title: Laparoscopic Approach for Fibroid Removal at 18 Weeks of Pregnancy.
abstract: Leiomyomas are the most frequently solid tumors found in pregnancy. This kind of tumor has a wide incidence depending on the age, race, and type of population studied. Most of the cases have an asymptomatic course; however, they could develop different kinds of complications during the pregnancy such as severe abdominal pain, often due to degeneration or torsion with ischemia. In these cases, a surgical approach is required because these tumors do not respond to the conventional treatment. Very few of these cases are reported in the literature. We report the case of a 36-year-old woman pregnant 18 weeks, who experienced acute abdominal pain without initial reponse to regular analgesics. She was taken to the operating room, and under laparoscopic exploration, torsion of a subserosal myoma was observed. The fibroid was resected laparoscopically, and she was released from the hospital without complications. Unfortunately, she was readmitted 45 days later with signs of preterm labor because of a motorcycle accident. An emergency cerclage was performed, but the pregnancy was compromised with amnionitis and early fetal demise. We concluded that the laparoscopic approach could be a successful alternative treatment in selected cases.
authors.affiliation: Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
authors.forename: Alfredo Cortes
authors.initials: AC
authors.lastname: Algara
authors.affiliation: Reproductive Endocrinology Division, Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
authors.forename: Alfredo Góngora
authors.initials: AG
authors.lastname: Rodríguez
authors.affiliation: Reproductive Endocrinology Division, Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
authors.forename: Alfredo Cortes
authors.initials: AC
authors.lastname: Vázquez
authors.affiliation: Robotics and Laparoscopy Division, Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
authors.forename: Florencia Elena Castañeda
authors.initials: FE
authors.lastname: Valladares
authors.affiliation: Anesthesiology Division ,Centro Mexicano de Cirugía de Invasión Mínima, Hospital San Ángel Inn, Chapultepec, México.
authors.forename: Pedro González
authors.initials: PG
authors.lastname: Ramírez
authors.affiliation: Basic and Clinical Investigation service, Escuela Superior de Medicina, Instituto Politécnico Nacional, México City, México.
authors.forename: Eleazar Lara
authors.initials: EL
authors.lastname: Padilla
authors.affiliation: Basic and Clinical Investigation service, Escuela Superior de Medicina, Instituto Politécnico Nacional, México City, México.
authors.forename: Cindy
authors.initials: C
authors.lastname: Bandala
authors.affiliation: Basic and Clinical Investigation service, Escuela Superior de Medicina, Instituto Politécnico Nacional, México City, México.
authors.forename: Saúl León
authors.initials: SL
authors.lastname: Hernández
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014594:Uterine Neoplasms / Q000601:surgery*