LaMorte A I, Lalwani S, Diamond M P
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Obstet Gynecol. 1993 Dec;82(6):897-900.
To review the recent experience at Yale-New Haven Hospital with abdominal myomectomy and to assess morbidity associated with the procedure.
The hospital records of 128 women who underwent abdominal myomectomies during a 39-month period were reviewed retrospectively. Particular attention was given to blood transfusion requirement and the febrile morbidity rate.
The average (+/- standard error of the mean) intraoperative estimated blood loss was 342 +/- 37 mL. Five cases (4%) had an estimated blood loss greater than 1000 mL. Intraoperative or postoperative transfusion occurred in 26 cases (20%); 70% of the transfused patients received autologous blood only. The operation was converted intraoperatively to a hysterectomy in one case. There were no other intraoperative complications. Febrile morbidity occurred in 15 patients (12%). Three women (2%) experienced postoperative complications including paralytic ileus, wound infection, and deep venous thrombosis.
Febrile morbidity and blood transfusions associated with abdominal myomectomy appear to occur at an acceptably low rate, especially when unnecessary blood transfusions are excluded. These findings should modify the way patients are counseled before abdominal myomectomy.
回顾耶鲁 - 纽黑文医院近期行腹部子宫肌瘤切除术的经验，并评估该手术相关的发病率。
回顾性分析128例在39个月期间接受腹部子宫肌瘤切除术的女性患者的医院记录。特别关注输血需求和发热发病率。
术中估计平均失血量（±平均标准误差）为342±37 mL。5例（4%）估计失血量超过1000 mL。26例（20%）发生术中或术后输血；70%的输血患者仅接受自体血。1例手术中转为子宫切除术。无其他术中并发症。15例（12%）出现发热发病率。3名女性（2%）经历术后并发症，包括麻痹性肠梗阻、伤口感染和深静脉血栓形成。
腹部子宫肌瘤切除术相关的发热发病率和输血发生率似乎处于可接受的低水平，尤其是排除不必要的输血时。这些发现应改变腹部子宫肌瘤切除术术前对患者的咨询方式。
