Analysis of perioperative morbidity according to whether the uterine cavity is opened or remains closed during abdominal myomectomy - Results of 423 abdominal myomectomy cases

M. Gavai, E. Berkes, T. Fekete, L. Lazar, Z. F. Takacs, Z. Papp

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

For women who desire pregnancy or who wish to retain their uterus, myomectomy is the standard approach for the treatment of fibroids. Abdominal myomectomy seems to be the best choice when there are large subserosal or intramural fibroids (> 5-7 cm), or submucosal fibroids > 3 cm or when multiple fibroids (> 3) are to be removed. When submucosal myomas are present or multiple fibroids are to be removed, opening the uterine cavity during the surgical procedure is more likely to happen. There is lack of published evidence about whether there is any difference in perioperative morbidity and management of those cases where the uterine cavity is opened during the surgical procedure compared with those where the uterine cavity remains closed. Methods: We undertook a retrospective review of 423 abdominal myomectomies via either an opened or closed uterine cavity. As a primary outcome we assessed the overall perioperative morbidity rate and as a secondary outcome we compared the necessity of pre and postoperative transfusions, intraoperative bleeding, febrile morbidity, unintended surgical interventions, life-threatening events, need for relaparotomies and duration of hospital stay between the opened and non opened uterine cavity groups. Results: The overall perioperative morbidity rate was significantly higher in those cases where the uterine cavity was opened during surgery; however the difference was caused only by the increased risk of intraoperative bleeding. All the other variables, such as febrile morbidity, number of relaparotomies, unintended surgical procedures and life-threatening events did not differ between the two groups. Conclusion: Although there is an increased risk of intraoperative bleeding it seems that entering the uterine cavity during abdominal myomectomy can be considered as safe a procedure as in those cases where the uterine cavity remains closed.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalClinical and Experimental Obstetrics and Gynecology
Volume35
Issue number2
Publication statusPublished - 2008

Fingerprint

Uterine Myomectomy
Leiomyoma
Morbidity
Hemorrhage
Fever
Myoma
Abdominal Cavity
Case Management
Uterus
Length of Stay
Pregnancy

Keywords

  • Abdominal myomectomy
  • Opened uterine cavity
  • Perioperative morbidity

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{59b99d99681b412f97bf80bfd9291a0e,
title = "Analysis of perioperative morbidity according to whether the uterine cavity is opened or remains closed during abdominal myomectomy - Results of 423 abdominal myomectomy cases",
abstract = "For women who desire pregnancy or who wish to retain their uterus, myomectomy is the standard approach for the treatment of fibroids. Abdominal myomectomy seems to be the best choice when there are large subserosal or intramural fibroids (> 5-7 cm), or submucosal fibroids > 3 cm or when multiple fibroids (> 3) are to be removed. When submucosal myomas are present or multiple fibroids are to be removed, opening the uterine cavity during the surgical procedure is more likely to happen. There is lack of published evidence about whether there is any difference in perioperative morbidity and management of those cases where the uterine cavity is opened during the surgical procedure compared with those where the uterine cavity remains closed. Methods: We undertook a retrospective review of 423 abdominal myomectomies via either an opened or closed uterine cavity. As a primary outcome we assessed the overall perioperative morbidity rate and as a secondary outcome we compared the necessity of pre and postoperative transfusions, intraoperative bleeding, febrile morbidity, unintended surgical interventions, life-threatening events, need for relaparotomies and duration of hospital stay between the opened and non opened uterine cavity groups. Results: The overall perioperative morbidity rate was significantly higher in those cases where the uterine cavity was opened during surgery; however the difference was caused only by the increased risk of intraoperative bleeding. All the other variables, such as febrile morbidity, number of relaparotomies, unintended surgical procedures and life-threatening events did not differ between the two groups. Conclusion: Although there is an increased risk of intraoperative bleeding it seems that entering the uterine cavity during abdominal myomectomy can be considered as safe a procedure as in those cases where the uterine cavity remains closed.",
keywords = "Abdominal myomectomy, Opened uterine cavity, Perioperative morbidity",
author = "M. Gavai and E. Berkes and T. Fekete and L. Lazar and Takacs, {Z. F.} and Z. Papp",
year = "2008",
language = "English",
volume = "35",
pages = "107--112",
journal = "Clinical and Experimental Obstetrics and Gynecology",
issn = "0390-6663",
publisher = "S.O.G. CANADA Inc.",
number = "2",

}

TY - JOUR

T1 - Analysis of perioperative morbidity according to whether the uterine cavity is opened or remains closed during abdominal myomectomy - Results of 423 abdominal myomectomy cases

AU - Gavai, M.

