Abstract
BackgroundWe present a minimal skin wound abdominal myomectomy performed in our hospital and attempt to identify the optimal range of this technique by considering the characteristics of target leiomyomas. In this procedure, we attempted to make the skin wound as small as possible, with a maximum length of approximately 5 cm.MethodsIn addition to introducing the minimal skin wound abdominal myomectomy, we retrospectively collected and analyzed the medical records of 76 patients treated with minimal skin wound abdominal myomectomy exclusively by the same physician at Maruyama Memorial General Hospital between January 2007 and December 2016. We statistically investigated relationships between ten factors, including body mass index; patient’s age; patient’s parity; administration of gonadotropin-releasing hormone analogue; presence of anemia; the uterine leiomyomas’ number, size, weight, and location; operation time; and blood loss.ResultsFirst, we introduce a case in which we performed minimal skin wound abdominal myomectomy for a 36-year-old Japanese patient with a large leiomyoma (10 cm in diameter). Then, we assessed the impacts of patient characteristics and leiomyoma characteristics on operation time and blood loss for this surgical method. In a multivariate analysis, only the number of resected leiomyomas significantly affected massive bleeding. Other factors showed no difference on operation time and the amount of blood loss.ConclusionsMinimal skin wound abdominal myomectomy is safe and effective for use in many patients, because only the number of leiomyomas affects the amount of blood loss. No other factor affected operation time. We suggest the possibility that the expanded use of minimal skin wound abdominal myomectomy may reduce the number of patients waiting for long periods to undergo laparoscopic surgery and may optimize the use of medical resources in rural areas.
Highlights
We present a minimal skin wound abdominal myomectomy performed in our hospital and attempt to identify the optimal range of this technique by considering the characteristics of target leiomyomas
Data on body mass index (BMI; measured as kg/m2), age, patient’s parity, the administration of gonadotropin-releasing hormone analogue (GnRHa), and the presence of anemia were collected from the medical records
The average age of patients treated with minimal skin incision abdominal myomectomy (MAM) was 37.1 ± 4.6 years, and approximately 80% of all patients (60 of 76) were treated with GnRHa before undergoing surgery
Summary
We present a minimal skin wound abdominal myomectomy performed in our hospital and attempt to identify the optimal range of this technique by considering the characteristics of target leiomyomas In this procedure, we attempted to make the skin wound as small as possible, with a maximum length of approximately 5 cm. We introduce our minimal skin incision laparotomy technique for leiomyomas, which offers improvements on classical abdominal myomectomy In this procedure, we attempted to make the abdominal wound as small as possible, with a maximum length of approximately 5 cm. We attempted to make the abdominal wound as small as possible, with a maximum length of approximately 5 cm In this retrospective analysis of patients who wished to preserve their uterus and underwent myomectomy, we tried to identify the optimal application of our surgical method in terms of decreased operative time and reduced blood loss
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