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RISS 인기검색어
- 검색키워드
- 저자 : ( Kyoung Ja Choo ) (검색결과 2 건)
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( Kyoung Ja Choo ),( Hyun Joo Lee ),( Tae Sung Lee ),( Ju Hyun Kim ),( Suk Bong Koh ),( Youn Seok Choi ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.5
Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into lowgrade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.
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Minilaparoscopic hysterectomy: A case report
( Kyoung Ja Choo ),( Sun Jae Lee ),( Ju Hyun Kim ),( Youn Seok Choi ),( Suk Bong Koh ),( Chi Dong Han ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
A 46-year old, multiparous woman visited to our department due to hypermenorrhea. Pelvic examination revealed a 10 weeks size uterus with globular enlargement, and ultrasonography demonstrated suspicious adenomyosis. Minilaparoscopic hysterectomy was performed. We inserted 4 ports (one 5-mm and three 3.5-mm ports) in the same manner as conventional laparoscopy. The left paraumbilical 5-mm port was used for instruments including bipolar forceps, vessel sealing device, needle holder, and suction canula. The umbilical 3.5-mm port was used for 3.3-mm 30° laparoscope. Two 3.5-mm ports were inserted at the right and left iliac fossa, and were used for grasping forceps and 3-mm bipolar forceps. After identification of both ureters, both round and tubo-ovarian ligaments were transected using bipolar and ultrasonic device. Bladder was sharply dissected, and both uterine arteries were transected using bipolar diathermy and ultrasonic energy. The colpotomy incision was made using monopolar diathermy, and the entire uterus was freed laparoscopically. During the colpotomy, we used pipe-type uterine manipulator, and this manipulator was effective to maintain the pneumoperitoneum. Additionally, when the vaginal cuff was closed, suture material was introduced into the abdominal cavity through this manipulator. The resected specimen was vaginally retrieved. The vaginal cuff was closed laparoscopically with a continuous suture using 2-0 absorbable unidirectional barbed suture material. We inserted a drainage tube through 5-mm port site. Operation time was 95 minutes, and estimated blood loss was 50 mL. Pathologic examination confirmed the diagnosis of adenomyosis and leiomyoma. Through adequate combination of various instruments, we could safely perform hysterectomy. If future advancement in technology offers the similar conditions as for conventional laparoscopy, minilaparoscopic hysterectomy may be a substitute for conventional laparoscopic hysterectomy.
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