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KMID : 0386020010130020115
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Korean Journal of Gynecology Endoscopy and Minimally Invasive Surgery
2001 Volume.13 No. 2 p.115 ~ p.120
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The Report on Safety and Efficacy of Laparoscopically Assisted Myomectomy
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심성신/Sung Shin Shim
송현정/유은희/Hyun Jung Song/Eun Hee Yoo
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Abstract
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Objective: This study was undertaken to assess the efficacy and safety of combined operative laparoscopy and minilaprotomy technique to remove myoma. Material and Methods: Retrospectively we evaluated the records of 39 women who
underwent
laparoscopically assisted myomectomy between February 1994 and January 2001. This procedure was done in the cases of less than 8-9㎝ size, less than 3 in number by one operator. Laparoscopically assisted myomectomy involved laparoscopic
dissection
of
the myoma from the uterus followed by extraction of the myoma specimen and repairing the uterine defect through a minilaparotomy incison. Results: These patients werer mean 36.5 years old, desiring preservation of uterus or fertility.
Their
mean
gravities and parties were 1.9 and 0.8, respectively. The indicatinos of the procedure were rapidly growing myoma(16/39), pressure symptom(13/39), abnormal uterine bleeding or menorrhagia(8/39) and infertility(2/39). The weight of the leiomyoma
ranged
from 50gm to 225gm (mean 114gm). The complication rate was 13%(5/39). During the operation, 2 cases of transfusion were done due to severe bleeding. Postoperatively, 1 case of paralytic ileus and 1 case of febrile morbidity and 1 case of wound
infection
occured. The postoperative hospital stay ranged from 2 to 8 days(mean 3.4 days). Most women resumed normal activity within 3 weeks. In these patients, the overall recurrence rate was 17.9%(7/39). The median duration of follow up was 23 months(11
to
35
months). Eight pregnancies occurred in 14 patients who desire childbearing who became following surgery, then the pregnancy rate was 57%. Conclusion: We found laparoscopically assisted myomectomy to be a safe alternative to myomectomy by
laparotomy. It is technically less difficult and possible meticulous suturing of myometrium than lapaorscopic myomectomy.
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KEYWORD
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