Utility of a minimal skin incision laparotomy technique for removing uterine leiomyomas at a regional core hospital: a retrospective study

Journal of Medical Case Reports

Ryo Sugiyama¹  Wada-Hiraike Osamu¹  Wataru Isono¹  Masanori Maruyama² 

[1] Department of Obstetrics and Gynaecology, Graduate School of Medicine, The University of Tokyo;Department of Obstetrics and Gynaecology, Maruyama Memorial General Hospital;

关键词: Minimal skin incision abdominal myomectomy;    Blood loss;    Operation time;    Characteristics of leiomyoma;   

DOI  :  10.1186/s13256-018-1703-2

来源: DOAJ

【 摘 要 】

Abstract Background We present a minimal skin wound abdominal myomectomy performed in our hospital and attempt to identify the optimal range of this technique by considering the characteristics of target leiomyomas. In this procedure, we attempted to make the skin wound as small as possible, with a maximum length of approximately 5 cm. Methods In addition to introducing the minimal skin wound abdominal myomectomy, we retrospectively collected and analyzed the medical records of 76 patients treated with minimal skin wound abdominal myomectomy exclusively by the same physician at Maruyama Memorial General Hospital between January 2007 and December 2016. We statistically investigated relationships between ten factors, including body mass index; patient’s age; patient’s parity; administration of gonadotropin-releasing hormone analogue; presence of anemia; the uterine leiomyomas’ number, size, weight, and location; operation time; and blood loss. Results First, we introduce a case in which we performed minimal skin wound abdominal myomectomy for a 36-year-old Japanese patient with a large leiomyoma (10 cm in diameter). Then, we assessed the impacts of patient characteristics and leiomyoma characteristics on operation time and blood loss for this surgical method. In a multivariate analysis, only the number of resected leiomyomas significantly affected massive bleeding. Other factors showed no difference on operation time and the amount of blood loss. Conclusions Minimal skin wound abdominal myomectomy is safe and effective for use in many patients, because only the number of leiomyomas affects the amount of blood loss. No other factor affected operation time. We suggest the possibility that the expanded use of minimal skin wound abdominal myomectomy may reduce the number of patients waiting for long periods to undergo laparoscopic surgery and may optimize the use of medical resources in rural areas.

【 授权许可】

Unknown