European journal of obstetrics, gynecology, and reproductive biology · 2014
Laparoendoscopic single-site (LESS) myomectomy: characteristics of the appropriate myoma.
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Yoon Aera, Kim Tae-Joong, Lee Yoo-Young, Choi Chel Hun, Lee Jeong-Won, Bae Duk-Soo, Kim Byoung-Gie
Аннотация
OBJECTIVE: To describe the characteristics of 35 myomas in 28 patients who underwent laparoendoscopic single-site myomectomy (LESS-M).
STUDY DESIGN: Retrospective analysis of 28 patients who underwent LESS-M at Samsung Medical Center from January 2009 to January 2013.
RESULTS: The median age of 28 patients was 34 years (range: 27-61) and median body mass index was 21.9 (range: 17.3-28.5). The median number of extracted myomas was one (range: 1-4) and the largest myoma diameter was 6cm (range: 2-15). The total number of extracted myomas was 35 and the types of extracted myoma were subserosal (16 myomas, 45.7%), intramural (nine myomas, 25.7%) and intraligamentary (seven myomas, 20%). In subserosal and intramural myoma, 21 myomas were located at the anterior wall and four myomas were located at the posterior wall of the uterus. Median operation time was 131min (range: 35-232). Estimated intraoperative blood loss was 65mL (range: 20-300), hemoglobin change was 2g/dL (range: 0.5-2.9) and hospital stay was 3 days (range: 1-4). There was no conversion to laparotomy but in one patient (3.6%), LESS-M converted to two-port laparoscopic myomectomy. There was no blood transfusion during and after operation. Intraoperative and postoperative complications did not occur.
CONCLUSION: Careful selection of patients considering the type and location of myomas is important for successful LESS-M. Myomas located in the anterior wall, subserosal or intraligamentary myomas are appropriate for LESS-M.
STUDY DESIGN: Retrospective analysis of 28 patients who underwent LESS-M at Samsung Medical Center from January 2009 to January 2013.
RESULTS: The median age of 28 patients was 34 years (range: 27-61) and median body mass index was 21.9 (range: 17.3-28.5). The median number of extracted myomas was one (range: 1-4) and the largest myoma diameter was 6cm (range: 2-15). The total number of extracted myomas was 35 and the types of extracted myoma were subserosal (16 myomas, 45.7%), intramural (nine myomas, 25.7%) and intraligamentary (seven myomas, 20%). In subserosal and intramural myoma, 21 myomas were located at the anterior wall and four myomas were located at the posterior wall of the uterus. Median operation time was 131min (range: 35-232). Estimated intraoperative blood loss was 65mL (range: 20-300), hemoglobin change was 2g/dL (range: 0.5-2.9) and hospital stay was 3 days (range: 1-4). There was no conversion to laparotomy but in one patient (3.6%), LESS-M converted to two-port laparoscopic myomectomy. There was no blood transfusion during and after operation. Intraoperative and postoperative complications did not occur.
CONCLUSION: Careful selection of patients considering the type and location of myomas is important for successful LESS-M. Myomas located in the anterior wall, subserosal or intraligamentary myomas are appropriate for LESS-M.