Laparoscopic uterine artery occlusion combined with myomectomy for uterine myomas.
We sought to evaluate the clinical feasibility and mid- to long-term effects of laparoscopic uterine artery occlusion before myomectomy in the treatment of uterine myomas. A total of 566 patients with uterine myoma were treated by laparoscopic uterine artery occlusion before myomectomy from October 2001 through July 2007. Mean blood loss was 88.2 +/- 52.7 mL (95% CI 82.7-93.8). The highest postoperative temperature was 37.8 +/- 0.3 degrees C, and the postoperative morbidity was 5.7% (32/566). Number of days to the return of bowel movement was 1.9 +/- 0.5d and in hospital stay after surgery was 7.7 +/- 2.5d. Complications included 2 instances of subcutaneous emphysema, 1 of vaginal bleeding, and 3 of mild intestinal obstruction. At a median of 26.3 months (range 6-69 months) of follow-up, the rate of myoma recurrence was 3.0% (15/517), uterus volume reduction was 48.9%, and correction of menstruation abnormality was 97.1% (502/517). Laparoscopic uterine artery occlusion before myomectomy can expand myomectomy indications with better results.
Cheng
Zhongping
Z
Department of Obstetrics and Gynecology, Yang-Pu Center Hospital, Shanghai, China. mdcheng18@263.net
Yang
Weihong
W
Dai
Hong
H
Hu
Liping
L
Qu
Xiaoyan
X
Kang
Le
L
D000328:Adult; D001158:Arteries / Q000601:surgery; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods*; D018231:Leiomyomatosis / Q000098:blood supply / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000098:blood supply / Q000601:surgery* / Q000628:therapy; D014599:Uterus / Q000098:blood supply