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Evaluation of Myomectomy During Cesarean Section: A Tertiary Center Experience

Yıl 2024, Cilt: 34 Sayı: 5, 708 - 713, 31.10.2024
https://doi.org/10.54005/geneltip.1523994

Öz

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.

Etik Beyan

Ethics Committee number: 2022/64

Kaynakça

  • Stein K, Ascher-Walsh C. A comprehensive approach to the treatment of uterine leiomyomata. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine: A Journal of Translational and Personalized Medicine 2009; 76(6), 546.
  • Garg P, Bansal R. Cesarean myomectomy: a case report and review of the literature. Journal of medical case reports 2021; 15(1), 193.
  • Perez-Roncero GR, Lopez-Baena MT, & Ornat L. Uterine fibroids and preterm birth risk: a systematic review and meta-analysis [published online ahead of print, JUL 6]. J. Obstet. Gynecol. Res 2020; 10, 1111.
  • González VG, Moreta A H, Triana A. M. et al. Prolapsed cervical myoma during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 252, 150-154.
  • Spyropoulou K, Kosmas I, Tsakiridis I, Mamopoulos A, Kalogiannidis I, Athanasiadis A, et. al. Myomectomy during pregnancy: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 254, 15-24.
  • Mitro SD, Peddada S, Chen Z, Louis GMB, Gleason JL, Zhang C, et. al. Natural history of fibroids in pregnancy: National institute of child health and human development fetal growth studies-Singletons cohort. Fertility and sterility 2022; 118(4), 656-665.
  • Senturk MB, Polat M, Doğan O, Pulatoğlu Ç, Yardımcı OD, Karakuş R, at. al. Outcome of cesarean myomectomy: is it a safe procedure?. Geburtshilfe und Frauenheilkunde 2017; 77(11), 1200-1206.
  • Ehigiegba AE, Ande AB, & Ojobo SI. Myomectomy during cesarean section. International Journal of Gynecology & Obstetrics 2001; 75(1), 21-25.
  • Kwawukume EY. Myomectomy during cesarean section. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2002; 76(2), 183-184.
  • Sparic R, Malvasi A, & Tinelli A. Analysis of clinical, biological and obstetric factors influencing the decision to perform cesarean myomectomy. Ginekologia Polska 2015; 86(1).
  • El-Refaie W, Hassan M, & Abdelhafez MS. Myomectomy during cesarean section: A retrospective cohort study. Journal of Gynecology Obstetrics and Human Reproduction 2020; 49(10), 101900.
  • Guler AE, Guler ZÇD, Kinci MF, & Mungan MT. Myomectomy during cesarean section: why do we abstain from? The Journal of Obstetrics and Gynecology of India 2020; 70, 133-137.
  • Maruyama T, Miyazaki K, Masuda H, Ono M, Uchida H, & Yoshimura Y. Human uterine stem/progenitor cells: Implications for uterine physiology and pathology. Placenta 2013; 34, S68-S72.
  • Sparic R. Uterine myomas in pregnancy, childbirth and puerperium. Srpski arhiv za celokupno lekarstvo 2014; 142(1-2), 118-124.
  • Lee JH, Cho DH. Myomectomy using purse-string suture during cesarean section. Archives of gynecology and obstetrics 2011; 283, 35-37.
  • Wegienka G, Havstad S, Coleman C, Cooper T, Wesselink A, Upson K, at.al. Ultrasound-confirmed, age-specific uterine leiomyoma incidence in a cohort of Black individuals. Obstetrics & Gynecology 2022; 140(6), 1042-1048.
  • Sparic R, Mirkovic L, Malvasi A, & Tinelli A. Epidemiology of uterine myomas: a review. International journal of fertility & sterility 2016; 9(4), 424.
  • Sakinci M, Turan G, Sanhal CY, Yildiz Y, Hamidova A, Guner FC,at. al. Analysis of myomectomy during cesarean section: A tertiary center experience. Journal of Investigative Surgery2022;35(1), 23-29.
  • Pergialiotis V, Sinanidis I, Louloudis IE, Vichos T, Perrea DN & Doumouchtsis K. Perioperative complications of cesarean delivery myomectomy: a meta-analysis. Obstetrics & Gynecology 2017; 130(6), 1295-1303.
  • Huang Y, Ming X, & Li Z. Feasibility and safety of performing cesarean myomectomy: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2022; 35(13), 2619-2627.

Sezaryen Sırasında Miyomektominin Değerlendirilmesi: Üçüncü Basamak Bir Merkez Deneyimi

Yıl 2024, Cilt: 34 Sayı: 5, 708 - 713, 31.10.2024
https://doi.org/10.54005/geneltip.1523994

Öz

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.

