Avtor/Urednik		Peternelj-Marinšek, Suzana; Ribič-Pucelj, Martina; Omahen, Andrej
Naslov		Kirurško zdravljenje adneksnih tumorjev v nosečnosti - pomen laparoskopskega operiranja
Prevedeni naslov		Surgical treatment of adnexal masses in pregnancy - the role of laparoscopy management
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 71, št. 4
Leto izdaje		2002
Obseg		str. 219-25
Jezik		slo
Abstrakt		Background. The aim of this retrospective study was to find the incidence and type of adnexal masses in pregnancy, reliability of preoperative ultrasound examination and the effect of the surgical approach used, duration of pregnancy at the time of surgery, and the effect of emergency or planned surgery on the outcome of pregnancy. The obtained results and the data from literature were to provide the basis of the guidelines for the management of pregnant women with adnexal masses. Methods. In the study we enrolled 42 women, who underwent a surgery in pregnancy for adnexal masses. All surgeries were performed at the Department of Obstetrics and Gynecology in the period 1 January 1993 - 31 August 2000. The course of pregnancy was followed by 28 February 2001. The data were obtained from the records kept at the Department and from the questionnaire sent to the women. Statistical analysis was done using Chi-square test. Statistical significance was set at P =< 0.05. Results. We found the incidence of adnexal masses in pregnancy, requiring surgical treatment, to be 1/1034 deliveries. There were 6 (14.3 %) borderline malignant and malignant ovarian tumours, the incidence being 1/7239 deliveries. Preoperative ultrasound examination was not reliable enough to differentiate neither between benign and malignant adnexal masses, nor between adnexal masses and leiomyomas. Forty-two surgeries were made, 21 by laparoscopy and 21 by laparotomy. The size of removed tumours ranged between 4 and 30 cm (mean 9.4 cm), the most frequent type was mature cystic teratoma (n =12). There were no differences in the outcome of pregnancy between the laparoscopy and laparotomy approach, between emergency and planned surgery, and between laparotomy performed by the 23rd and after the 23rd gestational week. Hemorrhagic shock due to heterotopic pregnancy lead to 1 spontaneous abortion. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Namen retrospektivne raziskave je bil ugotoviti pogostnost in vrsto adneksnih tumorjev v nosečnosti, zanesljivost predoperativne ultrazvočne preiskave (UZ) ter vpliv izbire kirurškega pristopa, trajanja nosečnosti ob kirurškem posegu, vpliv nujnega in programiranega kirurškega posega na izid nosečnosti. Na podlagi rezultatov raziskave in podatkov iz tuje literature smo želeli postaviti smernice za obravnavo nosečnic z adneksnim tumorjem. Metode. Vključili smo 42 nosečnic, ki so bile v obdobju od 1. 1. 1993 do 31. 8. 2000 v nosečnosti operirane na Ginekološki kliniki v Ljubljani zaradi tumorja v predelu adneksov. Potek nosečnosti smo spremljali do 28. 2. 2001. Podatke smo dobili iz dokumentacije Ginekološke klinike in ankete. Za statistično analizo smo uporabili test hi kvadrat. Vrednost p=<0.05 smo vzeli kot statistično pomembno. Rezultati. Incidenca adneksnih tumorjev v nosečnosti, zaradi katerih je bilo potrebno kirurško zdravljenje, je bila 1/1034 porodov. Mejno malignih in malignih tumorjev jajčnika je bilo 6 (14,3%), incidenca 1/7239 porodov. Izvid predoperativnega UZ pregleda ni dopuščal dovolj natančnega razlikovanja med benignimi in malignimi adneksnimi tumorji ter med adneksnim tumorjem in leiomiomom. Narejenih je bilo 42 kirurških posegov, 21 laparoskopskih in 21 z laparotomijo. Velikost odstranjenih tumorjev je bila od 4 do 30 cm (povprečje 9,4 cm). Najpogostejši tumor je bil zrel cistični teratom (odstranjen 12-krat oz. v 29%). Izid nosečnosti se ni razlikoval glede na vrsto pristopa, nujnost ali načrtovanost posega ter glede na trajanje nosečnosti ob laparotomiji (do 23. tedna nosečnosti in po 23. tednu nosečnosti). Ob hemoragičnem šoku zaradi heterotopne nosečnosti je 1-krat prišlo do spontanega splava. Dva novorojenčka sta se rodila prezgodaj, s 36 tedni nosečnosti, 2 sta imela premajhno težo za trajanje nosečnosti, 1 se je rodil s prirojeno napako (s hipospadijo in heksodaktilijo). (Izveleček prekinjen pri 2000 znakih).
Deskriptorji		PREGNANCY COMPLICATIONS, NEOPLASTIC OVARIAN NEOPLASMS PREGNANCY LAPAROSCOPY LAPAROTOMY ADNEXA UTERI PREGNANCY OUTCOME RETROSPECTIVE STUDIES