Modern Approach to Myomectomy on the Basis of Ultrastructural Analysis and Ribonucleotide Reductase Determination in Neoplasma and Myometrium
Myomectomy was performed in 950 patients under age 35; laparoscopy and laser was applied in 94 and 134 patients respectively. To evaluate the necessity of subsequent therapy, we studied the myoma nodule ultrastructure by means of pathology, electron microscopy and histochemistry. For the first time we measured enzyme ribonucleotide reductase (RR) in the nodule and surrounding tissues using electron magnetic resonance imaging. The RR quantity, measured in relative units, if increased from the nodule center to its periphery and surrounding tissues, was considered to be a sign of proliferative process. In such cases it seemed advisable to use gestagens or a GnRH analog to prevent recurrence. The results of the investigation demonstrated high effectiveness of laparoscopic and laser techniques in myomectomy, as well as a possible important role of RR in the pathogenesis of myomas and their recurrence.
Kulakov
VI
Department of Operative Gynecology, Scientific Center, for Obstetrics, Gynecology, and Perinatology, Oparin Str. 4, 117815 Moscow, Russia.
Adamyan
LV
Vanin
AF
Kondrikov
NI
Murashko
AV