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KMID : 0358420120550030172
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Korean Journal of Obstetrics and Gynecology
2012 Volume.55 No. 3 p.172 ~ p.179
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LAPAROSCOPIC MYOMECTOMY: PRESURGICAL CLASSIFICATION TO EVALUATE THE VALIDITY OF LAPAROSCOPIC SURGICAL TREATMENT
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Cho Hyun-Hee
Chung Youn-Jee
Kim Mee-Ran
Kim Jang-Heub
Kim Min-Jung
Jung In-Cheul
Lew Young-Ok
Kim Eun-Jung
Cheon Keun-Young
Lim Young-Taik
Kwon Dong-Jin
Song Jae-Yeon
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Abstract
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Objective: To evaluate if the preoperative scoring system effect the post operative prognosis and type of operation.
Methods: Patients who took myomectomy in Seoul St. Mary’s Hospital were enrolled this study. Retrospective analysis of preoperative leiomyoma scroings with imaging study were done. Prognostic factors were as follows: hospital days, bleeding amount, transfusion rate, operation time. Catholic Medical Center fi broid score system (CMFS) was used for analysis of fi broid.
Results: Patients were grouped into three as CMFS total score. Group I: scores<11, group II: 11?20, group III: 20<. Bleeding amount was 106.0mL in group I, 132.3 mL in group II and 135.6 mL in group III. The bleeding amount and
transfusion rate were signifi cantly low in group I (P <0.05). Total score of CMFS had signifi cant effect to type of operation (odds ratio, 1.339; 95% confi dence interval, 1.237 to 1.449, P <0.0001; area under curve, 0.810) and accuracy was 76.6%. Topographic score and size score effect signifi cantly to bleeding amount and operation time Topography score coefficient of determination (CD, 0.90, 0.82, P <0.01; size score CD, 1, 0.98, P <0.01). Repair score showed significant correlation with operation time, but showed no correlation with bleeding amount and operation time. Topographic score, size score, repair score showed signifi cant effect on type of operation (P <0.01).
Conslusion: Systematic scoring systems like CMFS help to predict the diffi culties and bleeding complications after myomectomy. Further study about preoperative the prognostic factors and accurate presurgical scoring system were helpful for the decision of type of operation.
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KEYWORD
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Myomectomy, Prognosis, Scoring
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