The surgical outcome of intracapsular cesarean myomectomy. A match control study

被引:36
作者
Tinelli, Andrea [1 ]
Malvasi, Antonio [2 ]
Mynbaev, Ospan A. [3 ,4 ]
Barbera, Antonio [5 ,6 ]
Perrone, Emanuele [7 ]
Guido, Marcello [8 ]
Kosmas, Ioannis [9 ]
Stark, Michael [10 ]
机构
[1] Vito Fazzi Hosp, Div Expt Endoscop Surg Imaging Minimally Invas Th, Dept Obstet & Gynecol, I-73100 Lecce, Italy
[2] Hosp Santa Maria, Dept Gynecol & Obstet, Bari, Italy
[3] Moscow State Univ Med & Dent, Expt Res & Modeling Div, Moscow, Russia
[4] Peoples Friendship Univ Russia, Dept ObGyn & Reprod Med, Moscow, Russia
[5] Univ Colorado Denver, Sch Med, Aurora, CO USA
[6] Swan Mt Womens Ctr, Dept Obstet & Gynecol, Breckenridge, CO USA
[7] Univ Perugia, Fac Med, Dept Obstet & Gynecol, I-06100 Perugia, Italy
[8] Univ Salento, Fac Sci, Dept Biol & Environm Sci & Technol, Hyg Lab, Lecce, Italy
[9] Univ Ioannina, Dept Obstet & Gynecol, GR-45110 Ioannina, Greece
[10] New European Surg Acad, Berlin, Germany
关键词
Cesarean myomectomy; cesarean section; labor; pregnancy; uterine fibroids; UTERINE ARTERY LIGATION; COMPLICATIONS; LEIOMYOMAS; MYOMAS; RISK;
D O I
10.3109/14767058.2013.804052
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Authors evaluated the outcome of intracapsular cesarean myomectomy by a prospective case-control study on 68 patients who underwent intracapsular cesarean myomectomy, compared with a control group of 72 patients with myomatosic pregnant uterus who underwent cesarean section (CS) without myomectomy. Mostly of removed myomas were subserous or intramural, fundal in 37 women (54.4%), corporal in 22 (32.3%) and peri-low uterine segment in 9 women (18.7%). The average myoma' size was 8 cm (1.5-20), in 40 women, with 8 myomas measuring 4-6 cm, 14 myomas between 10 and 12 cm and > 13 cm in 6 patients. Difference in blood tests and surgical outcome in intracapsular cesarean myomectomy was non significant (p > 0.05). The average duration of hospitalization of intracapsular cesarean myomectomies was 5 days. There was no correlation between complications or duration of hospital stay and patient age, gravidity, parity or indication for CS. The intracapsular cesarean myomectomy could be a reliable, feasible and safe obstetric procedure. Meticulous attention to gentle hemostasis, sharp pseudocapsule dissection, adequate approximation of the myometrium edges and all dead spaces to prevent hematoma formation, can further increase the safety of the procedure, without significant complications by experienced obstetricians.
引用
收藏
页码:66 / 71
页数:6
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