-
Journal of the College of Physicians... Jul 2022To assess the safety and efficacy of barbed suture laparoscopic myomectomy for large posterior myoma compared to conventional suture.
OBJECTIVE
To assess the safety and efficacy of barbed suture laparoscopic myomectomy for large posterior myoma compared to conventional suture.
STUDY DESIGN
Descriptive study.
PLACE AND DURATION OF STUDY
Department of Gynecology, Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China between July 2019 and June 2020.
METHODOLOGY
All cases of laparoscopic myomectomy for large posterior myoma (≥8cm in the largest diametre) were retrospectively reviewed. The surgical technique was identical except the selection of suture material. A comparison between the barbed suture and conventional suture was performed in terms of clinical characteristics and surgical outcomes such as total operative time, suture time, intraoperative blood loss, and changes in hemoglobin concentration.
RESULTS
A total of 48 eligible cases, 24 cases with barbed sutures and 24 cases with conventional sutures were included in the final analysis. Patients' clinical characteristics such as age, body mass index, number, and size of myomas were similar between the two groups. In patients with barbed sutures, the time for suturing, the total operative time, intraoperative blood loss, and the changes in hemoglobin concentration were significantly lower than in conventional sutures (all p<0.05). No significant differences in time for enucleation, time for morcellation, and postoperative complications were found between the two groups. Two patients with conventional sutures received postoperative emergent uterine artery embolization and three patients received a blood transfusion.
CONCLUSIONS
The use of barbed sutures could reduce the difficulty and enhance safety in laparoscopic myomectomy for large posterior myoma.
KEY WORDS
Barbed suture, Laparoscopy, Myomectomy, Posterior.
Topics: Blood Loss, Surgical; Child; Female; Hemoglobins; Humans; Laparoscopy; Myoma; Retrospective Studies; Suture Techniques; Sutures; Uterine Myomectomy; Uterine Neoplasms
PubMed: 35795944
DOI: 10.29271/jcpsp.2022.07.920 -
BMC Women's Health Feb 2023To explore the safety and efficiency of endometrial myomectomy (EM) and Serosal myomectomy (SM) for the removal of intramural myoma greater than 8 cm in diameter during...
OBJECTIVE
To explore the safety and efficiency of endometrial myomectomy (EM) and Serosal myomectomy (SM) for the removal of intramural myoma greater than 8 cm in diameter during cesarean section.
METHODS
Retrospective analysis and follow-up were used, and 190 cases of pregnancy complicated with uterine myoma from Jan. 2017 to May 2022 in Ningbo Women's and Children's Hospital were collected, 130 cases of caesarean myomectomy as study group, 64 cases of EM as study group A, 66 cases of SM as study group B, 33 cases with uterine fibroids removed before suturing the uterine incision as study group B1, 33 cases with uterine incision sutured followed by removal of fibroids as study group B2, 60 cases of Caesarean section alone as control group. To compare perioperative conditions between and within groups.
RESULTS
① Operation time, postoperative exhaust time, pre- and post-operative haemoglobin drop, intraoperative blood loss were all more than those of the control group in the study group (68.65 ± 11.87 vs 56.17 ± 9.18 min, 21.04 ± 4.98 vs 17.03 ± 1.3 h, 1.27 ± 0.59 vs 1.09 ± 0.43 g/dl, 613 ± 221 vs 532 ± 156 ml, P < 0.001, P < 0.001, P = 0.025, P = 0.011). ② For type III and V fibroids, the time of myoma removal, postoperative exhaust and pre- and post-operative haemoglobin drop and intraoperative blood loss in study group A were less than those in study group B (18.02 ± 3.89 vs 20.19 ± 5.32 min, 18.83 ± 2.57 vs 23.93 ± 6.84 h, 600 ± 194 vs 730 ± 277 ml, 1.20 ± 0.57 vs 1.59 ± 0.70 g/dl, P = 0.036, P < 0.001, P = 0.014, P = 0.008); For type IV uterine fibroids, only postoperative exhaust time was less in Study Group A than in Study Group B (19.27 ± 2.2 vs 21.35 ± 3.23 h, P = 0.016). ③ Time of myoma removed was less in study group B1 than in study group B2 (18.24 ± 4.53 vs 20.7 ± 4.59 min, P = 0.033).
CONCLUSION
It is safe and feasible to remove interstitial myomas larger than 8 cm in diameter during caesarean section. EM has the advantage of shorter operation time and less intraoperative bleeding, SM, in a way that the myoma is removed before suturing the uterine incision, can shorten the myomectomy time. It can benefit the patients more.
Topics: Female; Humans; Pregnancy; Blood Loss, Surgical; Cesarean Section; Hemoglobins; Laparoscopy; Leiomyoma; Myoma; Retrospective Studies; Treatment Outcome; Uterine Myomectomy; Uterine Neoplasms
PubMed: 36774454
DOI: 10.1186/s12905-023-02210-9 -
Zentralblatt Fur Gynakologie 1975According to Kayser myomas occur in 20% of all women over the age of 35. Such patients require special attention from their obstetrician. Although the presence of small...
