title: The surgical outcome of intracapsular cesarean myomectomy. A match control study.
abstract: Authors evaluated the outcome of intracapsular cesarean myomectomy by a prospective case-control study on 68 patients who underwent intracapsular cesarean myomectomy, compared with a control group of 72 patients with myomatosic pregnant uterus who underwent cesarean section (CS) without myomectomy. Mostly of removed myomas were subserous or intramural, fundal in 37 women (54.4%), corporal in 22 (32.3%) and peri-low uterine segment in 9 women (18.7%). The average myoma' size was 8 cm (1.5-20), in 40 women, with 8 myomas measuring 4-6 cm, 14 myomas between 10 and 12 cm and >13 cm in 6 patients. Difference in blood tests and surgical outcome in intracapsular cesarean myomectomy was non significant (p > 0.05). The average duration of hospitalization of intracapsular cesarean myomectomies was 5 days. There was no correlation between complications or duration of hospital stay and patient age, gravidity, parity or indication for CS. The intracapsular cesarean myomectomy could be a reliable, feasible and safe obstetric procedure. Meticulous attention to gentle hemostasis, sharp pseudocapsule dissection, adequate approximation of the myometrium edges and all dead spaces to prevent hematoma formation, can further increase the safety of the procedure, without significant complications by experienced obstetricians.
authors.affiliation: Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Department of Obstetric and Gynecology Vito Fazzi Hospital , Lecce , Italy .
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
authors.forename: Ospan A
authors.initials: OA
authors.lastname: Mynbaev
authors.forename: Antonio
authors.initials: A
authors.lastname: Barbera
authors.forename: Emanuele
authors.initials: E
authors.lastname: Perrone
authors.forename: Marcello
authors.initials: M
authors.lastname: Guido
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kosmas
authors.forename: Michael
authors.initials: M
authors.lastname: Stark
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D011247:Pregnancy; D011446:Prospective Studies; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery