Strategy of cervical myomectomy under laparoscopy.
OBJECTIVE
To evaluate a strategy of laparoscopic excision of a cervical myoma (CM).


METHODS
Prospective study.


METHODS
University-affiliated hospital.


METHODS
Twenty-eight patients with CM underwent laparoscopic myomectomy. These cases were classified into five types according to the location: [1] anterior cervical myoma (ACM); [2] posterior cervical myoma (PCM); [3] central cervical myoma (CCM); [4] lateral cervical myoma [LCM]; and [5] deep-rooted cervical myoma (DCM).


METHODS
After preoperative assessment, patients underwent laparoscopic myomectomy. Ligation of the uterine artery and diluted vasopressin injection were performed to decrease bleeding during laparoscopy.


METHODS
Myoma numbers, myoma weight, operative time, estimated blood loss, hospital stay, complication rate.


RESULTS
Most of the lesions were ACM (43%) and PCM (32%). The mean operative time was 121 minutes, mean blood loss was 99 mL, and mean myoma weight was 287 g. The mean hospital stay was 2.2 days. There were no complications. Histopathologic examination showed that all lesions were leiomyoma. Hypermenorrhea, dysmenorrhea, and symptoms of compression improved after the operation. Two infertile patients conceived spontaneously at 1 and 7 months postoperatively, and successfully delivered infants by cesarean section at term.


CONCLUSIONS
Surgical treatment of CM is empirically difficult. It is important that the approach be changed according to the location and size of the myoma.
Chang
Wen-Chun
WC
Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chen
Szu-yu
SY
Huang
Su-Cheng
SC
Chang
Daw-Yuan
DY
Chou
Li-Yun
LY
Sheu
Bor-Ching
BC
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D007889:Leiomyoma / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D055815:Young Adult