Laparoscopic Versus Abdominal Myomectomy Postoperative Outcomes
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Tarih
2014
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Miyomlar üreme çağındaki kadınların % 25-50'sini etkileyen benign uterin tümörlerdir. Miyomektomi fertilitesinin korunmasını talep eden kadınlar için halen altın standart tedavi yöntemidir. Ameliyat sonrası parametreleri ve operasyon süresini değerlendirmek için laparoskopik ve abdominal miyomektomi yapılan hastalarda gözlemsel bir çalışma planladık. GEREÇ VE YÖNTEM: Makalemizde Şubat 2011 ile Şubat 2013 tarihleri arasında opere edilen hastaların verilerini değerlendirdik. Çalışmaya dahil edilen hastalar yaş, kilo, boy, vücut kitle endeksi (VKE), miyomların sayısı ve operasyon süresi açısından karşılaştırıldı. Ek olarak ameliyat öncesi ve sonrası hemoglobin ve hematokrit değerleri ve hastanede kalış süreleri kaydedildi. BULGULAR: Yirmi iki hastaya laparoskopi uygulanırken, 15 hastaya laparotomi yapıldı. Ortalama yaş laparoskopi grubunda 40,1±9,1 iken, laparotomi grubunda 38,5±6,7 idi (p=0,513). Ortalama VKE laparoskopi grubunda 26,1±4,1 iken, laparotomi grubunda 27,9±5'di (p=0,281). Miyom sayıları iki grupta da benzerdi (p=0.232). Operasyon süresi laparoskopi grubunda daha uzundu (148,33±66,26 dakika ve 102,75±42,37 dakika)(p=0.013). Preoperatif ve postoperatif hemoglobin ve hema tokrit seviyeleri iki grupta benzerdi (Hemoglobin ppre= 0,680, ppost= 0,499, Hematokrit ppre=0,946, ppost= 0,499). Ameliyat öncesi ve sonrası hemoglobin ve hematokrit değerleri arasında iki grupta da fark yoktu (p=0,782 ve 0,717). Lapa - ros kopi grubu için hastanede yatış süresi ortanca değeri 2,5 gün (2-8) iken, laparotomi grubunda 3 gün (2-6)'dü (p=0,008). SONUÇ: Çalışmamız, laparoskopinin daha uzun bir ameliyat süresi ama daha kısa bir hastanede yatış süresi gerektirdiğini göstermiştir. Operasyon süresinin uzamasında morselasyon sırasında kaybedilen zamanın önemli olduğunu düşünüyoruz. Hematolojik parametrelerde değişim gözlenmeyişi de zaman kaybının morselasyon sırasında olduğu düşüncesini desteklemektedir. Seçilmiş hasta gruplarında, laparoskopik miyomektomi, laparotomiye göre kısa hospitalizasyon süresi gibi belirgin avantajlar sağlamaktadır.
OBJECTIVE: Myomas are benign uterine tumors affecting 25-70% of reproductive-aged women. Myomectomy remains the gold-standard for women who request preservation of fertility. We performed an observational investigation of a series of patients scheduled for laparoscopic or abdominal myomectomy to evaluate post-surgical parameters, operation duration, after laparoscopic and abdominal myomectomy. STUDY DESIGN: The manuscript involved data from women who were operated between February 2011 and February 2013. Patients enrolled into the study were compared according to the age, body weight, height, body mass indexes (BMI), the number of the myomas, and operation time. Additionally, pre and postoperative hemoglobin and hematocrit levels and the length of hospital stay were noted. RESULTS: Twenty-two patients underwent laparoscopy and 15 patients underwent laparotomy. Mean age was 40.1±9.1 in laparoscopy group and 38.5±6.7 in laparotomy group(p=0.513). Mean BMI was 26.1±4.1 in laparoscopy group and 27.9±5 in laparotomy group (p=0.281). Myoma numbers were similar in both groups (p=0.232). Operation duration was longer in laparoscopy group(148.33±66.26) compared to laparotomy group (102.75±42.37) (p=0.013). Preoperative and postoperative hemoglobin and hematocrit levels were similar in both groups (Hemoglobin ppre=0.680, ppost=0.499; Hematocrit ppre=0.946, ppost=0.499). The pre and post-operative hemoglobin and hematocrit levels were comparable (p=0.782 and 0.717). The median value of hospitalization duration for laparoscopy group was 2.5 days(2-8) and for laparotomy group it was 3 days (2-6) (p=0,008). CONCLUSION: Our study demonstrated laparoscopic approach needed significantly longer operative time but shorter hospitalization. We think that the time loss during the morcellation is important in the prolongation of the operation. Not observing any differences in variations of hematologic parameters supports the idea that the time is lost during the morcellation. In selected group of patients, laparoscopic myomectomy is an attractive alternative to laparotomic myomectomy, providing clear advantages such as shorter hospitalization duration.
OBJECTIVE: Myomas are benign uterine tumors affecting 25-70% of reproductive-aged women. Myomectomy remains the gold-standard for women who request preservation of fertility. We performed an observational investigation of a series of patients scheduled for laparoscopic or abdominal myomectomy to evaluate post-surgical parameters, operation duration, after laparoscopic and abdominal myomectomy. STUDY DESIGN: The manuscript involved data from women who were operated between February 2011 and February 2013. Patients enrolled into the study were compared according to the age, body weight, height, body mass indexes (BMI), the number of the myomas, and operation time. Additionally, pre and postoperative hemoglobin and hematocrit levels and the length of hospital stay were noted. RESULTS: Twenty-two patients underwent laparoscopy and 15 patients underwent laparotomy. Mean age was 40.1±9.1 in laparoscopy group and 38.5±6.7 in laparotomy group(p=0.513). Mean BMI was 26.1±4.1 in laparoscopy group and 27.9±5 in laparotomy group (p=0.281). Myoma numbers were similar in both groups (p=0.232). Operation duration was longer in laparoscopy group(148.33±66.26) compared to laparotomy group (102.75±42.37) (p=0.013). Preoperative and postoperative hemoglobin and hematocrit levels were similar in both groups (Hemoglobin ppre=0.680, ppost=0.499; Hematocrit ppre=0.946, ppost=0.499). The pre and post-operative hemoglobin and hematocrit levels were comparable (p=0.782 and 0.717). The median value of hospitalization duration for laparoscopy group was 2.5 days(2-8) and for laparotomy group it was 3 days (2-6) (p=0,008). CONCLUSION: Our study demonstrated laparoscopic approach needed significantly longer operative time but shorter hospitalization. We think that the time loss during the morcellation is important in the prolongation of the operation. Not observing any differences in variations of hematologic parameters supports the idea that the time is lost during the morcellation. In selected group of patients, laparoscopic myomectomy is an attractive alternative to laparotomic myomectomy, providing clear advantages such as shorter hospitalization duration.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum
Kaynak
GORM:Gynecology Obstetrics & Reproductive Medicine
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
1
