Watrowski Rafał, Jäger Christoph, Forster Johannes
Department of Gynecology and Obstetrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Freiburg, Germany.
Department of Pediatrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Freiburg, Germany.
Wideochir Inne Tech Maloinwazyjne. 2017;12(1):81-87. doi: 10.5114/wiitm.2017.66515. Epub 2017 Mar 13.
Laparoscopic myomectomy (LM) can be associated with significant bleeding.
To identify factors influencing the postoperative hemoglobin (Hb) drop after LM.
This is a retrospective, single-center study. We evaluated data of 150 consecutive patients undergoing LM due to intramural myomas between 2010 and 2015.
The median age of the patients was 37 (23-53) years. The mean diameter of the largest myoma was 5.7 ±2.3 (1.5-12) cm. The mean surgical time was 83 ±38 (35-299) min. The median number of sutures was 3 (1-11). The mean postoperative Hb drop was 1.6 ±1.2 (0-6) g/dl, and the mean estimated blood loss was 261 ±159 (50-1700) ml. In the univariate analysis, the postoperative Hb drop correlated with the duration of surgery (p < 0.001), diameter of the largest myoma (p < 0.001), cumulative myoma weight (p < 0.001), and number of sutures (p < 0.001), but not with patients' age or number of intramural myomas. In the multivariable analysis, the surgical time ( = 0.395, p < 0.001), diameter of the largest myoma ( = 0.292, p = 0.03) and preoperative Hb concentration ( = 0.299, p < 0.001) predicted the postoperative Hb change.
Surgical time and dominant myoma diameter are independent predictors of the postoperative Hb drop after LM.
腹腔镜子宫肌瘤切除术（LM）可能会导致大量出血。
确定影响LM术后血红蛋白（Hb）下降的因素。
这是一项回顾性单中心研究。我们评估了2010年至2015年间150例因壁间肌瘤接受LM的连续患者的数据。
患者的中位年龄为37（23 - 53）岁。最大肌瘤的平均直径为5.7±2.3（1.5 - 12）厘米。平均手术时间为83±38（35 - 299）分钟。缝线的中位数为3（1 - 11）。术后Hb平均下降1.6±1.2（0 - 6）克/分升，平均估计失血量为261±159（50 - 1700）毫升。在单因素分析中，术后Hb下降与手术时间（p < 0.001）、最大肌瘤直径（p < 0.001）、肌瘤累积重量（p < 0.001）和缝线数量（p < 0.001）相关，但与患者年龄或壁间肌瘤数量无关。在多变量分析中，手术时间（β = 0.395，p < 0.001）、最大肌瘤直径（β = 0.292，p = 0.03）和术前Hb浓度（β = 0.299，p < 0.001）可预测术后Hb变化。
手术时间和主要肌瘤直径是LM术后Hb下降的独立预测因素。
