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Federación Mexicana de Ginecología y Obstetricia, A.C.

2023, Number 03

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Ginecol Obstet Mex 2023; 91 (03)

Pregnancy and annexal mass; laparoscopic with minilaparotomy management. Case report and literature review

Rosales-Ortiz S, Becerra-Vázquez D

Language: Spanish
References: 43
Page: 175-183
PDF size: 184.88 Kb.


ABSTRACT

Background: Adnexal tumors during pregnancy require safe therapeutic behavior for the mother and the fetus, so the obstetrician must be clear when the surgical option is indicated and within the approach which would be less aggressive for the fetal-maternal binomial. Describing the implementation of laparoscopy with mini laparotomy in a case of adnexal tumor in pregnancy can contribute to understanding the advantages and disadvantages of the surgical strategy in these cases.
Clinic case: Patient aged 29 years, weight 70 kg, height 1.61 m and BMI 27 in the course of 16 weeks of pregnancy, who attended the emergency department due to abdominal pain. Given the persistence of the symptom, a diagnosis of painful abdominal syndrome secondary to a giant adnexal tumour was established. She was scheduled for diagnostic and operative laparoscopy with mini-laparotomy. She was discharged from hospital 24 hours after surgery and the pregnancy ended at 39 weeks.
Methodology: A literature search of the last 10 years was performed in Pubmed under the MeSH terms: adnexal masses pregnancy, adnexal masses pregnancy and laparoscopic surgery.
Results: Thirty-four review articles, eight case reports and one editorial were included, the latter nine were considered when they provided information relevant to the knowledge of a surgical technique. We eliminated articles in which robot-assisted surgery or a technique using natural orifices (NOTES) was used, reviews that were exclusive to oncological pathology, as well as cases in girls, as this technology was not available in our environment or they were not in the reproductive stage, which could incur a risk of transfer. Likewise, articles that did not explain the advantages of the proposed technique were eliminated.
Conclusion: In pregnant patients with giant adnexal tumours, laparoscopy with mini-laparotomy is a safe treatment option for the foetus and the mother. This technique achieves a rapid recovery, reduced risk of uterine injury, early reintegration into daily life and a good cosmetic outcome.


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