Resectoscopic myomectomy

Corson, Stephen L.; Brooks, Philip G.

doi:10.1016/s0015-0282(16)54349-0

Cited by 119 publications

(45 citation statements)

References 3 publications

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“…This technique, however, is associated with loss of the reproductive organ as well as a significant risk profile including general anesthesia and surgical complications, especially when performed under a hemodynamically unstable condition [8]. As the demand of myoma patients for uterine preservation as well as minimally invasive treatment has increased recently, hysteroscopic myomectomy [2] and UAE [5] were reported to be effective to manage symptomatic submucosal myoma. However, one significant complication after UAE for submucosal myoma is infection due to obstruction resulting from the sloughing of necrotic myoma tissue that interferes with the passage of intrauterine discharge.…”

Section: Discussionmentioning

confidence: 99%

“…Although only 5-10% of myomas are submucosal, these lesions sometimes, even in small cases, induce severe clinical symptoms such as iron-deficiency anemia due to metrorrhagia and were traditionally frequently treated by hysterectomy. With technical progress in recent years, hysteroscopic myomectomy has become a standard procedure as a minimally invasive treatment for submucosal myoma [2]. However, in an emergency case with acute severe uterine hemorrhage, those performing the procedure sometimes encounter difficulty in controlling bleeding during and after surgery, and hemostasis even by hysterectomy may be required [3].…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment of submucosal myoma with acute severe uterine hemorrhage by emergency uterine arterial embolization followed by early hysteroscopic myomectomy: a report of two cases

et al. 2005

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Two submucosal myoma cases with acute severe uterine hemorrhage were initially treated by emergency uterine arterial embolization for hemostasis. Then, after improvement of the general condition, early hysteroscopic myomectomy was performed. In one patient, complete resection was achieved. In another patient, the initial resection was incomplete because of the large tumor size. However, the remaining myoma tissue was spontaneously expelled later with no complications. Red blood cell transfusion was not required in either patient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Successful treatment of submucosal myoma with acute severe uterine hemorrhage by emergency uterine arterial embolization followed by early hysteroscopic myomectomy: a report of two cases

et al. 2005

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“…Val le u. Sci ar ra [2] Ta bel le 2 men kei ne Blu tungs kom pli ka tio nen. Corson u. Brooks [18] hat te in ih rem Pa ti en tenkol lek tiv (n=92) einen Fall mit star ker Blutung und Hä mo glo bi n ab fall, die mit ei ner Bal lontam po na de und ei ner Blut trans fu sion be han delt wer den muss te. Lof fer [19] be rich te te von star ken, un mit tel bar post- ope ra ti ven Blu tun gen bei 3 Pa ti en tin nen, bei de nen zur The ra pie ein Fo ley-Ka theter ein ge setzt wur de.…”

Section: Ute Rus Per Fo Ra Ti Onunclassified

Komplikationen der gynäkologischen Endoskopie

et al. 2005

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1 Uni ver si täts frau enkli nik Tü bin gen · 2 Evan ge li sches Dia ko nie kran ken haus gGmbH, Bre men · 3 KI-La bor des Zent rum für an ge wand te In for ma ti ons tech no lo gi en der Uni versi tät Bre men · 4 Pius-Hos pi tal Ol den burg, Ab tei lung Ge burts hil fe und Gy nä ko lo gie 5 Kli ni kum Süd stadt, Ros tock · 6 Kli ni kum Saar brücken 7 Be thes da-Kran ken haus gGmbH, Wup per tal · 8 Univ.-Kli ni kum Schles wig-Hol stein, Cam pus Kiel, Kli nik für Gy nä ko lo gie und Ge burts hil fe Kom pli ka tio nen der gy nä kolo gi schen En do sko pie Gynäkologe 2005Gynäkologe · 38:992-1000 Das Spekt rum der mo der nen ope rati ven Gy nä ko lo gie um fasst eine Vielzahl von ope ra ti ven Ein grif fen, von der Se no lo gie über ab do mi na le und va gi na le Zu gangs we ge bis hin zu mini mal-in va si ven Ope ra tio nen. Ge rade die mi ni mal-in va si ven Ein grif fe in der Gy nä ko lo gie wa ren und sind der Ka ta ly sa tor der Ent wick lung in no va tiver Ope ra ti ons ver fah ren mit en do skopi schen oder sog. "Mi ni mal-ac cess-Zugangs we gen" und da mit be deu tend für die ge sam te ope ra ti ve Me di zin.Wie schwer je doch die Eva lua ti on ope ra tiver Tech no lo gi en, ins be son de re auch der en do sko pi schen as sis tier ten Ope ra ti onsver fah ren in der Gy nä ko lo gie ist, zeigt ein Blick in die Li te ra tur. So exis tie ren in terna tio nal nur we ni ge Stu di en, die meis tens mo no zen trisch und da rü ber hi naus re trospek ti ve Er fas sun gen sind. In Deutsch land hat sich die Ar beits ge mein schaft Gy nä kolo gi sche En do sko pie (AGE) im Auf trag der Deut schen Ge sell schaft für Gy nä ko logie und Ge burts hil fe über Jah re be müht, die Ent wick lung der gy nä ko lo gi schen En do sko pie und die da mit ver bun de nen Kom pli ka tio nen pros pek tiv und mul ti zentrisch zu er fas sen. Die se stan dar di sier te Da ten er fas sung kann als "Werk zeug" der kli ni kin ter nen bzw. -ex ter nen Qua li täts siche rung her an ge zo gen wer den. Stand der Kom pli ka ti ons er fas sung AGE-Kom pli ka ti ons re gis terDas Kom pli ka ti ons re gis ter wur de im Auftrag der AGE von der Frau enkli nik des Ev. Dia ko nie kran ken hau ses zu sam men mit dem KI-La bor der Uni ver si tät Bremen ent wi ckelt. Pros pek tiv wer den seit 1996 la pa ro sko pi sche bzw. hys te ro skopi sche Ein grif fe und die auf ge tre te nen Kom pli ka tio nen er fasst (. Ta bel le 1). Seit dem Jah re 2000 kön nen auch alle ande ren gy nä ko lo gi schen Ope ra tio nen mit die sem In stru ment er fasst wer den. Die von den be tei lig ten Kli ni ken und Ope rati ons zen tren (. Ta bel le 2) durch ge führ-ten Ein grif fe wer den aus ge wer tet und die ana ly sier ten Kom pli ka ti ons ra ten mit den Da ten der in ter na tio na len Li te ra tur ver gli chen.Aus der um fang rei chen Da ten sammlung sei en im Fol gen den bei spiel haft die Er geb nis se der en do sko pi schen Ope ra tionen und ih rer Kom pli ka tio nen aus den Jah ren 1996-2000 dar ge stellt.In die sem Zeit raum wur den von den be tei lig ten In sti tu tio ...

