The surgical outcome of intracapsular cesarean myomectomy. A match control study

Authors evaluated the outcome of intracapsular cesarean myomectomy by a prospective case-control study on 68 patients who underwent intracapsular cesarean myomectomy, compared with a control group of 72 patients with myomatosic pregnant uterus who underwent cesarean section (CS) without myomectomy. Mostly of removed myomas were subserous or intramural, fundal in 37 women (54.4%), corporal in 22 (32.3%) and peri-low uterine segment in 9 women (18.7%). The average myoma' size was 8cm (1.5-20), in 40 women, with 8 myomas measuring 4-6cm, 14 myomas between 10 and 12cm and >13cm in 6 patients. Difference in blood tests and surgical outcome in intracapsular cesarean myomectomy was non significant (p>0.05). The average duration of hospitalization of intracapsular cesarean myomectomies was 5 days. There was no correlation between complications or duration of hospital stay and patient age, gravidity, parity or indication for CS. The intracapsular cesarean myomectomy could be a reliable, feasible and safe obstetric procedure. Meticulous attention to gentle hemostasis, sharp pseudocapsule dissection, adequate approximation of the myometrium edges and all dead spaces to prevent hematoma formation, can further increase the safety of the procedure, without significant complications by experienced obstetricians. © 2014 Informa UK Ltd.

Tinelli A.1 , Malvasi A.2 , Mynbaev O.A. 3, 10 , Barbera A.4, 5 , Perrone E.6 , Guido M.7 , Kosmas I.8 , Stark M.9
Taylor and Francis Ltd
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  • 1 Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Department of Obstetric, Gynecology Vito Fazzi Hospital, Lecce, Italy
  • 2 Department of Gynecology and Obstetric, Santa Maria Hospital, Bari, Italy
  • 3 Experimental Researches and Modeling Division, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
  • 4 School of Medicine, University of Colorado Denver, Aurora, CO, United States
  • 5 Department of Obstetrics and Gynecology, Swan Mountain Women's Center, Breckenridge, CO, United States
  • 6 Faculty of Medicine, University of Perugia, Department of Obstetrics and Gynecology, Perugia, Italy
  • 7 Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Salento, Lecce, Italy
  • 8 Department of Obstetrics and Gynecology, University of Ioannina, Greece
  • 9 New European Surgical Academy, Berlin, Germany
  • 10 Department of ObGyn and Reproductive Medicine, Peoples' Friendship University of Russia, Moscow, Russian Federation
Ключевые слова
Cesarean myomectomy; Cesarean section; Labor; Pregnancy; Uterine fibroids
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