Evaluation of Myomectomy During Cesarean Section: A Tertiary Center Experience

Year 2024, Volume: 34 Issue: 5, 708 - 713, 31.10.2024

Özlem Polat Bozbay , Dorşin Sancar Arslan , Reyhan Gündüz , Nizamettin Bozbay

https://doi.org/10.54005/geneltip.1523994

Abstract

Aim: The study aims to investigate the outcomes of patients who underwent myomectomy during cesarean section in our tertiary center.
Material and method: This study was conducted between January 1, 2015 and May 31, 2022. The patients included in the study were divided into three groups: patients with myoma uteri and pregnancy who underwent cesarean section and simultaneous myomectomy (Group 1), patients with myoma uteri and pregnancy who underwent cesarean section only (Group 2), and pregnant patients without myoma who underwent cesarean section only (Group 3). The groups were compared in terms of preoperative and postoperative results.
Results: A total of 138 patients, 56 40.6% (Group 1), 31 22.5% (Group 2), 51 37% (Group 3) were included in the study. When compared according to demographic characteristics, Group 1 and Group 2 had significantly higher age and significantly lower gravida and parity (p: <0.001, p: 0.048, p: 0.005, respectively). There was no significant difference between Group 1 and Group 2 in terms of myoma size and number (p: 0.162, p: 0.228, respectively). Operative time, laboratory results, and blood transfusion requirements were similar between the groups.
Conclusion: Although myomectomy can be performed during a cesarean section by an experienced surgeon in a tertiary center, it should be noted that complications may arise and that precautions must, therefore, be taken.

Keywords

pregnancy, myoma, cesarean myomectomy, tertiary center

Ethical Statement

Ethics Committee number: 2022/64

Sezaryen Sırasında Miyomektominin Değerlendirilmesi: Üçüncü Basamak Bir Merkez Deneyimi

Abstract

Amaç: Çalışmanın amacı, üçüncü basamak merkezimizde sezaryen sırasında miyomektomi geçiren hastaların sonuçlarını araştırmaktır.
Gereç ve yöntem: Bu çalışma 1 Ocak 2015 ile 31 Mayıs 2022 tarihleri arasında yürütülmüştür. Çalışmaya dahil edilen hastalar üç gruba ayrıldı: miyoma uteri ve gebeliği olan ve sezaryen ve eş zamanlı miyomektomi geçiren hastalar (Grup 1), miyoma uteri ve gebeliği olan ve sadece sezaryen geçiren hastalar (Grup 2) ve miyomu olmayan ve sadece sezaryen geçiren gebe hastalar (Grup 3). Gruplar ameliyat öncesi ve sonrası sonuçlar açısından karşılaştırıldı.
Bulgular: Çalışmaya toplam 138 hasta, 56 40,6% (Grup 1), 31 22,5% (Grup 2), 51 37% (Grup 3) dahil edildi. Demografik özelliklere göre karşılaştırıldığında, Grup 1 ve Grup 2’de anlamlı derecede daha yüksek yaş ve anlamlı derecede daha düşük gravida ve parite vardı (sırasıyla p: <0,001, p: 0,048, p: 0,005). Miyom boyutu ve sayısı açısından Grup 1 ve Grup 2 arasında anlamlı bir fark yoktu (sırasıyla p: 0,162, p: 0,228). Ameliyat süresi, laboratuvar sonuçları ve kan transfüzyonu gereksinimleri gruplar arasında benzerdi.
Sonuç: Verilerimize göre olası riskleri göz önünde bulundurarak sezaryen sırasında miyomektomi yapmak, üçüncü basamak hastanelerde deneyimli cerrahlar tarafından gerçekleştirildiğinde uygulanabilir bir işlemdir. Komplikasyonlar konusunda da önlemler alınmalıdır. Sezaryen sırasında miyomektomi yapma veya yapmama kararının, risk-fayda oranı ve yukarıda belirtilen faktörler göz önünde bulundurularak hasta ile görüşülmesi ve vaka bazında verilmesi gerektiğine inanıyoruz.

Keywords

Gebelik, Miyom, Sezaryen miyomektomi, Üçüncül merkez

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