Kaynakça

  • Stein K, Ascher-Walsh C. A comprehensive approach to the treatment of uterine leiomyomata. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine: A Journal of Translational and Personalized Medicine 2009; 76(6), 546.
  • Garg P, Bansal R. Cesarean myomectomy: a case report and review of the literature. Journal of medical case reports 2021; 15(1), 193.
  • Perez-Roncero GR, Lopez-Baena MT, & Ornat L. Uterine fibroids and preterm birth risk: a systematic review and meta-analysis [published online ahead of print, JUL 6]. J. Obstet. Gynecol. Res 2020; 10, 1111.
  • González VG, Moreta A H, Triana A. M. et al. Prolapsed cervical myoma during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 252, 150-154.
  • Spyropoulou K, Kosmas I, Tsakiridis I, Mamopoulos A, Kalogiannidis I, Athanasiadis A, et. al. Myomectomy during pregnancy: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 254, 15-24.
  • Mitro SD, Peddada S, Chen Z, Louis GMB, Gleason JL, Zhang C, et. al. Natural history of fibroids in pregnancy: National institute of child health and human development fetal growth studies-Singletons cohort. Fertility and sterility 2022; 118(4), 656-665.
  • Senturk MB, Polat M, Doğan O, Pulatoğlu Ç, Yardımcı OD, Karakuş R, at. al. Outcome of cesarean myomectomy: is it a safe procedure?. Geburtshilfe und Frauenheilkunde 2017; 77(11), 1200-1206.
  • Ehigiegba AE, Ande AB, & Ojobo SI. Myomectomy during cesarean section. International Journal of Gynecology & Obstetrics 2001; 75(1), 21-25.
  • Kwawukume EY. Myomectomy during cesarean section. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2002; 76(2), 183-184.
  • Sparic R, Malvasi A, & Tinelli A. Analysis of clinical, biological and obstetric factors influencing the decision to perform cesarean myomectomy. Ginekologia Polska 2015; 86(1).
  • El-Refaie W, Hassan M, & Abdelhafez MS. Myomectomy during cesarean section: A retrospective cohort study. Journal of Gynecology Obstetrics and Human Reproduction 2020; 49(10), 101900.
  • Guler AE, Guler ZÇD, Kinci MF, & Mungan MT. Myomectomy during cesarean section: why do we abstain from? The Journal of Obstetrics and Gynecology of India 2020; 70, 133-137.
  • Maruyama T, Miyazaki K, Masuda H, Ono M, Uchida H, & Yoshimura Y. Human uterine stem/progenitor cells: Implications for uterine physiology and pathology. Placenta 2013; 34, S68-S72.
  • Sparic R. Uterine myomas in pregnancy, childbirth and puerperium. Srpski arhiv za celokupno lekarstvo 2014; 142(1-2), 118-124.
  • Lee JH, Cho DH. Myomectomy using purse-string suture during cesarean section. Archives of gynecology and obstetrics 2011; 283, 35-37.
  • Wegienka G, Havstad S, Coleman C, Cooper T, Wesselink A, Upson K, at.al. Ultrasound-confirmed, age-specific uterine leiomyoma incidence in a cohort of Black individuals. Obstetrics & Gynecology 2022; 140(6), 1042-1048.
  • Sparic R, Mirkovic L, Malvasi A, & Tinelli A. Epidemiology of uterine myomas: a review. International journal of fertility & sterility 2016; 9(4), 424.
  • Sakinci M, Turan G, Sanhal CY, Yildiz Y, Hamidova A, Guner FC,at. al. Analysis of myomectomy during cesarean section: A tertiary center experience. Journal of Investigative Surgery2022;35(1), 23-29.
  • Pergialiotis V, Sinanidis I, Louloudis IE, Vichos T, Perrea DN & Doumouchtsis K. Perioperative complications of cesarean delivery myomectomy: a meta-analysis. Obstetrics & Gynecology 2017; 130(6), 1295-1303.
  • Huang Y, Ming X, & Li Z. Feasibility and safety of performing cesarean myomectomy: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2022; 35(13), 2619-2627.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Original Article
Yazarlar

Özlem Polat Bozbay 0000-0003-1975-6687

Dorşin Sancar Arslan 0009-0005-4144-9343

Reyhan Gündüz 0000-0001-8468-7038

Nizamettin Bozbay 0000-0001-9632-5093

Erken Görünüm Tarihi 27 Ekim 2024
Yayımlanma Tarihi 31 Ekim 2024
Gönderilme Tarihi 29 Temmuz 2024
Kabul Tarihi 7 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 34 Sayı: 5

Kaynak Göster

Vancouver Polat Bozbay Ö, Sancar Arslan D, Gündüz R, Bozbay N. Evaluation of Myomectomy During Cesarean Section: A Tertiary Center Experience. Genel Tıp Derg. 2024;34(5):708-13.