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单发性子宫前壁及子宫下段肌瘤患者行剖宫产子宫肌瘤切除术的安全性

Safety of cesarean myomectomy in women with single anterior wall and lower uterine segment myomas.

作者信息

Sparić Radmila, Malvasi Antonio, Kadija Saša, Stefanović Aleksandar, Radjenović Svetlana Spremović, Popović Jela, Pavić Aleksandra, Tinelli Andrea

机构信息

a Clinic of Gynecology and Obstetrics , Clinical Center of Serbia , Belgrade , Serbia.

b School of Medicine , University of Belgrade , Belgrade , Serbia.

出版信息

J Matern Fetal Neonatal Med. 2018 Aug;31(15):1972-1975. doi: 10.1080/14767058.2017.1333096. Epub 2017 Jun 6.

Abstract

OBJECTIVE

Cesarean myomectomy (CM) is a safe procedure in selected cases. Nevertheless, literature lacks clear guidelines on patient selection. We aimed to evaluate CM safety in patients with single anterior wall and lower uterine segment (LUS) myomas.

METHODS

The authors selected pregnants at term, scheduled for CSs, with single anterior wall or LUS myomas. All their clinical, demographic, obstetric, and surgical parameters were recorded.

RESULTS

Thirty-six women had a CM (study group), and 17 had a CS without myoma removal (control group). No significant differences were detected in the socio-demographic and clinical findings between the groups. The average size of myomas in the study and control group (p = .873), was 55.44 mm and 47.25 mm, respectively. The average surgery duration was 62.5 min in the study and 53.82 in the control group (p = .058). Intraoperative hemorrhage was more frequent in the study group (p = .045). Nevertheless, neither the number nor the volume of intraoperative transfusions was significantly different. None of the major CM complications were recorded, and the duration of hospitalization was similar in both groups.

CONCLUSIONS

CM in patients with single anterior wall and LUS myomas does not cause increased perioperative morbidity, and, therefore, can be considered safe in such cases.

摘要

目的

剖宫产子宫肌瘤切除术(CM)在特定病例中是一种安全的手术。然而,文献中缺乏关于患者选择的明确指南。我们旨在评估单发性前壁和子宫下段(LUS)肌瘤患者行CM的安全性。

方法

作者选择足月妊娠且计划行剖宫产、患有单发性前壁或LUS肌瘤的孕妇。记录她们所有的临床、人口统计学、产科和手术参数。

结果

36名女性接受了CM(研究组),17名女性接受了未切除肌瘤的剖宫产(对照组)。两组间社会人口统计学和临床结果未检测到显著差异。研究组和对照组肌瘤的平均大小分别为55.44mm和47.25mm(p = 0.873)。研究组平均手术时间为62.5分钟,对照组为53.82分钟(p = 0.058)。研究组术中出血更频繁(p = 0.045)。然而,术中输血的次数和输血量均无显著差异。未记录到CM的主要并发症,两组住院时间相似。

结论

单发性前壁和LUS肌瘤患者行CM不会导致围手术期发病率增加,因此,在这种情况下可认为是安全的。

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