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学会雑誌 (ISSN:18849938)
巻号頁・発行日
vol.25, no.2, pp.379-384, 2009 (Released:2010-11-11)
参考文献数
19
被引用文献数
1 1

Objective: 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).Patients: Twenty clomiphene-resistant anovulatery women with PCOS underwent laparoscopic ovarian drilling between March 2005 and December 2006.Results: 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.Conclusion: 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.
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

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
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

<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.