Predicting success of single step hysteroscopic myomectomy: A single centre large cohort study of single myomas

INTERNATIONAL JOURNAL OF SURGERY

卷:22

Article

Mazzon, Ivan¹  Favilli, Alessandro²  Grasso, Mario¹  Horvath, Stefano¹  Bini, Vittorio²  Di Renzo, Gian Carlo²  Gerli, Sandro² 

[1] Clin Nuova Villa Claudia, Arbor Vitae Ctr, I-00191 Rome, Italy

[2] Univ Perugia, SM Della Misericordia Hosp, Dept Obstet & Gynecol, I-06156 Perugia, Italy

关键词: Hysteroscopic myomectomy;    Myomas;    Cold loop;    One-step procedure;    Feasibility;   

DOI  :  10.1016/j.ijsu.2015.07.714

来源: Elsevier

【 摘 要 】

Introduction: Submucous myomas represent one of the main indications of operative hysteroscopy. Hysteroscopic resection of submucous fibroids should be a simple, well-tolerated and effective procedure and ideally accomplished in in only one surgical step. Methods: Retrospective cohort single Centre study of 1244 women undergoing hysteroscopic myomectomy. Data analysis included patients' and the myomas characteristics. A multiple logistic regression was carried out in order to assess which variables were able to determine a multiple step procedure. Results: 1090 myomas (87.62%) were completely resected in a single-step procedure (SS group) whereas a multiple-step procedure (MS group) was needed for the removal of 154 fibroids (12.38%). The mean size of myomas resected in the SS group was 22.83 +/- 9.36 mm whereas fibroids of the MS group measured 29.67 +/- 10.76 mm. The overall feasibility of hysteroscopic myomectomy in one surgical procedure was 88.28%. All hysteroscopic myomectomies of G0 fibroids were completed in a single step. The chance of success to accomplish the treatment in a single-step for G1 and G2 myomas were 88.59% and 82.55%, respectively. The multivariate analysis revealed an inverse correlation between age and multiple step procedures and size of myomas were all directly correlated to multiple step procedures. Conclusion: The grading, the size of the myomas and the age of patients play a crucial role in completing the hysteroscopic myomectomy in a single step. Only the diameter greater than 3 cm in G2 myomas is correlated to a higher risk of a multiple procedure. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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