クマキリ　ジユン   Kumakiri Jiyun   熊切　順    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases.
掲載誌名	正式名：Fertility and sterility 略　 称：Fertil Steril ISSNコード：15565653/00150282
掲載区分	国外
巻・号・頁	94(3),pp.862-8
著者・共著者	Takeuchi Hiroyuki, Kitade Mari, Kikuchi Iwaho, Kumakiri Jun, Kuroda Keiji, Jinushi Makoto
発行年月	2010/08
概要	OBJECTIVE:To define diagnostic criteria for juvenile cystic adenomyoma (JCA), describe the histologic features of the condition and evaluate laparoscopic excision for treating associated dysmenorrhea and pelvic pain.DESIGN:Prospective long-term follow-up study.SETTING:University-affiliated hospital.PATIENT(S):Nine consecutive patients with JCA.INTERVENTION(S):Patients meeting the diagnostic criteria for JCA underwent laparoscopic enucleation of the lesion. The severity of dysmenorrhea was evaluated before surgery and every 6 months after surgery. Five patients underwent second-look laparoscopy (SLL) 6 months after surgery.MAIN OUTCOME MEASURE(S):Relief of dysmenorrhea as measured by a visual analog scale, postoperative healing at SLL, and subsequent pregnancy when desired by the patient.RESULT(S):Laparoscopic enucleation of the cystic adenomyoma resulted in a statistically and clinically significant reduction in dysmenorrhea and improved chronic pelvic pain. Neither cystic adenomyoma nor severe dysmenorrhea recurred during the follow-up period. Adhesions were minimal at SLL. Two of the three patients who desired pregnancy conceived after surgery. The histologic findings of the JCA lesion and adenomyosis were similar, and the endometrial glands and stroma infiltrating the surrounding myometrium in all patients were consistent with the appearance of adenomyosis.CONCLUSION(S):We defined the diagnostic criteria for JCA, and demonstrated significant improvement of dysmenorrhea after laparoscopic excision of the lesion.
DOI	10.1016/j.fertnstert.2009.05.010
PMID	19539912