文献一覧: 日本産科婦人科内視鏡学会 (出版者)

1 0 0 0 腹腔鏡下手術を施行した陳旧性卵管妊娠の2症例

著者: 石山美由紀渡辺正黒澤大樹氷室裕美鈴木久也宇賀神智久中西透渡部洋
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.2, pp.345-351, 2019

Objective: To report our experience with the management of two cases of chronic tubal pregnancy by laparoscopic surgery.Case 1: A 37-year-old woman presented to our hospital with a small amount of genital bleeding at 10 weeks and 3 days of gestation, calculated from the date of her last menstrual period. Serum human chorionic gonadotropin level was elevated to 108.5 mIU/mL and transvaginal sonography (TVS) revealed a 52-mm diameter of irregularly shaped left periovarian mass. Magnetic resonance imaging (MRI) also showed a periovarian cystic mass with suspicion of an old hemorrhage. We performed laparoscopic left salpingectomy after the diagnosis of chronic left tubal pregnancy.Case 2: A 31-year-old woman was referred to our hospital with suspected left tubal abortion at 16 weeks and 1 day of gestation. Both TVS and MRI revealed a left periovarian mass with a diameter of 40 mm. After the mass was diagnosed as chronic left tubal pregnancy under laparoscopic vision, left fallopian tube was preserved by salpingotomy. She achieved twin pregnancy by ovulation induction with clomiphene 7 months after laparoscopic surgery.Conclusion: Although preoperative diagnosis of chronic tubal pregnancy is difficult, laparoscopic approach would be feasible, especially when salpingotomy would be performed for future fertility preservation.

2020-03-18 18:48:09
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1 0 0 0 OA 進行卵巣癌に対する審査腹腔鏡の有用性に対する検討

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

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.

2019-06-15 01:42:00
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1 0 0 0 正常子宮内妊娠と判断されたが卵管間質部妊娠であった一例

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

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.

2019-03-21 04:19:15
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1 0 0 0 OA 抗NMDA受容体脳炎を疑い、緊急腹腔鏡下手術を行った卵巣奇形腫の2例

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

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.