Laparoscopic uterine artery occlusion combined with myomectomy for uterine myomas

J Minim Invasive Gynecol. 2008 May-Jun;15(3):346-9. doi: 10.1016/j.jmig.2008.01.005. Epub 2008 Mar 20.

Abstract

We sought to evaluate the clinical feasibility and mid- to long-term effects of laparoscopic uterine artery occlusion before myomectomy in the treatment of uterine myomas. A total of 566 patients with uterine myoma were treated by laparoscopic uterine artery occlusion before myomectomy from October 2001 through July 2007. Mean blood loss was 88.2 +/- 52.7 mL (95% CI 82.7-93.8). The highest postoperative temperature was 37.8 +/- 0.3 degrees C, and the postoperative morbidity was 5.7% (32/566). Number of days to the return of bowel movement was 1.9 +/- 0.5d and in hospital stay after surgery was 7.7 +/- 2.5d. Complications included 2 instances of subcutaneous emphysema, 1 of vaginal bleeding, and 3 of mild intestinal obstruction. At a median of 26.3 months (range 6-69 months) of follow-up, the rate of myoma recurrence was 3.0% (15/517), uterus volume reduction was 48.9%, and correction of menstruation abnormality was 97.1% (502/517). Laparoscopic uterine artery occlusion before myomectomy can expand myomectomy indications with better results.

MeSH terms

  • Adult
  • Arteries / surgery
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy / methods*
  • Leiomyomatosis / blood supply
  • Leiomyomatosis / surgery*
  • Leiomyomatosis / therapy
  • Middle Aged
  • Uterine Neoplasms / blood supply
  • Uterine Neoplasms / surgery*
  • Uterine Neoplasms / therapy
  • Uterus / blood supply