V-NOTES术后足月妊娠经阴道分娩成功案例报告

目的初步探讨经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,V-NOTES)术后经阴道分娩的安全性和可行性。 方法回顾性分析在南京医科大学附属常州第二人民医院妇科行V-NOTES术后经阴道分娩患者的临床资料并进行总结分析。患者27岁,2019年2月25日因诊断为右侧输卵管异位妊娠,接受V-NOTES右侧输卵管切除术,术后恢复良好,阴道后穹窿切口愈合良好。患者术后成功妊娠,于2020年9月9日经阴道分娩。 结果该产妇成功分娩1个体质量3 600 g的健康男婴,母子情况良好,阴道后穹窿切口处未出现新的撕裂伤,定期随访结果良好。 结论在严格把握手术适应证与禁忌证的前提下,如果术者的手术技术娴熟,行V-NOTES治疗妇科疾病后的患者经阴道分娩可能是安全、可行的。

A case report of successful vaginal delivery for full-term pregnancy after transvaginal natural orifice transluminal endoscopic surgery(V-NOTES)

ObjectiveTo investigate the safety and feasibility of vaginal delivery after transvaginal natural orifice transluminal endoscopic surgery(V-NOTES). MethodsThe clinical data of one case who underwent vaginal delivery after V-NOTES operation in the Affiliated NO.2 People′s Hospital of Nanjing Medical University were retrospectively analyzed and summarized. A 27-year-old female patient with right tubal ectopic pregnancy who accepted right salpingectomy via V-NOTES on Feb. 25, 2019, and recovered well after operation. The incision of posterior vaginal fornix healed well. She underwent vaginal natural delivery on Sep. 9, 2020. ResultsThe parturient successfully delivered a healthy male infant of 3 600 g. The mother and child were in good condition, and there was no new laceration at the incision of posterior vaginal fornix. The results of regular follow-up were good. ConclusionsUnder the premise of strictly grasping the indications and contraindications of operation, if the surgeon was skilled in surgical techniques, the vaginal delivery of patients who accepted V-NOTES for gynecological diseases might be safe and feasible.