BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a ...BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a result of the continuous development of assisted reproductive technologies.When this type of pregnancy occurs,both the continuation of intrauterine pregnancy and the life of the pregnant woman are severely threatened.Early diagnosis and treatment using safe and effective methods are paramount in this situation.CASE SUMMARY A 30-year-old primigravida at a gestation age determined as 8 wk 4 d by scan was admitted to the hospital with heterotopic pregnancy and a right ovarian cyst.Laparoscopic resection of the ectopic pregnancy was performed,but the intrauterine pregnancy and ovarian cyst were preserved.CONCLUSION The approach to a patient with heterotopic pregnancy and a giant ovarian cyst is individualized base on the fertility requirements.We recommend the following:(1)If the patient satisfies parity and has no fertility requirement,a laparoscopic salpingectomy should be performed and the giant ovarian cyst and intrauterine pregnancy removed;(2)If the patient has fertility requirements wishes to have more children in the future,laparoscopic salpingectomy or salpingostomy should be performed and the intrauterine pregnancy preserved.Serial ovarian cyst aspiration can be performed under ultrasound and resection can be done after delivery;and(3)Heterotopic pregnancy should be diagnosed early by active surveillance during antenatal visits using ultra sound as this is important for the avoidance of catastrophic complications.展开更多
BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10...BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.展开更多
目的:探讨腹腔镜辅助手术治疗巨大卵巢囊肿的方法和可行性。方法:对18例巨大卵巢囊肿患者行腹腔镜辅助手术治疗,镜下行囊肿穿刺抽吸囊液,经11 mm Trocar切口将囊壁牵拉出腹腔外处理,根据病情行囊肿剥除术或附件切除术。结果:18例患者均...目的:探讨腹腔镜辅助手术治疗巨大卵巢囊肿的方法和可行性。方法:对18例巨大卵巢囊肿患者行腹腔镜辅助手术治疗,镜下行囊肿穿刺抽吸囊液,经11 mm Trocar切口将囊壁牵拉出腹腔外处理,根据病情行囊肿剥除术或附件切除术。结果:18例患者均在腹腔镜辅助下完成手术,术中未发生任何并发症,术中出血(50.3±10.2)ml,平均手术时间(51.3±12.3)min,术后平均住院日(3.4±1.6)天。结论:在严格选择病例的前提下进行腹腔镜辅助手术治疗巨大卵巢囊肿,创伤小、术后恢复快,有较大的应用价值。展开更多
目的探讨经脐无气腹单孔腹腔镜辅助下巨大卵巢囊肿体外剥除术的安全性和在医联体基层医院推广的可行性。方法选取2018年01月-2020年11月由同一术者(或指导)在笔者所在医院本部及两家医联体单位(县级人民医院)实施的41例巨大卵巢囊肿经...目的探讨经脐无气腹单孔腹腔镜辅助下巨大卵巢囊肿体外剥除术的安全性和在医联体基层医院推广的可行性。方法选取2018年01月-2020年11月由同一术者(或指导)在笔者所在医院本部及两家医联体单位(县级人民医院)实施的41例巨大卵巢囊肿经脐无气腹单孔腹腔镜辅助下的体外剥除手术,分为两组,一组20例在院本部完成,另一组21例在两家医联体单位完成。结果41例均成功完成手术,无一例增加辅助穿刺孔或中转开腹,无一例术中、术后出现并发症。比较两组手术时间、出血量、术后住院时间、术后24 h肛门排气率、术后24 h疼痛视觉模拟量表(Visual analog scale,VAS)评分及切口满意度评分,差异均无统计学意义。结论经脐无气腹单孔腹腔镜辅助的体外剥除治疗巨大卵巢囊肿安全可行,并可积极向医联体基层单位推广。展开更多
文摘BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a result of the continuous development of assisted reproductive technologies.When this type of pregnancy occurs,both the continuation of intrauterine pregnancy and the life of the pregnant woman are severely threatened.Early diagnosis and treatment using safe and effective methods are paramount in this situation.CASE SUMMARY A 30-year-old primigravida at a gestation age determined as 8 wk 4 d by scan was admitted to the hospital with heterotopic pregnancy and a right ovarian cyst.Laparoscopic resection of the ectopic pregnancy was performed,but the intrauterine pregnancy and ovarian cyst were preserved.CONCLUSION The approach to a patient with heterotopic pregnancy and a giant ovarian cyst is individualized base on the fertility requirements.We recommend the following:(1)If the patient satisfies parity and has no fertility requirement,a laparoscopic salpingectomy should be performed and the giant ovarian cyst and intrauterine pregnancy removed;(2)If the patient has fertility requirements wishes to have more children in the future,laparoscopic salpingectomy or salpingostomy should be performed and the intrauterine pregnancy preserved.Serial ovarian cyst aspiration can be performed under ultrasound and resection can be done after delivery;and(3)Heterotopic pregnancy should be diagnosed early by active surveillance during antenatal visits using ultra sound as this is important for the avoidance of catastrophic complications.
文摘BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.
文摘目的:探讨腹腔镜辅助手术治疗巨大卵巢囊肿的方法和可行性。方法:对18例巨大卵巢囊肿患者行腹腔镜辅助手术治疗,镜下行囊肿穿刺抽吸囊液,经11 mm Trocar切口将囊壁牵拉出腹腔外处理,根据病情行囊肿剥除术或附件切除术。结果:18例患者均在腹腔镜辅助下完成手术,术中未发生任何并发症,术中出血(50.3±10.2)ml,平均手术时间(51.3±12.3)min,术后平均住院日(3.4±1.6)天。结论:在严格选择病例的前提下进行腹腔镜辅助手术治疗巨大卵巢囊肿,创伤小、术后恢复快,有较大的应用价值。
文摘目的探讨经脐无气腹单孔腹腔镜辅助下巨大卵巢囊肿体外剥除术的安全性和在医联体基层医院推广的可行性。方法选取2018年01月-2020年11月由同一术者(或指导)在笔者所在医院本部及两家医联体单位(县级人民医院)实施的41例巨大卵巢囊肿经脐无气腹单孔腹腔镜辅助下的体外剥除手术,分为两组,一组20例在院本部完成,另一组21例在两家医联体单位完成。结果41例均成功完成手术,无一例增加辅助穿刺孔或中转开腹,无一例术中、术后出现并发症。比较两组手术时间、出血量、术后住院时间、术后24 h肛门排气率、术后24 h疼痛视觉模拟量表(Visual analog scale,VAS)评分及切口满意度评分,差异均无统计学意义。结论经脐无气腹单孔腹腔镜辅助的体外剥除治疗巨大卵巢囊肿安全可行,并可积极向医联体基层单位推广。
