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Feasibility and Perioperative Outcomes of Minimally Invasive Higher Order Myomectomy.
Leaf, Marie-Claire; Lombardo, Alexandra; Wainger, Julia J; Borahay, Mostafa A; Frost, Anja; Patzkowsky, Kristin; Wang, Karen C; Wu, Harold; Simpson, Khara.
Afiliação
  • Leaf MC; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson). Electronic address: marieclaire.leaf@gmail.com.
  • Lombardo A; Johns Hopkins School of Medicine, Baltimore, MD (Lombardo).
  • Wainger JJ; Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Dr. Wainger).
  • Borahay MA; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
  • Frost A; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
  • Patzkowsky K; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
  • Wang KC; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
  • Wu H; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
  • Simpson K; Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD (Drs. Leaf, Borahay, Frost, Patzkowsky, Wang, Wu, and Simpson).
J Minim Invasive Gynecol ; 31(10): 870-874, 2024 Oct.
Article em En | MEDLINE | ID: mdl-38705376
ABSTRACT
STUDY

OBJECTIVE:

To investigate perioperative outcomes of minimally invasive higher order myomectomy as defined by removal of 10 or more fibroids.

DESIGN:

A retrospective cohort study between January 2018 and December 2022.

SETTING:

A tertiary academic medical center. PATIENTS Women who underwent minimally invasive myomectomy via laparoscopic or robotic approach.

INTERVENTIONS:

Surgical intervention in the form of minimally invasive myomectomy. MEASUREMENTS AND MAIN

RESULTS:

A total of 735 women met inclusion criteria of whom 578 had fewer than 10 fibroids removed, and 157 patients had 10 or more removed (average number of fibroids removed 3.8 vs 14.7, p <.001; specimen's weight 317.4 g vs 371.0 g, p = .07). Body mass index was similar in both groups (p = .66) and patients with higher order myomectomy were more likely to have a history of myomectomy (12.0% vs 26.8%, p <.001). The average estimated blood loss (EBL) was 246 mL vs 470 mL in each group (p <.001). There were no significant differences in packed red blood cell transfusion (1.0% vs 0.6%, p = .65), conversion to laparotomy (0.5% vs 0.6%, p = .86), or complications including visceral injury, wound complication, venous thromboembolism, ileus, or readmission (5.9% vs 4.5%, p = .49). The hospital length of stay was similar in both groups (0.5 days vs 0.5 days, p = .63). On linear regression analysis, after adjusting for specimen's weight, operative time, and history of myomectomy, EBL remained significantly higher in patients with 10 or more fibroids removed (p = .02).

CONCLUSION:

EBL is increased in higher order myomectomy; however, blood transfusions, conversion to laparotomy, complication rates, and length of hospital stay did not differ compared with patients with fewer than 10 fibroids removed, highlighting the feasibility of minimally invasive higher order myomectomy.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Estudos de Viabilidade / Laparoscopia / Miomectomia Uterina / Procedimentos Cirúrgicos Robóticos / Leiomioma Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Uterinas / Estudos de Viabilidade / Laparoscopia / Miomectomia Uterina / Procedimentos Cirúrgicos Robóticos / Leiomioma Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article