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Laparoscopic hysterectomy as optimal approach for 5400 grams uterus with associated polycythemia: A case report

World Journal of Clinical Cases 2019年第19期7卷 3027-3032页

作者： Antonio Macciò giacomo chiappe Fabrizio Lavra Elisabetta Sanna Romualdo Nieddu Clelia Madeddu Department of Gynecologic Oncology Azienda Ospedaliera BrotzuCagliari 09100Italy Department of Medical Sciences and Public Health Medical Oncology UnitUniversity of CagliariCagliari 09042Italy

BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is *** is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and *** we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated *** SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous *** suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several *** analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of *** blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 *** computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 *** reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic *** uterus weighed 5400 g and the histology confirmed a diagnosis of *** did not find increased erythropoietin levels in the supernatant of the myomatous uterine *** were no *** postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,*** blood gas analysis after surgery showed a pO2 of 144.7 *** results suggested the diagnosis of myomatous erythrocytosis *** patient was discharged on the second postoperative day in very good condition with no *** We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and *** VTE risk factors warranted a laparoscopic approach.

关键词： Hysterectomy Laparoscopy Myoma Myomatous erythrocytosis syndrome Polycythemia,huge uterus Total laparoscopic hysterectomy Case report

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