Predictors of postoperative hemoglobin drop after laparoscopic myomectomy.

Watrowski, Rafał; Jäger, Christoph; Förster, Johannes

doi:10.5114/wiitm.2017.66515

Cited by 11 publications

(8 citation statements)

References 29 publications

(42 reference statements)

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“…The blood loss is related with different factors such as myomas' size and number. The localization in this work [35] has not found impact on the amount of blood lost, but in an another study, intramural myomas with a size between 8 and 12 cm had a higher amount of blood loss compared to sub-serosal myomas of the same size (median blood loss = 275 vs. 200, P < 0.05) [36].…”

Section: F O R P U B L I C a T I O Ncontrasting

confidence: 55%

“…In addition, the impact of the number of myomas was also evaluated ≥5 myomas were found to be significantly associated with blood transfusion requirements within 1 week of the myomectomy, and there was a linear increase in blood loss with the size of myoma [38]. Hemoglobin drop of more than 2 units g/dl was found when there were ≥3 myomas [39].…”

Section: F O R P U B L I C a T I O Nmentioning

confidence: 99%

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Surgical adhesions after laparoscopic myomectomy: methods of prevention

Serafino¹,

Palumbo²,

Viciglione³

et al. 2023

It Journ Gyn Obs

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Background: Adhesions are one of the most common complications of myomectomy and subsequent surgical procedures. Laparoscopic myomectomy is a low-risk procedure, with an adhesion rate of 50%, unlike laparotomy which has increased rates of 94%. The primary consequences of postoperative adhesions are chronic pelvic pain and female infertility.Objectives: This narrative review is conducted to report the evidence on methods to reduce adhesions after laparoscopic myomectomy.Methods: An electronic database search (Pubmed, Medline and Embase) was performed up to April 2022. A search algorithm was developed incorporating the terms "myomectomy", "adhesions", "laparoscopy", "infertility", "anti-adhesion agents". Results:The incidence of adhesions after laparoscopic myomectomy without adhesion barriers is variable, between 23% and 88%. The variability in adhesions' onset is due to tissue trauma, the incision location and length, number of knots or kind of suture material and the experience of the surgeon, but also the use of anti-adhesion agents. The icodextrin 4% and the auto-crosslinked hyaluronic acid solution gel showed a significant decrease in the incidence and severity of adhesions in intervention groups. The polyethylene glycol amine plus dextran aldehyde polymers reported a decrease in the total adhesion score at second-look surgery after laparoscopic myomectomy. Oxidized regenerated cellulose showed efficacy in prevention of adhesions after laparoscopic myomectomy. Conclusion:Laparoscopic myomectomy reduces the risk of new adhesion formation but do not eliminate it entirely. Oxidized regenerated cellulose, auto-crosslinked hyaluronic acid gel among natural materials, and polyethylene glycol amine plus dextran aldehyde polymers among synthetic materials, decrease the incidence of adhesions.

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Section: F O R P U B L I C a T I O Ncontrasting

confidence: 55%

Section: F O R P U B L I C a T I O Nmentioning

confidence: 99%

Surgical adhesions after laparoscopic myomectomy: methods of prevention

Serafino¹,

Palumbo²,

Viciglione³

et al. 2023

It Journ Gyn Obs

View full text Add to dashboard Cite

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“…The most seen complication was hemorrhage, and mean hemoglobin drop was 1.5 g/dl [8]. In a study about predictors of hemorrhage in laparoscopic myomectomy; the hemorrhage risk was found associated with the duration of surgery, the largest diameter of fibroid, the cumulative fibroid weight, and the number of the suture [9]. There are numerous studies about the prediction of hemorrhage risk in laparoscopic myomectomy, but none of them mention whether the location of fibroid is associated with the risk of hemorrhage or other complications.…”

Section: Discussionmentioning

confidence: 99%

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

et al. 2020

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Objective: To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy. Background: Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury, and conversion to laparotomy may be seen in laparoscopic myomectomy. We do not know whether the fibroid location affects these complications. Materials and methods: Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4, or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e., anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery and complication rates were compared across categories. Results: Two hundred nineteen women with a mean age of 35.7 ± 6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. The other ten women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior, and posterior groups, respectively (p = 0.9). The median (25th-75th percentile) changes in hemoglobin levels were 1.5 (0.8-2.2), 1.3 (0.6-2.1), and 1.3 (0.9-2) g/dl in fundal, anterior, and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion: The incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.

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“…[8] In a study about predictors of hemorrhage in laparoscopic myomectomy, there was found that hemorrhage risk is associated with duration of surgery, largest diameter of fibroid, cumulative fibroid weight, and number of suture. [9] There are numerous studies about prediction of hemorrhage risk in laparoscopic myomectomy but none of them mention whether the location of fibroid is associated with the risk of hemorrhage or other complications. Based on these concerns, in our study we planned to detect whether hemorrhage and complication rates vary according the location of the dominant fibroid.…”

Section: Discussionmentioning

confidence: 99%

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

Aslan

Orhan

Türkgeldi

et al. 2020

Preprint

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Objective To determine whether hemorrhage and complication rates vary according location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury and conversion to laparotomy may be seen in laparoscopic myomectomy. We don’t know whether fibroid location effect these complications. Materials & Methods Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4 or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e. anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery, and complication rates were compared across categories. Results 219 women with mean age of 35.7 +/-6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. Other 10 women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior and posterior groups, respectively (p=0.9). The median (25 th – 75 th percentile) changes in hemoglobin levels were 1.5 (0.8 – 2.2), 1.3 (0.6 – 2.1), and 1.3 (0.9 – 2) g/dl in fundal, anterior and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion Incidence of hemorrhage or complication does not seem to vary depending on fibroid location. However, the sample size was limited, the observed values suggest that fibroid location does not affect hemorrhage and complication rates.

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Predictors of postoperative hemoglobin drop after laparoscopic myomectomy.

Cited by 11 publications

References 29 publications

Surgical adhesions after laparoscopic myomectomy: methods of prevention

Surgical adhesions after laparoscopic myomectomy: methods of prevention

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

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