The Effect of Myoma Size on Cesarean Myomectomy Results

Abstract

Objective: To investigate the effect of myoma size on intraoperative and postoperative outcomes in patients with cesarean section myomectomy.

Materials and Methods: We retrospectively analyzed the data of 89 pregnant women who underwent cesarean section myomectomy. Study participants were divided into 2 groups according to fibroid size. Assessment of intramural myomectomy patients was carried out by taking 5 cm as the cutoff value. Maternal age, gestational age, neonatal weight, fibroid characteristics, pre- and postoperative hemogram values, operation time and transfusion need were compared between the two groups.

Results: Sixty-five women with myoma size ≤5 cm (Group-1) and 24 women with myoma size >5 cm (Group-2) underwent cesarean section myomectomy. There was no statistically significant difference between the two groups in terms of pre- and post-operative hemoglobin (hb), mean hb values, operation time and hospital stay. The most common fibroids in this study were subserosal fibroids (77.5%) located on the anterior uterine wall (56.1%) with a diameter of 2 to 5 cm (70.7%).

Conclusion: Cesarean section myomectomy performed by experienced surgeons can be performed as a safe and effective method in selected patients regardless of fibroid size. Moreover, fibroid has a wide spectrum of patients in terms of number, localization, size and patient characteristics. Therefore, treatment should be individualized. 

Keywords

• Cesarean section
• myoma uteri
• myomectomy

Myom Boyutlarının Sezaryen Myomektomi Sonuçlarına Etkisi

Öz

Amaç: Sezaryen sırasında myomektomi uygulanan olgularda myom boyutunun intraoperatif ve postoperatif sonuçlara etkisini araştırmak.

Materyal ve Metot: Sezaryen myomektomi yapılan 89 hastanın sonuçları retrospektif olarak incelendi. Hastalar, myom boyutuna göre 2 gruba ayrıldı. Myomektomili hastalar, cutoff değeri olarak 5 cm baz alınarak değerlendirildi. İki grup arasında anne yaşı, doğumdaki gebelik haftası, yenidoğan ağırlığı, myom özellikleri, ameliyat öncesi ve sonrası hemoglobin (hb) değerleri, operasyon süresi ve transfüzyon ihtiyacı karşılaştırıldı.

Bulgular: Bu çalışmada, myom boyutu ≤5 cm olan (Grup-1) 65 gebeye ve myom boyutu >5 cm olan (Grup-2) 24 gebeye sezaryen sırasında myomektomi uygulandı. Ameliyat öncesi ve sonrası hb, ortalama hb değerleri, operasyon süresi ve hastanede kalış süresinde iki grup arasında istatistiksel olarak anlamlı fark bulunmadı. Bu çalışmada, en sık uterus anterior duvar (%56,1) yerleşimli, çapları 2 ile 5 cm (%70,7) aralığında değişen subserozal (%77,5) myomlar görüldü.

Sonuç: Deneyimli cerrahlar tarafından yapılan sezaryen sırasında myomektomi ameliyatı seçilmiş hastalarda myom boyutundan bağımsız olarak güvenli ve etkili bir yöntemdir. Ayrıca myom; sayısı, lokalizayonu, büyüklüğü ve hasta özellikleri açısından geniş bir hasta spektrumuna sahiptir. Bu nedenle tedavi kişiye özel olmalıdır. 

Anahtar Kelimeler

• Myoma uteri
• sezaryen
• myomektomi

Kaynakça

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