当科における妊娠期間中の腹腔鏡下卵巣腫瘍手術の留意点

抄録

Objectives: The purposes of this study were to assess the appropriate operative procedures for adnexal masses during pregnancy and to determine what kind of pregnant women with adnexal masses are especially suitable for total laparoscopic ovarian cystectomy.

Design: A retrospective study was conducted in 17 patients who underwent surgical treatment for adnexal masses during pregnancy at our institution between January 2010 and November 2013.

Patients and interventions: Three pregnant patients with adnexal masses underwent open laparotomy and 14 underwent laparoscopic surgery. In the open laparotomy group, two patients had preoperative suspicion of ovarian malignancy and one patient was diagnosed with ovarian torsion at 17 weeks of gestation. In the laparoscopic surgery group, eight patients whose ovarian tumor size was less than 8 cm underwent total laparoscopic surgery and 6 patients whose tumor size was greater than or equal to 8 cm underwent laparoscopic-assisted surgery.

Measurements and main results: There were no intraoperative or major postoperative complications. Hospitalization was longer after laparotomy than laparoscopy. All patients' pregnancies after surgery were uneventful, except for that of one patient who developed gestational hypertension. All neonates were healthy and there were no fetal anomalies. Conclusions: Having an adnexal mass of less than 8 cm in size is a favorable indication for total laparoscopic ovarian cystectomy in pregnant women. For patients whose ovarian tumor size is at least 8 cm, cystectomy is the best option.