PDF(Pubmed)
Abstract：
BACKGROUND: Hysterectomy after microwave ablation (MWA) is more difficult than conventional surgery which increases the probability of postoperative complications due to MWA\'s collateral thermal damage to nearby intestines. Here we report a case of multiple postoperative complications after hysterectomy following MWA.
METHODS: A 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy.
METHODS: 1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation.
METHODS: The patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation.
RESULTS: After 48 days of comprehensive treatment, the patient was cured and discharged.
CONCLUSIONS: Microwave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.
METHODS: A 44-year-old female was admitted due to progressive abdominal pain during menstruation for 30 years and no relief 1 year after MWA. Hysterectomy was performed. Intraoperative findings: pelvic inflammatory exudation; the uterus and the left adnexa were extensively and densely adhered to the intestine, bladder, pelvic wall and surrounding tissues; the local tissue of the uterus was brittle and dark yellow. Intestinal obstruction, abdominal infection and urinary fistula occurred after hysterectomy.
METHODS: 1. Adenomyosis. 2. Endometrial polyps. 3. Left chocolate cyst of ovary. 4. Pelvic adhesions. 5. Pelvic inflammation.
METHODS: The patient underwent intestinal obstruction catheter implantation, ultrasound-guided pelvic fluid mass puncture drainage, right kidney puncture and fistula drainage, right ureteral bladder replantation, and right ureteral stent implantation.
RESULTS: After 48 days of comprehensive treatment, the patient was cured and discharged.
CONCLUSIONS: Microwave ablation has a poor therapeutic effect on diffuse adenomyosis, and should avoid excessive ablation during the ablation process.
摘要：
背景：微波消融（MWA）后的子宫切除术比传统手术更困难，这增加了由于MWA对附近肠道的附带热损伤而导致的术后并发症的可能性。在这里，我们报告了一例MWA后子宫切除术后的多种术后并发症。
方法：一名44岁女性因月经期间进行性腹痛30年而入院，MWA后1年无缓解。进行子宫切除术。术中发现：盆腔炎性渗出，子宫及左侧附件广泛致密地粘附于肠道，膀胱,盆腔壁及周围组织；子宫局部组织脆性，呈深黄色。肠梗阻,子宫切除术后发生腹腔感染和尿瘘。
方法：1.子宫腺肌病。2.子宫内膜息肉。3.卵巢左侧巧克力囊肿。4.盆腔粘连。5.盆腔炎.
方法：患者行肠梗阻导管植入术，超声引导盆腔积液穿刺引流,右肾穿刺和瘘引流，右输尿管膀胱再植术,和右输尿管支架植入术。
结果：经过48天的综合治疗，病人痊愈出院。
结论：微波消融对弥漫性子宫腺肌病的治疗效果较差，并应避免在消融过程中过度消融。
方法：一名44岁女性因月经期间进行性腹痛30年而入院，MWA后1年无缓解。进行子宫切除术。术中发现：盆腔炎性渗出，子宫及左侧附件广泛致密地粘附于肠道，膀胱,盆腔壁及周围组织；子宫局部组织脆性，呈深黄色。肠梗阻,子宫切除术后发生腹腔感染和尿瘘。
方法：1.子宫腺肌病。2.子宫内膜息肉。3.卵巢左侧巧克力囊肿。4.盆腔粘连。5.盆腔炎.
方法：患者行肠梗阻导管植入术，超声引导盆腔积液穿刺引流,右肾穿刺和瘘引流，右输尿管膀胱再植术,和右输尿管支架植入术。
结果：经过48天的综合治疗，病人痊愈出院。
结论：微波消融对弥漫性子宫腺肌病的治疗效果较差，并应避免在消融过程中过度消融。
