Author(s): Fambrini M, Penna C, Pieralli A, Andersson KL, Zambelli V,
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Abstract BACKGROUND: To evaluate feasibility and clinical outcomes of myomectomy performed through minilaparotomic access in a large series of consecutive patients. METHODS: All patients submitted to laparotomic conservative surgery for uterine myomas through an initial minilaparotomic approach (4-8-cm transverse skin incision) were retrospectively evaluated. Preoperative findings, surgical technique, rate of laparotomic enlargement, operative time, surgical complications and length of recovery were the main analyzed outcomes. RESULTS: One hundred and seventy out of 212 patients experienced minilaparotomic approach for uterine myomatosis. In 97 (57.1\%) multiple myomas were present (maximum, 23). The size of the largest myoma ranged from 2 to 19 cm (median 5.6). In 161 (94.7\%) patients myomectomy was ended through minilaparotomic access with a mean length of skin incision of 6.2 cm (4-7.8). The correlation between severe obesity and laparotomic enlargement was statistically significant (p<0.05). The mean operative time was 57 min (32-118). One bladder intraoperative injury was successfully managed through minilaparotomic incision. Bowel or vascular complications never occurred. Estimated blood loss was not significant except in three cases (1.9\%) requiring transfusion. Febrile complications were observed in nine patients (5.6\%). The median postoperative stay in uncomplicated patients was 2.5 days (2-4). CONCLUSIONS: Our report supports the wide application of minilaparotomic myomectomy and suggests that more than 85\% of women with fit uterine myomatosis could be successfully managed in this way with a failure rate of 5.3\% in eligible patients. The main criteria of minimal invasive surgery seem to be by minilaparotomic myomectomy, which should be considered a valid option for uterine myohas conservative treatment.
This article was published in Acta Obstet Gynecol Scand
and referenced in Journal of Addiction Research & Therapy