma nodule. Final pathology findings on immunohistochemical study of the surgical specimen confirmed the diagnosis of uterine leiomyoma.Conclusion:   Laparoscopic surgery provides many advantages in clinical gynecological practice. We stress the importance of laparoscopic surgery in preventing misdiagnosis, and in providing definitive diagnosis and treatment in cases of benign gynecologic tumors, including the rare uterine adenomatoid tumor presented herein. We recommend laparoscopic surgical intervention particularly in cases where various imaging studies including MRI, CT, and sonogram, are incompatible with or unable to confirm benign tumor origin.

著者

亀井 清 玉崗 有吉 吉田 憲一 横倉 恒雄 中村 英世 落合 寛

出版者

日本産科婦人科内視鏡学会

雑誌

日本産科婦人科内視鏡学会雑誌 (ISSN:18849938)

巻号頁・発行日

vol.4, no.1, pp.93, 1988

著者

井上 裕美

出版者

JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY

雑誌

日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology (ISSN:18849938)

巻号頁・発行日

vol.16, no.2, pp.180-185, 2000-12-01

著者

青木 卓哉 中村 公彦 成本 勝彦 刈谷 方俊 壺井 和彦

出版者

JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY

雑誌

日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology (ISSN:18849938)

巻号頁・発行日

vol.25, no.2, pp.379-384, 2009-12-01

参考文献数

19

被引用文献数

1

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<B>Objective:</B> The aim of this study was to evaluate the ovulatory performance and reproductive outcome after laparoscopic ovarian drilling using a harmonic scalpel in infertile women with clomiphene-resistant polycystic ovarian syndrome (PCOS).<BR><B>Patients:</B> Twenty clomiphene-resistant anovulatery women with PCOS underwent laparoscopic ovarian drilling between March 2005 and December 2006.<BR><B>Results:</B> After surgery, LH serum levels and the LH/FSH ratio showed statistically significant reductions, and ovulation occurred spontaneously in 70% (14/20) of the patients. The pregnancy rate was 50% (10/20) in < 1 year. Within 4 months postoperatively, 50% of all pregnancies had occurred.<BR><B>Conclusion:</B> Laparoscopic ovarian drilling is an effective treatment in women with clomiphene-resistant polycystic ovarian syndrome, yet without major complications associated with medical treatment, such as ovarian hyperstimulation syndrome and, plural gestations.