Celal Kadı, Hülya Cıçek
Obstetrics and Gynecology Clinic, Alanya State Hospital, Antalya, Turkey.
Niger Med J. 2011 Jul;52(3):186-8. doi: 10.4103/0300-1652.86135.
We evaluated the data of patients who had applied myomectomy during cesarean section operation in our clinic between April, 2008 and December, 2010.
I0 n this period, 3689 cesarean sections were done in our clinic, we analyzed their data retrospectively and determined 27 myomectomy cases during cesarean section operation. The age of the patients, the numbers of pregnancy, parities, the rates of abortus, indications of cesarean, pregnancy weeks, residential areas of myoms detected during the cesarean and their size, were recorded. Furthermore, pre-operative and post-operative hemoglobin (Hb) values, differences between hemoglobin values, whether there was bleeding or not, the need of blood transfusion if it occurred, the duration of operation and hospitaization and the pathological diagnoses of myomectomy materials, were examined.
Retrospective study of myomectomies.
The mean age of patients was 29.6±5.9 (19-42) and mean gestational age was 39.2±1.0(37-42) weeks. The mean size of the fibroids was 5.94±6.29 cm(3) (0.96-26.50 cm3). Subserous myoms were the most frequently seen ones (24 of 27 patients=89%) with fundal, corporal localizations in most of the instances. T0 he pre-operative and post-operative values of Hb were 11.8±1.52 (8.6-10.5) and 10.3±2.6 (6.9-13.3) g/dl respectively and the difference was statistically significant (P<0.001). Blood transfusion was not necessary in any patient. The mean duration of the operation was found to be 40.7±13.9 (13-60) minutes.
Myomectomies can be performed safely during cesarean section by experienced obstetricians and gynecologists, and myomectomy performed for fibroids in appropriate localizations does not increase post-operative bleeding or maternal morbidity or mortality.
我们评估了2008年4月至2010年12月期间在我们诊所进行剖宫产手术时同时行子宫肌瘤切除术的患者数据。
在此期间，我们诊所共进行了3689例剖宫产手术，我们对其数据进行回顾性分析，确定了27例剖宫产手术时行子宫肌瘤切除术的病例。记录患者年龄、妊娠次数、产次、流产率、剖宫产指征、孕周、剖宫产时发现肌瘤的部位及其大小。此外，还检查了术前和术后血红蛋白（Hb）值、血红蛋白值差异、是否有出血、如有出血是否需要输血、手术时间和住院时间以及子宫肌瘤切除标本的病理诊断。
对子宫肌瘤切除术进行回顾性研究。
患者平均年龄为29.6±5.9（19 - 42）岁，平均孕周为39.2±1.0（37 - 42）周。肌瘤平均大小为5.94±6.29 cm³（0.96 - 26.50 cm³）。浆膜下肌瘤最为常见（27例患者中有24例 = 89%），大多数位于子宫底部和体部。术前和术后Hb值分别为11.8±1.52（8.6 - 10.5）g/dl和10.3±2.6（6.9 - 13.3）g/dl，差异有统计学意义（P<0.001）。所有患者均无需输血。手术平均时长为40.7±13.9（13 - 60）分钟。
经验丰富的妇产科医生在剖宫产时可安全地进行子宫肌瘤切除术，对位于合适部位的肌瘤进行切除不会增加术后出血或产妇发病率及死亡率。
