Second look after laparoscopic myomectomy.
The goal of this study was to assess the risk of adhesions after laparoscopic myomectomy. To this end our enquiry was based on observations with a prospective collection of data. Between October 26, 1990 and October 1, 1996, 45 patients underwent a second look after laparoscopic myomectomy. Seventy-two myomectomy sites were checked. The overall rate of postoperative adhesion was 35.6% per patient. The rate of adhesions per myomectomy site was 16.7%. The factors which influenced the occurrence of an adhesion on the myomectomy site were posterior location of the myoma and the existence of sutures. The rate of adhesions on the adnexa after laparoscopic myomectomy was 24.4%. The factors which influenced the occurrence of adnexal adhesions were another surgical procedure carried out at the same time, the existence of adhesions prior to the operation and posterior location of the myoma. The rate of adhesions after laparoscopic myomectomy is low and the adhesions rarely involved the adnexa. We recommend that a second-look laparoscopy be carried out systematically after laparoscopic myomectomy in patients desiring pregnancy.
Service de Chirurgie Gynécologique, Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, Paris, France.
J B
JB
Dubuisson
A
A
Fauconnier
C
C
Chapron
G
G
Kreiker
C
C
Nörgaard
D000291:Adnexal Diseases / Q000209:etiology; D000328:Adult; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D000267:Tissue Adhesions / Q000209:etiology; D014594:Uterine Neoplasms / Q000601:surgery*