Successful pregnancy following myomectomy of a giant uterine myoma: role of a combined surgical approach.
OBJECTIVE
There are very few reports in the literature about the conservative surgical approach of large uterine myoma. The individualization of the surgery approach, the technical expertise and skill of the surgeon, the use of modern technologies/facilities could offer the optimal individualized treatment.


METHODS
We performed a conservative combined surgical approach consisting of open laparoscopy myomectomy followed by laparotomy for the treatment of a very large uterine myoma of the anterior uterine wall in a 27-year-old non-pregnant woman with a history of progressive abdominal distension and symptoms related to abdomen pressure and constipation.


RESULTS
The myoma weighted 12.010 kg. The postoperative course was good and 20 months after surgery, the patients had a successful pregnancy with a spontaneous delivery at the 39th week of a healthy baby weighting 3.260 kg.


CONCLUSIONS
In the case reported here, the careful pre-surgical evaluation, the technical expertise and skill of the surgeon, the choice of a combined approach with laparoscopy and open surgery and the use of modern surgical instruments have enabled us to achieve a significant result: the preservation of the anatomical integrity of the uterus and adnexa which allowed a successful natural pregnancy with spontaneous delivery.
Department of Obstetrics and Gynaecology, "Sirai" Hospital, 09013 Carbonia, Italy. a.maccio@tin.it
Antonio
A
Macciò
Clelia
C
Madeddu
Antonio
A
Caffiero
Anna Maria
AM
Paoletti
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D050498:Live Birth; D009214:Myoma / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*