Prediction of the operative time for hysteroscopic myomectomy for leiomyomas penetrating the intramural cavity using leiomyoma weight and clinical characteristics of patients

Abstract

PurposeTo preoperatively predict the operative time (OT) for hysteroscopic myomectomy for G1 or G2 leiomyoma based on leiomyoma weight.MethodsThe data from 544 patients who underwent one‐step hysteroscopic myomectomy were analyzed retrospectively. A total of 340 patients with leiomyoma penetrating the intramural cavity were identified as suitable candidates for calculation of the OT based on leiomyoma weight; we considered leiomyoma weight to be the most objective parameter for evaluating leiomyoma tissues. Additionally, 460 patients with a single leiomyoma were analyzed to estimate the weight of the resected leiomyoma based on its diameter.ResultsConsidering total leiomyoma weight (TLW) and two additional coefficients (1.5: G2 leiomyoma, 0.75: vaginal parity of the patient), we demonstrated that our formula correlated well with OT (R 2 = 0.72). TLW also correlated well with the cube of the average diameter (AD) of leiomyomas (R 2 = 0.89). Predicting TLW significantly improved the application of specific coefficients depending on its value (1.0: AD 0.1‐2.0 cm, 0.8: AD 2.1‐3.0 cm, 0.7: AD 3.1‐5.7 cm).ConclusionThe OT for hysteroscopic myomectomy of intracavital leiomyoma can be predicted prior to surgery using simple clinical information of the target leiomyoma and the patient.

New Hysteroscopic Approaches to Uterine Fibroids

“…For the safety increase of the procedure, the use of ultrasound vaginal scan has been shown to be of the greatest value. This allows estimation of the operating time; for example, in a study by Isono et al [11], using the cubic value for the average diameter of the myoma was useful both in estimating the total weight of the tumor and the operating time, with differences from those with diameter of 1-2, 2-3, or >3 cm). During the procedure, the ultrasound scan has been proposed by Korkmazer et al [12], for assessing the limits of the remaining myometrial tissue after resection of type 1 and especially type 2 myomas.…”