臨床婦人科産科73巻5号

2019年05月発行

今月の臨床 妊婦の腫瘍性疾患の管理―見つけたらどう対応するか 良性疾患

妊婦に良性卵巣腫瘍手術を行う場合の留意点

著者： 倉品隆平¹ 可世木華子¹ 明樂重夫¹

所属機関： ¹日本医科大学産婦人科

ページ範囲：P.442 - P.448

●妊娠中の良性卵巣腫瘍の手術においては，ルテイン囊胞を除き，6cmを超えたら手術を考慮する．手術時期は妊娠12週以降が望ましい．

●腹腔鏡下手術は開腹手術と比較して低侵襲であり，周術期の合併症や出血量，入院期間も短縮され，周産期予後についても腹腔鏡手術は開腹手術と比較して遜色ない．

●腹腔鏡下手術においては気腹，吊り上げのいずれの方法でも選択可能である．ただし，気腹においては気腹圧を12mmHgまでとし，影響を最小限にするよう留意する．

●増大した子宮により視野確保が困難になったり，マニピュレータを使用できないため，トロッカー穿刺位置の決定や術中体位などは，症例によって事前に十分な戦略を立てて臨むことが肝要である．

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