AU - Berkes, E.

AU - Fekete, T.

AU - Lazar, L.

AU - Takacs, Z. F.

AU - Papp, Z.

PY - 2008

Y1 - 2008

N2 - For women who desire pregnancy or who wish to retain their uterus, myomectomy is the standard approach for the treatment of fibroids. Abdominal myomectomy seems to be the best choice when there are large subserosal or intramural fibroids (> 5-7 cm), or submucosal fibroids > 3 cm or when multiple fibroids (> 3) are to be removed. When submucosal myomas are present or multiple fibroids are to be removed, opening the uterine cavity during the surgical procedure is more likely to happen. There is lack of published evidence about whether there is any difference in perioperative morbidity and management of those cases where the uterine cavity is opened during the surgical procedure compared with those where the uterine cavity remains closed. Methods: We undertook a retrospective review of 423 abdominal myomectomies via either an opened or closed uterine cavity. As a primary outcome we assessed the overall perioperative morbidity rate and as a secondary outcome we compared the necessity of pre and postoperative transfusions, intraoperative bleeding, febrile morbidity, unintended surgical interventions, life-threatening events, need for relaparotomies and duration of hospital stay between the opened and non opened uterine cavity groups. Results: The overall perioperative morbidity rate was significantly higher in those cases where the uterine cavity was opened during surgery; however the difference was caused only by the increased risk of intraoperative bleeding. All the other variables, such as febrile morbidity, number of relaparotomies, unintended surgical procedures and life-threatening events did not differ between the two groups. Conclusion: Although there is an increased risk of intraoperative bleeding it seems that entering the uterine cavity during abdominal myomectomy can be considered as safe a procedure as in those cases where the uterine cavity remains closed.

AB - For women who desire pregnancy or who wish to retain their uterus, myomectomy is the standard approach for the treatment of fibroids. Abdominal myomectomy seems to be the best choice when there are large subserosal or intramural fibroids (> 5-7 cm), or submucosal fibroids > 3 cm or when multiple fibroids (> 3) are to be removed. When submucosal myomas are present or multiple fibroids are to be removed, opening the uterine cavity during the surgical procedure is more likely to happen. There is lack of published evidence about whether there is any difference in perioperative morbidity and management of those cases where the uterine cavity is opened during the surgical procedure compared with those where the uterine cavity remains closed. Methods: We undertook a retrospective review of 423 abdominal myomectomies via either an opened or closed uterine cavity. As a primary outcome we assessed the overall perioperative morbidity rate and as a secondary outcome we compared the necessity of pre and postoperative transfusions, intraoperative bleeding, febrile morbidity, unintended surgical interventions, life-threatening events, need for relaparotomies and duration of hospital stay between the opened and non opened uterine cavity groups. Results: The overall perioperative morbidity rate was significantly higher in those cases where the uterine cavity was opened during surgery; however the difference was caused only by the increased risk of intraoperative bleeding. All the other variables, such as febrile morbidity, number of relaparotomies, unintended surgical procedures and life-threatening events did not differ between the two groups. Conclusion: Although there is an increased risk of intraoperative bleeding it seems that entering the uterine cavity during abdominal myomectomy can be considered as safe a procedure as in those cases where the uterine cavity remains closed.

KW - Abdominal myomectomy

KW - Opened uterine cavity

KW - Perioperative morbidity

UR - http://www.scopus.com/inward/record.url?scp=44349095913&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44349095913&partnerID=8YFLogxK

M3 - Article

VL - 35

SP - 107

EP - 112

JO - Clinical and Experimental Obstetrics and Gynecology

JF - Clinical and Experimental Obstetrics and Gynecology

SN - 0390-6663

IS - 2

ER -