日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
症例報告
腎移植後に単孔式で行った腹腔鏡下異所性妊娠手術
武田 哲谷村 悟舟本 寛野村 学史田中 友理細野 隆炭谷 崇義舌野 靖中島 正雄南 里恵飴谷 由佳中野 隆
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2015 年 31 巻 1 号 p. 218-221

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Introduction: In the field of gynecology, there have been few reports of laparoscopic surgery following renal transplantation. Thus, important aspects of perioperative management have not yet been elucidated. Here, we report a case of laparoscopic surgery for ectopic pregnancy following renal transplantation.
Case presentation: The patient, a 37-year-old nulligravid woman who had undergone right kidney transplantation, presented to her local physician with abdominal pain and abnormal vaginal bleeding. She was diagnosed with a right tubal pregnancy and transported to our hospital, where she was scheduled to undergo a single-port laparoscopic, right tubal resection. Preoperative transabdominal sonography was performed to confirm the transplanted kidney's location in the pelvis. The patient was at risk for postoperative wound infection because she was receiving immunosuppressants; however, no signs of infection were observed. Furthermore, since she had renal dysfunction prior to surgery, pain control was managed with minimal analgesics that could have adverse effects on the kidneys. Renal dysfunction was not exacerbated.
Conclusions: For patients with ectopic pregnancies following renal transplantation, laparoscopic surgery may need to be performed, as it is less invasive compared with laparotomy. Furthermore, single-port laparoscopic surgery has a lower risk of renal injury during port insertion than multiple-port laparoscopic surgery.
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© 2015 日本産科婦人科内視鏡学会
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