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Misawa A, Okubo MM, Nagae S, Yokomizo R, Aoki H, Takanashi H. Successful use of single-port laparoscopic surgery for ovarian cyst removal during pregnancy: a case series of three cases. J Surg Case Rep 2023; 2023:rjad345. [PMID: 37346456 PMCID: PMC10281701 DOI: 10.1093/jscr/rjad345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023] Open
Abstract
Pregnant patients have an increased risk of torsion compared to that seen in nonpregnant patients, and those with larger cysts undergo torsion more frequently, which can cause obstructions during labor. The risks associated with emergent surgery are higher than those with elective surgery. Laparoscopic surgery can be safely performed during pregnancy. Single-port laparoscopic surgery is reported to be a minimally invasive laparoscopic technique. We report three cases of ovarian dermoid cysts, which were successfully removed during pregnancy through elective single-port laparoscopic surgery. In all cases, imaging showed a dermoid cyst and the cyst size was greater than 6 cm. All patients requested the surgery. The ovarian cysts were successfully removed by single-port laparoscopy without additional ports and without intra- or postoperative complications. All pregnancies progressed well and delivered vaginally at full term. The single-port laparoscopic approach is useful for removing ovarian cysts during pregnancy.
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Affiliation(s)
- Akihiko Misawa
- Correspondence address. Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, 5-15-1, Honson, Chigasaki-city, Kanagawa, 253-0042, Japan, Tel: 81-46-752-1111 ext. 5238; Fax: 81-46-754-0770; E-mail:
| | - Miki Muto Okubo
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Seika Nagae
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Ryo Yokomizo
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Hiroaki Aoki
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
| | - Hiroko Takanashi
- Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, Chigasaki-City, Kanagawa, Japan
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Bernigaud O, Fraison E, Thiberville G, Lamblin G. Ovarian torsion in a twin pregnancy at 32 weeks and 6 days: A case-report. J Gynecol Obstet Hum Reprod 2021; 50:102117. [PMID: 33737247 DOI: 10.1016/j.jogoh.2021.102117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ovarian torsion during pregnancy is a rare event and occurs mostly during the first trimester. This is the first case describing the diagnosis and management of an ovarian torsion at 33 weeks in a twin pregnancy with a normal term delivery. CASE SUMMARY The patient presented with irregular uterine contraction due to an acute abdominal pain in the right iliac fossa. A cyst was discovered during the ultrasound scan on the right ovary and a torsion was highly suspected. A small laparotomy facing the ovarian mass after an ultrasound guidance was chosen. The patient finally delivered at 37 weeks. CONCLUSION The clinic holds a preponderant place in the diagnosis of ovarian torsion. Our surgical approach by laparotomy under ultrasound guidance was less risky than by laparoscopy.
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Affiliation(s)
- Oriane Bernigaud
- Department of Obstetrics and Gynecology, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500, Bron, France
| | - Eloise Fraison
- Department of Obstetrics and Gynecology, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500, Bron, France; Department of Reproductive Medicine, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500, Bron, France.
| | - Gabriel Thiberville
- Department of Obstetrics and Gynecology, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500, Bron, France
| | - Gery Lamblin
- Department of Obstetrics and Gynecology, CHU Lyon, Hôpital Femme Mère Enfant, 59 Bd Pinel, 69500, Bron, France
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Abstract
La torsion d'ovaire est une étiologie rare de douleurs pelviennes en postpartum. L'absence de signes cliniques et radiologiques spécifiques rend la suspicion et le diagnostic préopératoire difficiles. Le retard de prise en charge peut mettre en jeu la viabilité de l'ovaire. Nous présentons le cas d'une patiente de 24 ans à J5 du postpartum qui s'est présentée aux urgences pour des douleurs pelviennes aiguës, chez qui le diagnostic de torsion ovarienne sur masse kystique a été fait sur la base des signes échographiques, permettant à la patiente de bénéficier d'une kystectomie et d'un traitement conservateur.
