The indication and curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas.

Haibo Wang,Jinrong Zhao,Ping Li,Shujuan Tian,Caihong Lu,Zhong-Hua Wang,Xiujuan Li

doi:10.1186/s12893-016-0124-7

Abstract

BackgroundThe aim of this study was to assess curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas between 3 and 5 cm in diameter and explore the optimal surgical indications.MethodsA retrospective analysis was performed of those who underwent hysteroscopic or laparoscopic myomectomy from January 2008 to January 2013. The patients were divided into three subgroups according to the myomas diameter (namely, 30 mm ≤ myomas diameter <40 mm; 40 mm ≤ myomas diameter <50 mm; and myomas diameter ≥ 50 mm). Clinical data such as operation time, amount of bleeding, postoperative anal exsufflation time, hospital stay, and complications were collected.ResultsThere was no significant difference regarding operation time and amount of bleeding in two groups. We found significant difference in hysteroscopic group (within-subgroup) difference regarding operation time and amount of bleeding, whereas no significant difference in the laparoscopic group, while significant differences between-subgroup differences regarding operation time. Complete removal of myoma was seen in all patients.ConclusionsBoth techniques are feasible for type II submucous myomas. Laparoscopic operation has higher advantages in type II submucous myomas of greater than 4 cm in diameter whereas hysteroscopic operation has higher advantages in type II submucous myomas of lower than 4 cm in diameter.

Highlights

The aim of this study was to assess curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas between 3 and 5 cm in diameter and explore the optimal surgical indications
The diagnosis of type II submucous myomas in this study was determined by ultrasound and hysteroscopic examination according to the European Society of Hysteroscopy classification [21, 22]
The inclusion criteria was as follows: (1) patients with menorrhagia, secondary anemia, and infertility; (2) single type II submucosal myomas s with diameter between 3 and 5 cm; (3) the free myometrial margin (FMM) had to be at least 2 mm; (4) patients with uteri of less than 10 weeks and uterine cavity depth ≤ 12 cm; (5) preoperative examination showing uterine fibroid without endometrial lesions; (6) Thinprep cytology test (TCT) showing no malignant lesions of the uterine cervix

Summary

Introduction

The aim of this study was to assess curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas between 3 and 5 cm in diameter and explore the optimal surgical indications. Uterine myomas are the most common benign tumors of the female genital tract affecting approximately 30 % of women by the age of 35 and 70–80 % of women aged ≥ 50 [1, 2]. Depending on their location in the uterus, they may be subserous, intramural, or submucous. Type 0 myoma is entirely in the endometrial cavity, type I myoma extends less than 50 % into the myometrium and type II myoma extends greater than 50 % into the myometrium [4, 5]

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