Strategy of cervical myomectomy under laparoscopy
Journal
Fertility and Sterility
Journal Volume
94
Journal Issue
7
Pages
2710-2715
Date Issued
2010
Author(s)
Abstract
Objective: To evaluate a strategy of laparoscopic excision of a cervical myoma (CM). Design: Prospective study. Setting: University-affiliated hospital. Patient(s): Twenty-eight patients with CM underwent laparoscopic myomectomy. These cases were classified into five types according to the location: [1] anterior cervical myoma (ACM); [2] posterior cervical myoma (PCM); [3] central cervical myoma (CCM); [4] lateral cervical myoma [LCM]; and [5] deep-rooted cervical myoma (DCM). Intervention(s): After preoperative assessment, patients underwent laparoscopic myomectomy. Ligation of the uterine artery and diluted vasopressin injection were performed to decrease bleeding during laparoscopy. Main Outcome Measure(s): Myoma numbers, myoma weight, operative time, estimated blood loss, hospital stay, complication rate. Result(s): Most of the lesions were ACM (43%) and PCM (32%). The mean operative time was 121 minutes, mean blood loss was 99 mL, and mean myoma weight was 287 g. The mean hospital stay was 2.2 days. There were no complications. Histopathologic examination showed that all lesions were leiomyoma. Hypermenorrhea, dysmenorrhea, and symptoms of compression improved after the operation. Two infertile patients conceived spontaneously at 1 and 7 months postoperatively, and successfully delivered infants by cesarean section at term. Conclusion(s): Surgical treatment of CM is empirically difficult. It is important that the approach be changed according to the location and size of the myoma. Copyright ? 2010 American Society for Reproductive Medicine, Published by Elsevier Inc.
SDGs
Other Subjects
vasopressin; adult; anterior cervical myoma; artery ligation; article; bleeding; central cervical myoma; cervical myomectomy; clinical article; deep rooted cervical myoma; dysmenorrhea; female; female infertility; histopathology; human; human tissue; hypermenorrhea; injection; laparoscopy; lateral cervical myoma; leiomyoma; length of stay; myoma; myomectomy; operation duration; posterior cervical myoma; postoperative complication; pregnancy disorder; preoperative evaluation; priority journal; prospective study; surgical technique; tenesmus; tumor localization; tumor volume; urinary frequency; uterine artery; Adult; Female; Gynecologic Surgical Procedures; Humans; Infant, Newborn; Laparoscopy; Leiomyoma; Middle Aged; Postoperative Complications; Pregnancy; Tumor Burden; Uterine Cervical Neoplasms; Young Adult
Type
journal article