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Theory and Practice in Medicine, 2015 Vol. 21 No. 4.3


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CHARACTERISTICS OF MEDIUM AND BIG SIZE LAPAROSCOPIC MYOMECTOMY. IMPORTANCE OF LOCALIZATION

Amelija Melech, Tomas Lūža, Gediminas Mečėjus


Correspondence Address: gediminas.mecejus@gmail.com

Key words: laparoscopy, myomectomy, size, localization.
Objective. To evaluate the influence of laparascopically removed myomas size and localization on operation course and complications.
Materials and methods: Study was held with patiens who had undergone laparascopic myomectomy in 2014 year. Patients were divided in two groups according to the diameter of removed myomas: medium (<8 cm) and big size myoma (>8 cm). To evaluate influence of localization and perioperative complications rate, patients were divided into two groups according to the localization: myoma excreting the anterior or posterior wall. We evaluated and analyzed demographic data, complaints, intraoperative findings, surgery and hospitalization time, intraoperative and postoperative complications. The data were processed using MS Excel ir MedCalc v 15.2.2. The difference was considered statistically significant at p < 0.05.

Results. Totally 96 cases of uterine myoma removal were analyzed. The average duration of the operation was: in medium size group – 71.5 ± 41.7 min. and in big size group – 73.6 ± 36.7 min., p > 0.05. Bleeding occurred in medium size group in 3 cases (5.6 %) and in big size group in 7 cases (16.7 %). Blood transfusion was performed in medium size group in 1 (33.3 %) and in big size group in 3 (42.9 %) cases. The average blood loss was similar between groups. The size and weight of myomas analyzed according to the localization of myoma were similar. Operation time in anterior wall group was 63.5 ± 24.5 min. and in posterior wall group 76.8 ± 46.0 min., p > 0.05. Bleeding occurred in anterior wall in 3 (9.7 %) and in posterior wall group in 4 (9.8 %) of cases. Blood loss in anterior wall was 81,3 ± 114,7 ml and in posterior wall group 95,1 ± 167,6 ml, p > 0.05. Blood transfusion was performed in anterior wall group in 1 (33.3 %) case.
Conclusions: The size and localization of myoma significantly does not increase the rate of complications and time of hospitalization. There were no critical blood loss observed nor conversion to laparotomy was needed. In cases of huge myomas are appropriate to prepare for active monitoring of a patient or possible blood transfusion.



DOI: 10.15591/mtp.2015.134
Submited: October 5, 2015.
Accepted: October 26, 2015.
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