腎移植後患者に対し腹腔鏡下卵巣腫瘍摘出術を施行した2例

抄録

  Along with the rise in kidney engraftment rates the number of women who are candidates for gynecologic laparoscopic surgery after a kidney transplantation has increased. Although kidney function may be maintained within operable range in these women, characteristic complications caused by the dislocation of the transplanted kidney and immunosuppression are risks for surgery. We report two cases of women with ovarian tumors, who underwent laparoscopic surgery following kidney transplantation. We performed laparoscopic bilateral adnexectomy for a 58-year-old postmenopausal woman with serous cystadenofibroma arising from both ovaries, and laparoscopic cystectomy for a 30-year-old woman with a left ovarian endometrial cyst. We adjusted the laparoscopic port placement to the location of the transplanted kidney, and administered perioperative immunosuppressive drugs and antibiotics in consultation with the renal transplantation specialists. Postsurgical hospital stay was 4 days and no complications were observed in both women. Minimally invasive surgery, such as laparoscopic surgery, is suitable for women after kidney transplantation because of better perioperative infection control. Considerations should be made for dislocations of transplanted kidneys and ureters, and it is critical for primary physicians to be familiar with immunosuppressive medications, their side effects