Number of Myomas Is the Most Important Risk Factors for Blood Loss of Robotic Myomectomy: Analysis of 242 Cases

Abstract

Study Objective To find out factors affecting estimated blood loss (EBL) during reduced port robotic myomectomy. Design Retrospective study. Setting University-based hospital. Patients or Participants Two hundred forty-two patients who underwent reduced port robotic myomectomy (RM) between 1 January 2019 and 28 February 2021 by two gynecologic surgeons. Interventions Among 448 patients who underwent RM during the study period at our hospital, 47 patients who underwent single site RM (n=34) or single port RM (n=13) were excluded. For surgical proficiency, 242 cases of two surgeons who performed over 80 cases of RM during the study periods were included in this study. Measurements and Main Results The primary endpoint was to identify the factors affecting EBL and the secondary endpoint was to identify the factors of total OT during multi-port RM. Univariate and multivariate analysis were used to identify the factors affecting the EBL and OT during RM. Medians of the maximal diameter and weight of the removed myomas were 9.00 (IQR: 7.00-10.00) cm and 249.75 (IQR: 142.88-401.00) g, respectively. The median number of myomas was 2 (IQR: 1-4) with the range of (1–34). There were 155 cases with low EBL and 87 cases with high EBL. The most common main type of myomas was intramural type (n=179). The odds of having EBL>320ml increased by 251% (OR=2.51; 95%CI: 1.16-5.42) for 5-9 myomas and by 647% (OR=6.47; 95%CI: 1.87-22.33) for ≥10 myomas. The odds of subserosal type myomas decreased by 77% (OR=0.33; 95%CI: 0.14-0.80). History of abdominal surgery other than c-section were positively correlated with EBL. Weights of the retrieved myomas and previous c-section were not correlated with EBL. Conclusion Number of myomas (5-9 and ≥10), maximal diameter, and history of abdominal surgery other than c-section affect EBL in RM. To find out factors affecting estimated blood loss (EBL) during reduced port robotic myomectomy. Retrospective study. University-based hospital. Two hundred forty-two patients who underwent reduced port robotic myomectomy (RM) between 1 January 2019 and 28 February 2021 by two gynecologic surgeons. Among 448 patients who underwent RM during the study period at our hospital, 47 patients who underwent single site RM (n=34) or single port RM (n=13) were excluded. For surgical proficiency, 242 cases of two surgeons who performed over 80 cases of RM during the study periods were included in this study. The primary endpoint was to identify the factors affecting EBL and the secondary endpoint was to identify the factors of total OT during multi-port RM. Univariate and multivariate analysis were used to identify the factors affecting the EBL and OT during RM. Medians of the maximal diameter and weight of the removed myomas were 9.00 (IQR: 7.00-10.00) cm and 249.75 (IQR: 142.88-401.00) g, respectively. The median number of myomas was 2 (IQR: 1-4) with the range of (1–34). There were 155 cases with low EBL and 87 cases with high EBL. The most common main type of myomas was intramural type (n=179). The odds of having EBL>320ml increased by 251% (OR=2.51; 95%CI: 1.16-5.42) for 5-9 myomas and by 647% (OR=6.47; 95%CI: 1.87-22.33) for ≥10 myomas. The odds of subserosal type myomas decreased by 77% (OR=0.33; 95%CI: 0.14-0.80). History of abdominal surgery other than c-section were positively correlated with EBL. Weights of the retrieved myomas and previous c-section were not correlated with EBL. Number of myomas (5-9 and ≥10), maximal diameter, and history of abdominal surgery other than c-section affect EBL in RM.