Kristen Pepin1, Monalisa Dmello2, Evelien Sandberg3, Catherine Hill-Verrochi4, Parmida Maghsoudlou2, Mobolaji Ajao2, Sarah L Cohen5, Jon I Einarsson2. 1. Department of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston Massachusetts. (Drs. Pepin, Dmello, Sandberg, Hill-Verrochi, Ajao, Cohen, Einarsson, and Ms. Maghsoudlou). Electronic address: kpepin@partners.org. 2. Department of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston Massachusetts. (Drs. Pepin, Dmello, Sandberg, Hill-Verrochi, Ajao, Cohen, Einarsson, and Ms. Maghsoudlou). 3. Department of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston Massachusetts. (Drs. Pepin, Dmello, Sandberg, Hill-Verrochi, Ajao, Cohen, Einarsson, and Ms. Maghsoudlou); Leiden University Medical Centre, Leiden, The Netherlands, (Dr. Sandberg). 4. Department of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston Massachusetts. (Drs. Pepin, Dmello, Sandberg, Hill-Verrochi, Ajao, Cohen, Einarsson, and Ms. Maghsoudlou); Baystate Medical Center, Springfield, Massachusetts (Dr. Hill-Verochi). 5. Department of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston Massachusetts. (Drs. Pepin, Dmello, Sandberg, Hill-Verrochi, Ajao, Cohen, Einarsson, and Ms. Maghsoudlou); The Mayo Clinic, Rochester, Minnesota (Dr. Cohen).
Abstract
STUDY OBJECTIVE: To review pregnancy outcomes after laparoscopic myomectomy with the use of barbed suture. DESIGN: Retrospective cohort study and follow-up survey. SETTING: Single, large academic medical center. PATIENTS: Patients who underwent laparoscopic myomectomy with the use of barbed suture for myometrial closure between 2008 and 2016. INTERVENTION: Laparoscopic myomectomy and a follow-up survey regarding pregnancy outcome. MEASUREMENTS AND MAIN RESULTS: A total of 486 patients met inclusion criteria and underwent a laparoscopic myomectomy between 2008 and 2016. Of the 428 with viable contact information, 240 agreed to participate (56%). Of those who responded to the survey, 101 (42%) attempted to get pregnant, and there were 4 unplanned pregnancies. There were 110 pregnancies among 76 survey respondents. In total, of the women attempting a postoperative pregnancy, 71% had at least 1 pregnancy. Comparing the women who did and did not conceive postoperatively, the group who got pregnant was on average younger, 33.8 ± 4.5 years vs 37.5 ± 6.5 years (p = .001); had fewer myomas removed, median = 2 (range 1-9) vs median = 2 (range 1-16) myomas (p = .038); and had a longer follow-up period, 30 months ( vs 30 (11-93 months) ± 20 (p <.001). The mean time to first postoperative pregnancy was 18.0 months (range 2-72 months). Of the 110 reported postoperative pregnancies, there were 60 live births (55%), 90% by means of cesarean section. The mean gestational age at birth was 37.8 weeks. In the cohort, there were 8 preterm births, 3 cases of abnormal placentation, 2 cases of fetal growth restriction, 3 cases of hypertensive disorders of pregnancy, and 2 cases of myoma degeneration requiring hospitalization for pain control. There were no uterine ruptures reported. CONCLUSION: According to our findings, pregnancy outcomes after laparoscopic myomectomy with barbed suture are comparable with available literature on pregnancy outcomes with conventional smooth suture.
STUDY OBJECTIVE: To review pregnancy outcomes after laparoscopic myomectomy with the use of barbed suture. DESIGN: Retrospective cohort study and follow-up survey. SETTING: Single, large academic medical center. PATIENTS: Patients who underwent laparoscopic myomectomy with the use of barbed suture for myometrial closure between 2008 and 2016. INTERVENTION: Laparoscopic myomectomy and a follow-up survey regarding pregnancy outcome. MEASUREMENTS AND MAIN RESULTS: A total of 486 patients met inclusion criteria and underwent a laparoscopic myomectomy between 2008 and 2016. Of the 428 with viable contact information, 240 agreed to participate (56%). Of those who responded to the survey, 101 (42%) attempted to get pregnant, and there were 4 unplanned pregnancies. There were 110 pregnancies among 76 survey respondents. In total, of the women attempting a postoperative pregnancy, 71% had at least 1 pregnancy. Comparing the women who did and did not conceive postoperatively, the group who got pregnant was on average younger, 33.8 ± 4.5 years vs 37.5 ± 6.5 years (p = .001); had fewer myomas removed, median = 2 (range 1-9) vs median = 2 (range 1-16) myomas (p = .038); and had a longer follow-up period, 30 months ( vs 30 (11-93 months) ± 20 (p <.001). The mean time to first postoperative pregnancy was 18.0 months (range 2-72 months). Of the 110 reported postoperative pregnancies, there were 60 live births (55%), 90% by means of cesarean section. The mean gestational age at birth was 37.8 weeks. In the cohort, there were 8 preterm births, 3 cases of abnormal placentation, 2 cases of fetal growth restriction, 3 cases of hypertensive disorders of pregnancy, and 2 cases of myoma degeneration requiring hospitalization for pain control. There were no uterine ruptures reported. CONCLUSION: According to our findings, pregnancy outcomes after laparoscopic myomectomy with barbed suture are comparable with available literature on pregnancy outcomes with conventional smooth suture.