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“…Resectoscopic myomectomy had some disadvantages like excessive bleeding, time consumed for cutting the myoma into chips of tissues and their extraction outside the uterine cavity in addition to the risks of fluid overload [2,3]. The larger the size of the myoma, the longer the time required for its excision.…”

Section: Introductionmentioning

confidence: 99%

Modified Hysteroscopic Myomectomy of Large Submucous Fibroids

Darwish

2003

Gynecol Obstet Invest

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Objective: To compare the efficacy, feasibility, operative time and possible complications of a modified technique of hysteroscopic removal of large submucus myomata versus traditional morcellation technique, and to assess the efficacy of preoperative sonohysterography (SHG). Design: A prospective comparative study. Setting: Gynecologic Endoscopy Unit, Assiut University Hospital, Assiut, Egypt. Subjects: One hundred forty-two women of childbearing age with a clinical and transvaginal sonographic diagnosis of large solitary submucous myomata (>3 cm in diameter) with or without an intramural element. Interventions: The patients were divided into two groups. In group A (65 patients), a modified resectoscopic technique was used where the base of the myoma was excised followed by ring forceps extraction after misoprostol priming. In group B (77 patients), the myoma was cut using traditional resectoscopic morcellation. Main Outcome Measures: For each patient, operating time, intra- and postoperative complications and feasibility of the procedure were recorded. The accuracy of preoperative SHG in localizing submucous myoma and detecting intramural extension was assessed by diagnostic hysteroscopy. Results: Transvaginal SHG showed good agreement with hysteroscopy in localizing submucous myomata and detecting intramural extension (k = 0.83). The operating time was significantly shorter in group A (15.6 ± 3.02 min) than in group B (28.9 ± 4.3 min). The procedure was completed in 60 (92%) and 51 patients (66%), whereas a second session was required in 2 (3%) and 20 patients (25.9%) in both groups respectively. Glycine volume was highly significantly less in group A (2.3 ± 0.86 vs. 6.3± 1.7 liters, p = 0.001). Intraoperative complications were encountered in 9 (13.8%) and 22 patients (28.5%) in both groups respectively (p = 0.03). Cervical laceration was diagnosed in 3 cases (4.6%) in group A. Postoperative visual disturbances were diagnosed in 4 cases (5%) in group B. Conclusions: Hysteroscopic resection of large submucous myomata with minimal intramural encroachment is feasible using a modified technique. It shows a minimal complication rate and fluid deficit and a shorter operative time than the standard morcellation technique. If the excised myoma is extracted as one mass, this carries a minimal risk of cervical lacerations and possible cervical incompetence in a subsequent pregnancy. Transvaginal SHG is a reliable diagnostic aid to assess submucous myomata.

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Resectoscopic myomectomy

Cited by 119 publications

References 3 publications

Successful treatment of submucosal myoma with acute severe uterine hemorrhage by emergency uterine arterial embolization followed by early hysteroscopic myomectomy: a report of two cases

Successful treatment of submucosal myoma with acute severe uterine hemorrhage by emergency uterine arterial embolization followed by early hysteroscopic myomectomy: a report of two cases

Komplikationen der gynäkologischen Endoskopie

Modified Hysteroscopic Myomectomy of Large Submucous Fibroids

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