According to Kayser myomas occur in 20% of all women over the age of 35. Such patients require special attention from their obstetrician. Although the presence of small myomas may not necessarily interfere with the pregnancy, they can start to grow quite rapidly at this time. In such cases the rates of abortion and premature birth are enhanced and there are often serious puerperal complications. It is therefore recommended that the nodes are enucleated during early pregnancy. Here a 20% abortion rate is to be expected. In the case of large myomas it is necessary for postpartum to be supervised individually. Here two cases are reported, one conservative with long puerperium and one operative with twin pregnancy. Both patients were discharged with healthy infants.
Topics: Adult; Cesarean Section; Chloramphenicol; Female; Humans; Hysterectomy; Infant, Newborn; Infant, Premature; Myoma; Pregnancy; Pregnancy Complications; Puerperal Disorders; Twins; Ultrasonics
PubMed: 1237975
DOI: No ID Found -
American Journal of Obstetrics and... Jun 2015
Topics: Adult; Female; Humans; Myoma; Uterine Neoplasms
PubMed: 25711933
DOI: 10.1016/j.ajog.2015.02.014 -
Das Deutsche Gesundheitswesen Sep 1955
Topics: Humans; Myoma
PubMed: 13277379
DOI: No ID Found -
JSLS : Journal of the Society of... 2008Numerous procedures have been developed in recent decades that claim to provide significant improvement in myoma status without hysterectomy. However, what is the cost... (Review)
Review
Numerous procedures have been developed in recent decades that claim to provide significant improvement in myoma status without hysterectomy. However, what is the cost in time and money of these procedures? This is a review of the current literature regarding these recent procedures to determine which, if any, is the best treatment for myomas. We conducted a search of PubMed using the terms "bipolar-, cryo-, radiofrequency, laparoscopic-, focused high-energy MRI-guided ultrasound, and MRI-guided laser myolysis" to identify reports of the various procedures. Based on these published reports, we describe the various types of myolysis performed in multiple patients in outpatient facilities including patient outcomes, complications, cost, and efficiency of the procedures.
Topics: Catheter Ablation; Cryosurgery; Female; Humans; Laparoscopy; Laser Therapy; Myoma; Uterine Artery Embolization; Uterine Neoplasms
PubMed: 19275864
DOI: No ID Found -
Medicina Clinica Oct 2023
Topics: Humans; Female; Leiomyoma; Uterine Neoplasms; Myoma
PubMed: 37923514
DOI: 10.1016/j.medcli.2023.06.036 -
Surgical Technology International May 2022In this final section of our three-part series, we will apply the basic and intermediate skills described in the first two parts to advance the gynecologist's skills to... (Review)
Review
In this final section of our three-part series, we will apply the basic and intermediate skills described in the first two parts to advance the gynecologist's skills to accomplish the most demanding of resectoscopic surgical challenges. In Part I of this series, we reviewed the benefits of the continuous flow gynecologic resectoscope (CFGR) and how the motivated gynecologist can assemble an operative team and overcome the impediments to learning the use of this versatile and minimally invasive instrument. In this first section, we outlined and analyzed basic resectoscopic surgery-endometrial ablation, the resection of small submucous myomas and endometrial polyps, as well as the treatment of mild Asherman's syndrome and the removal of retained products of conception. In Part II-intermediate level resectoscopic surgery-we introduced procedures such as endomyometrial resection, the resection of intermediate-size submucous leiomyomas, hysteroscopic metroplasty, and endocervical resection. Though it is not considered an absolute requirement to accomplish procedures at this level, sonographic guidance was introduced in preparation for more challenging cases. In Part III, the author reviews advanced resectoscopic procedures in which sonographic guidance is a requirement for the management of severe intrauterine adhesions and late-onset endometrial ablation failures, the management of FIGO Type 3 and 4 intramural myomas, as well as large submucous myomas.
Topics: Endometrial Ablation Techniques; Female; Humans; Hysteroscopy; Leiomyoma; Myoma; Uterine Neoplasms
PubMed: 35158402
DOI: 10.52198/22.STI.40.GY1549 -
Gynecologie, Obstetrique, Fertilite &... Sep 2022
Topics: Female; Humans; Leiomyoma; Myoma; Treatment Outcome; Uterine Artery Embolization; Uterine Neoplasms
PubMed: 35470128
DOI: 10.1016/j.gofs.2022.04.004 -
Fertility and Sterility Aug 2007To review the currently available literature regarding the current management alternatives available to women with uterine myomas. (Review)
Review
OBJECTIVE
To review the currently available literature regarding the current management alternatives available to women with uterine myomas.
DESIGN
Literature review of 198 articles pertaining to uterine myomas.
RESULT(S)
Many advances have been made in the management of uterine myomas. Watchful waiting; medical therapy; hysteroscopic myomectomy; endometrial ablation; laparoscopic myomectomy; abdominal myomectomy; abdominal, vaginal, and laparoscopic hysterectomy; uterine artery embolization; uterine artery occlusion; and focused ultrasound are now available.
CONCLUSION(S)
Many options are now available to women with uterine myomas. The presently available literature regarding the treatment of myomas is summarized.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Female; Fertility; Gonadotropin-Releasing Hormone; Gynecologic Surgical Procedures; Humans; Intrauterine Devices; Leiomyoma; Menopause; Models, Biological; Myoma; Obstetric Surgical Procedures; Pregnancy; Premedication; Progesterone; Prognosis; Uterine Neoplasms
PubMed: 17658523
DOI: 10.1016/j.fertnstert.2007.06.044