剖宫产子宫肌瘤切除术：来自三级护理教学医院的经验。
Cesarean Myomectomy: An Experience from a Tertiary Care Teaching Hospital.
作者信息
Ramya T, Sabnis Shraddha S, Chitra T V, Panicker Seetha
机构信息
Department of Obstetrics and Gynaecology, PSG Institute of Medical Sciences and Research (PSGIMSR), Coimbatore, Tamil Nadu 641004 India.
出版信息
J Obstet Gynaecol India. 2019 Oct;69(5):426-430. doi: 10.1007/s13224-019-01239-x. Epub 2019 Jun 3.
BACKGROUND
Recent literature supports the removal of myomas during cesarean section, which traditionally was considered a relative contraindication, given a higher complication rate. This study is to share our experience of cesarean myomectomy in the last decade.
METHODS
This study is a retrospective review of our prospectively maintained database, from January 2008 to December 2017, at a tertiary care level teaching institution. All patients who underwent myomectomy during cesarean section were included. There were no exclusions.
RESULTS
A total of twenty patients underwent myoma removal along with the cesarean operation during this period with a mean age of 30 years. Majority of patients were nulliparous (70%). Common comorbidities were diabetes mellitus (40%) and hypothyroidism (20%). Mean size of myomas were 5.33 cm (± 2.08), and the number varied from one to three. The most common location was the posterior surface of the uterus with the commonest variety being subserous. Most patients were discharged on the fifth postoperative day.
CONCLUSION
This study demonstrates that cesarean myomectomy to be a safe and feasible procedure in experienced hands. It offers the advantage of avoiding a second surgery in selected patients.
背景
近期文献支持在剖宫产时切除肌瘤，传统上鉴于较高的并发症发生率，剖宫产时切除肌瘤被视为相对禁忌证。本研究旨在分享我们在过去十年中进行剖宫产肌瘤切除术的经验。
方法
本研究是对一家三级护理教学机构2008年1月至2017年12月前瞻性维护数据库的回顾性分析。纳入所有在剖宫产时接受肌瘤切除术的患者，无排除标准。
结果
在此期间，共有20例患者在剖宫产手术的同时接受了肌瘤切除术，平均年龄为30岁。大多数患者为未产妇（70%）。常见合并症为糖尿病（40%）和甲状腺功能减退症（20%）。肌瘤平均大小为5.33 cm（±2.08），数量从1个到3个不等。最常见的位置是子宫后表面，最常见的类型是浆膜下肌瘤。大多数患者术后第五天出院。
结论
本研究表明，在经验丰富的医生手中，剖宫产肌瘤切除术是一种安全可行的手术。它为特定患者避免二次手术提供了优势。
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