Limits and complications of laparoscopic myomectomy: which are the best predictors? A large cohort single-center experience

作者：Saccardi Carlo; Gizzo Salvatore^*; Noventa Marco; Ancona Emanuele; Borghero Angela; Litta Pietro Salvatore

来源：Archives of Gynecology and Obstetrics, 2014, 290(5): 951-956.

DOI：10.1007/s00404-014-3289-2

• Laparoscopic myomectomy
• Surgical outcomes
• Surgical complications
• Risk factors
• Myomas features

Purpose To determine whether a correlation exists between size, location, type of myomas and perioperative outcomes. %26lt;br%26gt;Methods This is a observational study in women undergone to laparoscopic myomectomy (LM) because of single symptomatic myoma %26gt;4 cm in diameter. We collected data about general features, surgical outcomes, intraoperative/ postoperative complications and time to return to normal activity. %26lt;br%26gt;Results A total of 444 patients (mean age 36.7+/-6.4 years) resulted eligible for the study. Myomas sized between 8 and 12 cm were linked to an increased amount of blood loss (significantly higher in intramural than subserosal myoma). The removal of intramural myomas %26gt;8 cm and the subserosal ones %26gt;12 cm required a significant longer surgical time. Patients returned 17.9 +/- 9.5 days after surgery to their personal activities. Six cases (1.35 %) required conversion to laparotomy, and only in two cases blood transfusion was necessary. %26lt;br%26gt;Conclusion Myomas size and type represent the best predictors of surgical difficulties and possible intrapostoperative complications. Intramural myomas %26gt; 8 cm and subserosal ones %26gt; 12 cm should be considered as a challenging procedure. LM remains the gold standard approach because of very low perioperative complication rate and faster return to normal activity.

• 出版日期2014-11