Abdominal myomectomy in women with very large uterine size.

OBJECTIVE

To evaluate feasibility and safety of abdominal myomectomy with uterine myomas equal to or greater than 16 weeks in size.

DESIGN

Retrospective chart review.

SETTING

Private hospital.

PATIENT(S): Women with uterine fibroids equal to or larger than 16 weeks in size.

INTERVENTION(S): Abdominal myomectomy performed by one surgeon between March 1, 1998-February 28, 2003.

MAIN OUTCOME MEASURE(S): Operating time, estimated blood loss, transfusion, cell-saver use, number and weight of fibroids removed, complications, pathology, and hospital stay were evaluated.

RESULT(S): Ninety-one abdominal myomectomies met criteria. Mean operating time was 236 minutes (range, 120-390 minutes). Mean estimated blood loss was 794 mL (range, 50-3,000 mL). Seven (8%) women required homologous transfusion. Complications included one bowel injury, one bladder injury, one wound infection, and one reoperation for incarcerated small bowel. No woman had a uterine sarcoma or adenocarcinoma, and none required conversion to hysterectomy.

CONCLUSION(S): Large uterine size does not preclude abdominal myomectomy and the results compare favorably with prior studies of hysterectomy for similar size uteri.