Predicting success of single step hysteroscopic myomectomy: A single centre large cohort study of single myomas

Mazzon, Ivan; Favilli, Alessandro; Grasso, Mario; Horvath, Stefano; Bini, Vittorio; Renzo, Gian Carlo Di; Gerli, Sandro

doi:10.1016/j.ijsu.2015.07.714

Cited by 44 publications

(28 citation statements)

References 12 publications

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“…In the present study, we found a complete myomectomy rate of 63.31%, which is lower than the one reported by Mazzon et al 15 in 2015, which was of 87.62%. However, in their study, Mazzon et al 15 included only women with single fibroids. In the present study, $ 10% of the women had more than one submucosal fibroid to be treated, which may justify the difference observed.…”

Section: Discussioncontrasting

confidence: 77%

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Factors Associated with the Complications of Hysteroscopic Myomectomy

Lima

Brito

Baccaro

2020

Rev Bras Ginecol Obstet

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Objective To evaluate the factors associated with complete myomectomy in a single surgical procedure and the aspects related to the early complications. Methods A cross-sectional study with women with submucous myomas. The dependent variables were the complete myomectomy performed in a single hysteroscopic procedure, and the presence of early complications related to the procedure. Results We identified 338 women who underwent hysteroscopic myomectomy. In 89.05% of the cases, there was a single fibroid to be treated. According to the classification of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French), most fibroids were of grade 0 (66.96%), followed by grade 1 (20.54%), and grade 2 (12.50%). The myomectomies were complete in 63.31% of the cases, and the factors independently associated with complete myomectomy were the diameter of the largest fibroid (prevalence ratio [PR]: 0.97; 95% confidence interval [95%CI]: 0.96–0.98) and the classification 0 of the fibroid according to the FIGO (PR: 2.04; 95%CI: 1.18–3.52). We observed early complications in 13.01% of the hysteroscopic procedures (4.44% presented excessive bleeding during the procedure, 4.14%, uterine perforation, 2.66%, false route, 1.78%, fluid overload, 0.59%, exploratory laparotomy, and 0.3%, postoperative infection). The only independent factor associated with the occurrence of early complications was incomplete myomectomy (PR: 2.77; 95%CI: 1.43–5.38). Conclusions Our results show that hysteroscopic myomectomy may result in up to 13% of complications, and the chance of complete resection is greater in small and completely intracavitary fibroids; women with larger fibroids and with a high degree of myometrial penetration have a greater chance of developing complications from hysteroscopic myomectomy.

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Section: Discussioncontrasting

confidence: 77%

“…10 An incomplete resection of a myoma is a suboptimal outcome. A study 15 suggests that in $ 12% of the cases it is not possible to perform complete myomectomy in a single procedure, which can result in the exposure of the women to new risk in a subsequent procedure, in addition to resulting in more costs to health systems.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Complications of Hysteroscopic Myomectomy

Lima

Brito

Baccaro

2020

Rev Bras Ginecol Obstet

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“…The myoma size remains the most important factor determining the likelihood of completing the hysteroscopic resection in one setting. Increasing leiomyoma size was negatively correlated with complete removal [21,22]. Several methods and techniques were published trying to increase the possibility of one session removal.…”

Section: Discussionmentioning

confidence: 99%

Slice and Excise Technique in Hysterscopic Myomectomy for Large G0 Submucous Myoma

El-Tawab¹

2017

OGIJ

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“…The retrospective study of Mazzon [16] of 1244 cases showed a 87% of one step myomectomy in general, and 82% for type 2 myoma. Other series also allowed large myomas of >3 cm to be resected in one step by this technique, with an operating time of 10-58 min [17].…”

Section: Cold Loop Resection: Principles and Limitsmentioning

confidence: 99%

New Hysteroscopic Approaches to Uterine Fibroids

Socolov¹,

Păvăleanu²,

Socolov³

et al. 2020

Leiomyoma

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The hysteroscopic myomectomy is a very important application of the gynecologic endoscopy, as it allows minimal invasive removal of the type 0, 1, and 2 fibroids with minimal damage to the uterine wall. In the last decade, new developments of this method allowed an even less invasive approach, with possibility of ambulatory procedure. We discuss the importance of these new developments, based very much on the pseudocapsule of the myoma, and analyze the literature data regarding the outcome. The cold loop resection is a technique that could be used in type 1 and type 2 myomas, with less complications and limitations than the classical electrical resectoscope. Another development, more useful for type 0 and 1 myoma, is the hysteroscopic morcellator, similar to the laparoscopic one, but providing a faster and safer procedure. We also update the complications of hysteroscopic myomectomy and their management, including long-term and obstetrical complications related to hysteroscopic myomectomy. In conclusion, new developments and studies show that hysteroscopic myomectomy has become a valid endoscopic technique ready to be used by many specialists.

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Predicting success of single step hysteroscopic myomectomy: A single centre large cohort study of single myomas

Abstract: The grading, the size of the myomas and the age of patients play a crucial role in completing the hysteroscopic myomectomy in a single step. Only the diameter greater than 3 cm in G2 myomas is correlated to a higher risk of a multiple procedure.

Cited by 44 publications

References 12 publications

Factors Associated with the Complications of Hysteroscopic Myomectomy

Factors Associated with the Complications of Hysteroscopic Myomectomy

Slice and Excise Technique in Hysterscopic Myomectomy for Large G0 Submucous Myoma

New Hysteroscopic Approaches to Uterine Fibroids

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