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Affiliation(s)
- Houda Chattri
- Service de Radiologie, Centre Hospitalier Provincial de Guercif, Maroc
| | - Meryem Kouara
- Service de Gynéco-obstétrique, Centre Hospitalier Provincial de Guercif, Maroc
| | - Khadija Chetouani
- Service de Réanimation, Centre Hospitalier Provincial de Guercif, Maroc
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Haddad S, Selleret L, Fedida B, Benjoar M, Beldjord S, Thomassin-Naggara I, Bazot M. Masses annexielles et grossesse : quelle imagerie et quels diagnostics ? Imagerie de la Femme 2017. [DOI: 10.1016/j.femme.2017.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Makhovsky VZ, Yurin SV, Makhovsky VV. [Synchronous primary multiple malignancies of colon and ovary followed by acute intestinal obstruction]. Khirurgiia (Mosk) 2016:67-69. [PMID: 27239919 DOI: 10.17116/hirurgia2016467-69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- V Z Makhovsky
- Stavropol Institute of Continued Medical and Pharmaceutical Education, Stavropol Regional Clinical Hospital, Polyclinic #1 of the Russian Presidential Administration, Moscow
| | - S V Yurin
- Stavropol Institute of Continued Medical and Pharmaceutical Education, Stavropol Regional Clinical Hospital, Polyclinic #1 of the Russian Presidential Administration, Moscow
| | - V V Makhovsky
- Stavropol Institute of Continued Medical and Pharmaceutical Education, Stavropol Regional Clinical Hospital, Polyclinic #1 of the Russian Presidential Administration, Moscow
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Abstract
A 31-year-old female was in the 13th week of pregnancy when an abdominal ultrasound examination revealed a large retroperitoneal tumour. Magnetic resonance imaging was carried out and the imaging described a 10-cm mass in diameter extending from the right kidney. Given that the patient was in her first trimester and that there was a suspicion of malignancy, further surgical exploration of the tumour was warranted. During the operation, the tumour was removed, but nephrectomy was not necessary. Histologic analysis of the resected tumour showed a mucinous cystic adenoma, and no signs of malignancy were present. Following the surgery, the pregnancy was otherwise uneventful and further complications did not occur. This case illustrates that surgery is recommended in patients with a retroperitoneal tumour early during a pregnancy, when a malignancy cannot be excluded.
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Affiliation(s)
- Csaba Berczi
- Department of Urology, University of Debrecen, Debrecen, Hungary
| | - Peter Osvath
- Department of Urology, University of Debrecen, Debrecen, Hungary
| | - Tibor Flasko
- Department of Urology, University of Debrecen, Debrecen, Hungary
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Brun JL, Fritel X, Aubard Y, Borghese B, Bourdel N, Chabbert-Buffet N, Collinet P, Deffieux X, Dubernard G, Huchon C, Kalfa N, Lahlou N, Marret H, Pienkowski C, Sevestre H, Thomassin-Naggara I, Levêque J. Management of presumed benign ovarian tumors: updated French guidelines. Eur J Obstet Gynecol Reprod Biol 2014; 183:52-8. [DOI: 10.1016/j.ejogrb.2014.10.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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French College of Gynecologists and Obstetricians. [Recommendations for clinical practice: Presumed benign ovarian tumors--short text]. ACTA ACUST UNITED AC 2013; 42:856-66. [PMID: 24210710 DOI: 10.1016/j.jgyn.2013.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
These guidelines from the French College of Gynecologists and Obstetricians on the diagnosis and treatment of presumed benign ovarian tumors (PBOT) concern physicians whether gynecologists, obstetricians, surgeons, radiologists, pediatricians, and general practitioners. Vaginal pelvic ultrasound is the first-line imaging examination in case of PBOT in adult women (grade A). In case of pure fluid unilocular mass less than 7 cm size, ultrasound is sufficient to characterize the mass (grade A). MRI is recommended as second-line to explore indeterminate masses or masses greater than 7 cm (grade B). Serum CA125 assay is not recommended as first-line diagnostic in adult women (grade C). Among women with a pure unilocular liquid cyst, hormonal therapy is ineffective (LE1) and is not recommended (grade A). Ultrasound-guided puncture is not recommended (grade B). In adult women without history of cancer, abstention is possible in case of asymptomatic pure unilocular cyst less than 10 cm (grade B). If symptoms develop, laparoscopy is the reference approach for PBOT surgical treatment (grade A). A conservative surgical treatment (cystectomy) should be preferred to oophorectomy in non-menopausal women without previous history of cancer (grade C). In cases of suspected adnexal torsion, laparoscopic surgical exploration is recommended (grade B). Conservative treatment, untwisting without oophorectomy, is recommended for non-menopausal women whatever the estimated duration of the twist and the macroscopic appearance of the ovary (grade B). During pregnancy, expectation is recommended for asymptomatic unilocular liquid masses less than 6 cm (grade C).
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Brun JL, Fritel X, Levêque J. [Clinical practice guidelines: Presumed benign ovarian tumors--aims, methods, and organization]. ACTA ACUST UNITED AC 2013; 42:710-4. [PMID: 24210232 DOI: 10.1016/j.jgyn.2013.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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