배꼽을 통한 단일공 복강경하 자궁외 임신 수술
Transumbilical single-port access laparoscopic surgery of ectopic pregnancy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 본 연구는 배꼽을 통한 단일공 복강경하 자궁외 임신 수술의 방법, 유용성과 안전성을 평가하기 위함이다. 연구 방법: 2009년 10월부터 2010년 2월까지 울산대학교병원 산부인과에서 자궁외 임신으로 단일공 복강경 수술을 시행 받은 총 6명의 환자들의 의무기록지를 후향적 연구 방법으로 분석하였다. 결과: 환자의 나이의 중앙값은 33.5세 (범위, 32~36)였고 BMI의 중앙값은 20.6 kg/m2 (범위, 16.5~28.7)이었다. 자궁외 임신낭의 가장 큰 직경의 중앙값은 4.8 cm (범위, 3.0~5.4)이었고 모든 환자에서 임신낭 파열과 복강내 출혈을 보였다. 수술에 소요 시간의 중앙값은 77.5분 (범위, 59~95)이었고, 수술 중 실혈량의 중앙값은 40 mL (범위, 20~50)이었다. 수술 후 재원 기간의 중앙값은 2일 (범위, 1~3)이었고, 재원기간과 마지막 추적 관찰 기간 동안에 합병증이 발생한 경우는 없었다. 결론: 배꼽을 통한 단일공 복강경하 자궁외 임신 수술은 자궁외 임신 치료에서 안전하고 유용하였고, 기존 다공법 복강경하 수술에 대안이 될 가능성이 있다.
Abstract
Objective: To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy. Methods: Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies. Results: The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up. Conclusion: Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.
참고문헌 (26)
- Ory SJ, "New options for diagnosis and treatment of ectopic pregnancy", JAMA, 267, pp.534~537 (1992)
- Vermesh M, "Management of unruptured ectopic gestation by linear salpingostomy: a prospective, randomized clinical trial of laparoscopy versus laparotomy", Obstet Gynecol, 73, pp.400~404 (1989)
- Brzezinski A, "Current status of endoscopic surgical management of tubal pregnancy", Eur J Obstet Gynecol Reprod Biol, 54, pp.43~53 (1994)
- Silva PD, "A laparoscopic approach can be applied to most cases of ectopic pregnancy", Obstet Gynecol, 72, pp.944~947 (1988)
- Henderson SR, "Ectopic tubal pregnancy treated by operative laparoscopy", Am J Obstet Gynecol, 160, pp.1462~1466 (1989)
- Lundorff P, "Laparoscopic surgery in ectopic pregnancy. A randomized trial versus laparotomy", Acta Obstet Gynecol Scand, 70, pp.343~348 (1991)
- 김용욱, "배꼽만을 통한 단일공법 복강경하 전자궁절제술: 한국최초 임상보고", Korean Journal of Obstetrics and Gynecology, 52(4), pp.480~486 (2009), 대한산부인과학회
- Pelosi MA, "Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture", N J Med, 88, pp.721~726 (1991)
- Canes D, "Transumbilical single-port surgery: evolution and current status", Eur Urol, 54, pp.1020~1029 (2008)
- Cartwright PS, "Ectopic pregnancy. In Novak's textbook of gynecology. 11th ed.", pp.479~506 (1988), Williams & Wilkins
- Breen JL, "A 21 year survey of 654 ectopic pregnancies", Am J Obstet Gynecol, 106, pp.1004~1019 (1970)
- 박성호, "자궁외임신의 최근 8년간의 임상적 고찰", Korean Journal of Obstetrics and Gynecology, 52(2), pp.245~252 (2009), 대한산부인과학회
- 고영채, "자궁외임신의 치료에 있어서 복강경 수술과 개복술의 비교", Korean Journal of Obstetrics and Gynecology, 48(1), pp.178~183 (2005), 대한산부인과학회
- Tait RL, "Five cases of extrauterine pregnancy operated upon at the time of rupture", Br Med J, 1, pp.1250~1254 (1984)
- Shapiro HI, "Excision of an ectopic pregnancy through the laparoscope", Am J Obstet Gynecol, 117, pp.290~291 (1973)
- DeCherney AH, "Laparoscopic salpingostomy for ectopic pregnancy", Obstet Gynecol, 70, pp.948~950 (1987)
- Stovall TG, "Methotrexate treatment of unruptured ectopic pregnancy: a report of 100 cases", Obstet Gynecol, 77, pp.749~953 (1991)
- Bozzini P, "Lichteiter, eine efridung zur anschung innerer theile und krankheitennebst abbildung", Pract Arzerykunde, 24, pp.107~109 (1806)
- Ott D, "Die beleuchtung der bauchhole (ventroskopie) als metode bei vaginaler coeliotomie", Abl Gynekol, 231, pp.817~821 (1902)
- Reich H, "Laparoscopic treatment of tubal pregnancy", Obstet Gynecol, 69, pp.275~279 (1987)
- Reich H, "Laparoscopic treatment of extensive pelvic adhesions, including hydrosalpinx", J Reprod Med, 32, pp.736~742 (1987)
- Zouves C, "Laparoscopic surgical treatment of tubal pregnancy. A safe, effective alternative to laparotomy", J Reprod Med, 37, pp.205~209 (1992)
- Pelosi MA, "Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy)", J Reprod Med, 37, pp.588~594 (1992)
- Pelosi MA, "Laparoscopic supracervical hysterectomy using a single-umbilical puncture (mini-laparoscopy)", J Reprod Med, 37, pp.777~784 (1992)
- Kim TJ, "Single port access laparoscopic adnexal surgery", J Minim Invasive Gynecol, 16, pp.612~615 (2009)
- Lee YY, "Single-port access laparoscopic-assisted vaginal hysterectomy: a novel method with a wound retractor and a glove", J Minim Invasive Gynecol, 16, pp.450~453 (2009)