A case report of a laparoscopic nephrectomy for renal cell carcinoma in a pregnant woman: Clinical evaluation of the utero-fetal circulation during the laparoscopic procedure.
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- Takagi Kazuko
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Yokoyama Motofumi
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Tohjo Shinpei
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Yuge Norihito
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Sakaguchi Kenichiro
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Ohshita Yuhko
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Senoh Daisaku
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Honda Naotoshi
- Department of Obstetrics and Gynecology, MATSUYAMA RED CROSS HOSPITAL
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- Yano Akira
- Urology, MATSUYAMA RED CROSS HOSPITAL
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- Miyamoto Katsutoshi
- Urology, MATSUYAMA RED CROSS HOSPITAL
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- Tachoh Takatoshi
- Urology, MATSUYAMA RED CROSS HOSPITAL
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- Fujii Motohiro
- Urology, MATSUYAMA RED CROSS HOSPITAL
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- Shimizu Ichiroh
- Anesthesiology, MATSUYAMA RED CROSS HOSPITAL
Bibliographic Information
- Other Title
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- 腹腔鏡下左腎臓摘出術を施行した腎細胞癌合併妊娠の1例: <BR>術中の気腹圧と子宮・胎児血流動態に関する考察
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Abstract
Renal cell carcinoma during pregnancy has rarely been reported in the literature. We report a case of a 34 year-old pregnant woman who underwent a laparoscopic nephrectomy for renal cell carcinoma at 15 weeks of gestation. Clinical symptoms included lower abdominal pain at 12 weeks of gestation. The UST, MRI and CT scan findings revealed a 7.6-cm tumor originating from the left kidney that was highly suspicious for malignancy. Further examinations suggested neither invasion nor metastasis to other organs, including the left renal vein and bones. Following an explanation of the above results, the patient and her family wished to continue the pregnancy. After obtaining informed consent, a laparoscopic nephrectomy was performed at 15 weeks of gestation under CO2 pneumoperitoneum. The insufflated pressure was changed from 5mmHg to 12mmHg depending on the surgical process. The patient was lying in the right lateral position. The operation time was 5 hours and 15 minutes and the estimated blood loss was 50 ml. No operative complications were encountered during the procedure. The post-operative pathological diagnosis was clear cell carcinoma. During the operation, we examined the blood flow of the uterine arteries and the umbilical artery under pneumoperitoneum. The resistance index (RI) of the right uterine artery only correlated with the pressure of the pneumoperitoneum. A significant difference between the RIs of the both uterine arteries was observed. It was suggested that the difference of the RI resulted from the pressure of pneumoperitoneum and the body position during the operation. From our observations, we recommend that when performing laparoscopic surgery during pregnancy, the pressure of pneumoperitoneum should be kept under 12 mmHg and the body should be positioned to maintain adequate blood flow for both uterine arteries.
Journal
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- JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY
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JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY 26 (2), 363-369, 2010
JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY
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Details 詳細情報について
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- CRID
- 1390282680323403136
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- NII Article ID
- 10029376542
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- NII Book ID
- AN10068110
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- ISSN
- 18845746
- 18849938
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- Text Lang
- en
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed