Italian multicenter study on complications of laparoscopic myomectomy

Sizzi, Ornella; Rossetti, Alfonso; Malzoni, Mario; Minelli, Luca; Grotta, Francesco La; Soranna, Liberato; Panunzi, Simona; Spagnolo, Rocco; Imperato, F; Landi, Stefano; Fiaccamento, Andrea; Stola, Emilio

doi:10.1016/j.jmig.2007.01.013

Cited by 281 publications

(185 citation statements)

References 35 publications

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“…Our complication rates can therefore not be extrapolated to larger populations. This case series does, however, illustrate that the complication risk may not be as high as previously suggested [2], with the prerequisite of an experienced laparoscopic surgeon and adequate intraoperative precautions.…”

Section: Discussionmentioning

confidence: 46%

“…Anatomical location within the broad ligament has previously been associated with an increased complication risk at myomectomy [2]. Ultrasound, as the first-line imaging tool for uterine structural abnormalities such as fibroids [10], plays an important role in pre-operative planning for such procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Their anatomical location may cause local pressure effects including ureteric obstruction [1]. Excision, however, is associated with risk of surgical complications particularly ureteric and uterine vessel injuries [2] and concealed haematoma formation [3].…”

Section: Introductionmentioning

confidence: 99%

“…The probability of complications arising at myomectomy for intraligamentous fibroids is increased compared to fibroids in other locations. Sizzi et al indicated an 18.8 % complication rate, reporting an odds ratio of 2.43 for developing any complication [2].…”

Section: Introductionmentioning

confidence: 99%

“…Given the potential complications of intraligamentous myomectomy [2], surgical anticipation is crucial, particularly for the inexperienced laparoscopic surgeon. We therefore aimed to assess the accuracy of pre-operative imaging for broad ligament fibroids within our unit, as well as our associated complication rate at laparoscopic myomectomy.…”

Section: Introductionmentioning

confidence: 99%

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Broad ligament fibroids—a radiological and surgical challenge

2014

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Currently, there is limited data on the ease of imaging of broad ligament fibroids and their safe laparoscopic management. We aimed to review all laparoscopic myomectomies over an 8-year period, focusing on intraoperative findings and corresponding pre-operative imaging. All laparoscopic myomectomies performed between 2004 and 2012 were reviewed. Cases with broad ligament fibroids were identified. Presenting symptoms, imaging, intraoperative findings, complications and 6-month follow-up were noted. Ten broad ligament fibroids were identified from 185 cases of laparoscopic myomectomies. Mean broad ligament fibroid diameter was 8.1 cm, and the largest was 15 cm. Mean combined fibroid weight was 267 g (range 30-560 g). Blood loss was associated with the total number of fibroids excised rather than the diameter of the broad ligament fibroid (range 30-400 ml). Accurate pre-operative diagnosis at imaging was made in only one of the ten broad ligament fibroids. Of the remainder, one was thought to be an ovarian mass, one fibroid was missed entirely and seven were reported non-specifically as 'lateral'. This case series indicates the challenge posed by broad ligament fibroids at pre-operative imaging. Underreporting may reflect a lack of awareness of the surgical significance of broad ligament fibroids. There should be a high level of suspicion for location within the broad ligament if a fibroid reported is as lateral. With adequate operator experience, large fibroid size should not contraindicate laparoscopic management of broad ligament fibroids.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Broad ligament fibroids—a radiological and surgical challenge

2014

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Laparoscopic Myomectomy

Sarıdoğan¹

2016

Gynecologic and Obstetric Surgery

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Uterine sarcoma dissemination during myomectomy: If not “acceptable collateral damage,” is it possible to mitigate the risk?

Judson

Miah

2014

Cancer

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Uterine sarcomas are rare, but benign leiomyomas (fibroids) are extremely common and frequently require surgery: either hysterectomy or myomectomy. A rare but potentially devastating consequence of myomectomy is inadvertent incomplete resection of a uterine sarcoma, resulting in tumor dissemination and a worse prognosis. The authors discuss the acceptable level of risk and how such a risk could be mitigated.

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Italian multicenter study on complications of laparoscopic myomectomy

Cited by 281 publications

References 35 publications

Broad ligament fibroids—a radiological and surgical challenge

Broad ligament fibroids—a radiological and surgical challenge

Laparoscopic Myomectomy

Uterine sarcoma dissemination during myomectomy: If not “acceptable collateral damage,” is it possible to mitigate the risk?

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