Şafak Hatırnaz1, Oğuz Güler1, Serdar Başaranoğlu1, Cengiz Tokgöz1, Gokhan S Kılıç2. 1. a Department of Obstetrics and Gynecology , Private Bilge Hospital , Istanbul , Turkey. 2. b Department of Obstetrics and Gynecology , The University of Texas Medical Branch , Galveston, TX , USA.
Abstract
STUDY OBJECTIVE: Comparing surgical outcomes of a novel surgical technique endometrial myomectomy (EM) to serosal myomectomy (SM) during ceserean section (CS). DESIGN: Retrospective cohort study (Canadian task force classification level II 1). SETTING: Private hospital. PATIENTS: Fourty-six women with leiomyomas during cesarean section Interventions: Endometrial myomectomy and serosal myomectomy during cesarean section between 2013 and 2016. MAIN OUTCOME MEASURES: Total 22 consequtive cases (Group 1) underwent EM in the last 2 years. The control group created from SM (Group 2) cases performed before EM implemented in our practice. Group 2 was matched based on anteriorly located intramural or submucosal leiomyoma. The size, location and number of leiomyoma, hematological course during pre- and postoperative period, the need for blood transfusion, duration of surgery, and any prolongation of hospital stay also documented. RESULTS: Median number of leiomyoma was higher in EM than in SM (p = 0.001). Median myomectomy procedure time and amount of intra-operative bleeding in SM were higher than EM (respectively, p = 0.005 and p = 0.001). In terms of other variables, there is no difference between the two myomectomy groups (p > 0.05). CONCLUSION: This novel technique EM is a safe, feasible surgical technique compared with SM. Besides the less intra-operative blood loss, it also has the potential to diminish the risk of abdominal adhesion formation.
STUDY OBJECTIVE: Comparing surgical outcomes of a novel surgical technique endometrial myomectomy (EM) to serosal myomectomy (SM) during ceserean section (CS). DESIGN: Retrospective cohort study (Canadian task force classification level II 1). SETTING: Private hospital. PATIENTS: Fourty-six women with leiomyomas during cesarean section Interventions: Endometrial myomectomy and serosal myomectomy during cesarean section between 2013 and 2016. MAIN OUTCOME MEASURES: Total 22 consequtive cases (Group 1) underwent EM in the last 2 years. The control group created from SM (Group 2) cases performed before EM implemented in our practice. Group 2 was matched based on anteriorly located intramural or submucosal leiomyoma. The size, location and number of leiomyoma, hematological course during pre- and postoperative period, the need for blood transfusion, duration of surgery, and any prolongation of hospital stay also documented. RESULTS: Median number of leiomyoma was higher in EM than in SM (p = 0.001). Median myomectomy procedure time and amount of intra-operative bleeding in SM were higher than EM (respectively, p = 0.005 and p = 0.001). In terms of other variables, there is no difference between the two myomectomy groups (p > 0.05). CONCLUSION: This novel technique EM is a safe, feasible surgical technique compared with SM. Besides the less intra-operative blood loss, it also has the potential to diminish the risk of abdominal adhesion formation.