caa a22 4500 445309237 CHVBK 20180317142623.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00404-010-1622-y doi (NATIONALLICENCE)springer-10.1007/s00404-010-1622-y Perioperative complications in conventional and microsurgical abdominal myomectomy [Elektronische Daten] [Andreas Schüring, Guillermo Garcia-Rocha, Hans-Walter Schlösser, Robert Greb, Ludwig Kiesel, Cordula Schippert] Purpose: It has become evident that laparoscopic myomectomy is limited by size, number and location of fibroids. Myomectomy performed by laparotomy can be technically challenging and the surgical benefits have to be weighed against associated risks and impairing fertile potential, especially in multiple and large fibroids that may be positioned close to the cavity. Our aim was to evaluate the effect of microsurgical myomectomy technique on perioperative morbidity in premenopausal women. Methods: This retrospective study included 228 patients with symptomatic uterine fibroids and/or infertility undergoing myomectomy by laparotomy. As much as 156 patients were treated by standardized microsurgical technique and 72 patients by conventional myomectomy. The following data were recorded and analysed: postoperative haemoglobin, haemoglobin decrease, rate of blood transfusion, and number, size and location of myomas. Results: In 228 patients, seven complications occurred (abdominal wall haematoma, bowel and colon injury, transient ileus). The transfusion rate was 1.3%. Microsurgical technique was associated with a smaller haemoglobin decrease compared to conventional myomectomy (1.77 vs. 2.38g/dl; P=0.007). Microsurgical technique correlated inversely with haemoglobin decrease (P<0.001). Haemoglobin decrease correlated positively with myoma number (P<0.001), size of myoma (P<0.001) and the opening of the cavum uteri (P=0.014). Conclusions: In this large series of abdominal myomectomies, procedure-related morbidity, mainly perioperative blood loss, was amongst the lowest reported when microsurgical techniques were used. In patients with multiple, large or deep intramural fibroids who desire future pregnancies, the use of microsurgical techniques may decrease intraoperative blood loss and perioperative morbidity. Springer-Verlag, 2010 Abdominal myomectomy nationallicence Infertility nationallicence Microsurgical technique nationallicence Morbidity nationallicence Blood loss nationallicence Schüring Andreas Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut Garcia-Rocha Guillermo Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut Schlösser Hans-Walter Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut Greb Robert Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut Kiesel Ludwig Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut Schippert Cordula Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 137-144 0932-0067 284:1<137 2011 284 404 https://doi.org/10.1007/s00404-010-1622-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1622-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schüring Andreas Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut NATIONALLICENCE 700 1- Garcia-Rocha Guillermo Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Schlösser Hans-Walter Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut NATIONALLICENCE 700 1- Greb Robert Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut NATIONALLICENCE 700 1- Kiesel Ludwig Department of Obstetrics and Gynecology, Medical Center, University of Muenster, Albert Schweitzer Str. 33, 48149, Münster, Germany aut NATIONALLICENCE 700 1- Schippert Cordula Department of Obstetrics, Gynecology and Reproductive Medicine, Medical University of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 137-144 0932-0067 284:1<137 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer