Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section

Yan Dai,Jinxiao Lin,Rongli Xu,Wenqiang You,Li Xia

doi:10.1186/s12884-021-04226-1

Abstract

IntroductionA retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section.MethodsThe medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively.ResultsNo significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05).ConclusionFibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.

Highlights

A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section
With the progress of surgical hemostasis to prevent postpartum hemorrhage, many clinical studies have shown that cesarean section while eviscerating uterine fibroids can be a safe operation [5,6,7], for some patients can save the time and cost borne by reoperation [8]
The patients were divided into two groups according to the method of enucleation of the largest leiomyoma: in 40 patients (44%), enucleation was performed through the incision margin of the lower segment of the uterus, and in 50 patients (56%), enucleation was performed through a subserous incision

Summary

Introduction

A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. With the progress of surgical hemostasis to prevent postpartum hemorrhage, many clinical studies have shown that cesarean section while eviscerating uterine fibroids can be a safe operation [5,6,7], for some patients can save the time and cost borne by reoperation [8]. In order to minimize abdominal and intrauterine adhesions as possible, the present study introduces a surgical technigue, which can remove anterior uterine wall myoma by caesarean section incision without additional uterine incision. The aim of the present investigation was to evaluate the safety and effectiveness of the innovative method in patients with anterior wall uterine segment fibroids

Methods

Results

Conclusion