https://scholars.lib.ntu.edu.tw/handle/123456789/546011
標題: | Comparison of uterine scarring between robot-assisted laparoscopic myomectomy and conventional laparoscopic myomectomy | 作者: | BOR-CHING SHEU KUAN-JU HUANG Huang, Su-Cheng WEN-CHUN CHANG |
關鍵字: | Laparoscopic myomectomy; robot-assisted laparoscopic myomectomy; ultrasound; uterine scarring | 公開日期: | 十月-2020 | 出版社: | TAYLOR & FRANCIS INC | 卷: | 40 | 期: | 7 | 起(迄)頁: | 974 | 來源出版物: | Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology | 摘要: | This study compared uterine wound healing after robot-assisted laparoscopic myomectomy (RM) and laparoscopic myomectomy (LM). Ultrasound was used to evaluate the scar repair of uterine wounds at 1, 3, and 6 months postoperatively. Ninety-three RM and 110 LM patients were enrolled. More myomas excised using RM were type 1∼type 3(51.1%) and more myomas excised using LM were type 4∼type 6(54.2%), p < .001. Both groups had myomas of similar size (RM vs. LM, 9.0 vs. 8.4 cm, p = .115) and weight (RM vs. LM, 322 vs. 274 g, p = .102). The mean myoma number was significantly larger in RM patients than LM patients (RM vs. LM, 3.3 vs. 1.8, p < .001). Significantly more patients were found to have haematomas in the LM than the RM group (RM vs. LM, 0 vs. 6, p = .032); two in type 3, two in type 4 and two in type 8 myomas. Four small haematomas spontaneously resolved at the 3rd month, and a large one resolved at the 9th month postoperatively. One haematoma caused pelvic infection and a 7-cm peritoneal inclusion cyst during sonographic follow up. RM resulted in fewer postoperative haematomas and may result in superior uterine repair relative to LM after excision of symptomatic type 3, type 4 and type 8 myomas. RM is suggested for these patients, especially those considering future pregnancy.IMPACT STATEMENTWhat is already known on this subject? Reconstructive suturing and uterine wound healing are the main challenges when performing laparoscopic myomectomy (LM), and spontaneous uterine rupture during pregnancy following LM has been reported because of its limitations in multilayer closure of the myoma bed. Robot-assisted laparoscopic myomectomy (RM) has improved visualisation and EndoWrist movements resulted in adequate multilayered suturing, which may overcome the technical limitations of reconstructive suturing in conventional LM.What do the results of this study add? We evaluated postoperative uterine scarring after RM and LM using ultrasound and found RM resulted in fewer postoperative haematomas, which result in superior uterine wound repair, relative to LM after excision of symptomatic type 3, type 4 and type 8 myomas.What are the implications of these findings for clinical practice and/or further research? RM is suggested for symptomatic type 3, type 4 and type 8 myomas because of superior uterine wound repair, especially those considering future pregnancy. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/546011 | ISSN: | 0144-3615 | DOI: | 10.1080/01443615.2019.1678015 | SDG/關鍵字: | antibiotic agent; adolescent; adult; Article; cancer surgery; cohort analysis; cyst; female; follow up; hematoma; hospitalization; human; intermethod comparison; laparoscopic surgery; major clinical study; myomectomy; pelvic inflammatory disease; peritoneal disease; peritoneal inclusion cyst; postoperative complication; postoperative hemorrhage; postoperative infection; priority journal; prospective study; robot assisted surgery; scar formation; surgical drainage; tumor volume; uterus disease; uterus myoma; adverse event; comparative study; diagnostic imaging; echography; hematoma; laparoscopy; leiomyoma; middle aged; myomectomy; pathology; pathophysiology; procedures; robot assisted surgery; scar; surgical wound; Taiwan; uterus cancer; uterus disease; wound healing; young adult; Adolescent; Adult; Cicatrix; Cohort Studies; Female; Hematoma; Humans; Laparoscopy; Leiomyoma; Middle Aged; Prospective Studies; Robotic Surgical Procedures; Surgical Wound; Taiwan; Ultrasonography; Uterine Diseases; Uterine Myomectomy; Uterine Neoplasms; Wound Healing; Young Adult |
顯示於: | 醫學系 |
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