Is robot-assisted laparoscopic myomectomy limited in multiple myomas?: a feasibility for ten or more myomas
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives To evaluate the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10. MethodsA retrospective study was conducted for 662 patients who underwent robot-assisted laparoscopic myomectomy and open myomectomy by a single operator in a tertiary university hospital. Results A total of 30 women underwent removal of 10 or more uterine myomas by robotics and 13 patients were selected for this study. The average number of myomas removed was 13.7 (range 10–20). The maximum diameter of the myomas was 6.8 cm (range 5.0–10.0 cm). The sum of the diameters of each myoma was 34.7 cm (range 20.0-54.5 cm) and the mass of resected myomas for each case was 229.1 g (range 106.8–437.9 g). In no case was the robotic procedure converted into conventional laparoscopy or laparotomy, and all patients recovered without any major complications. In comparison with 13 cases of open myomectomy during the same period, robotic surgery took longer time than open surgery (360.5 vs. 183.8 minutes; P=0.001) but had shorter postoperative hospital days after surgery (mean 2.5 vs. 3.5 days; P=0.003). Conclusion Robot-assisted laparoscopic myomectomy could be an alternative to laparotomic myomectomy for numerous myomas over 10 in number.
Abstract
Objectives To evaluate the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10. MethodsA retrospective study was conducted for 662 patients who underwent robot-assisted laparoscopic myomectomy and open myomectomy by a single operator in a tertiary university hospital. Results A total of 30 women underwent removal of 10 or more uterine myomas by robotics and 13 patients were selected for this study. The average number of myomas removed was 13.7 (range 10–20). The maximum diameter of the myomas was 6.8 cm (range 5.0–10.0 cm). The sum of the diameters of each myoma was 34.7 cm (range 20.0-54.5 cm) and the mass of resected myomas for each case was 229.1 g (range 106.8–437.9 g). In no case was the robotic procedure converted into conventional laparoscopy or laparotomy, and all patients recovered without any major complications. In comparison with 13 cases of open myomectomy during the same period, robotic surgery took longer time than open surgery (360.5 vs. 183.8 minutes; P=0.001) but had shorter postoperative hospital days after surgery (mean 2.5 vs. 3.5 days; P=0.003). Conclusion Robot-assisted laparoscopic myomectomy could be an alternative to laparotomic myomectomy for numerous myomas over 10 in number.
참고문헌 (15)
- Practice Committee of the American Society for Reproductive Medicine, "Myomas and reproductive function", Fertil Steril, 82(Suppl 1), pp.S111~S116 (2004)
- Somigliana E, "Fibroids and female reproduction: a critical analysis of the evidence", Hum Reprod Update, 13, pp.465~476 (2007)[DOI]
- Pritts EA, "Fibroids and infertility: an updated systematic review of the evidence", Fertil Steril, 91, pp.1215~1223 (2009)[DOI]
- Seracchioli R, "Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy", Hum Reprod, 15, pp.2663~2668 (2000)[DOI]
- Mais V, "Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome", Am J Obstet Gynecol, 174, pp.654~658 (1996)[DOI]
- Bedient CE, "Comparison of robotic and laparoscopic myomectomy", Am J Obstet Gynecol, 201, pp.566.e1~566.e5 (2009)[DOI]
- Hurst BS, "Laparoscopic myomectomy for symptomatic uterine myomas", Fertil Steril, 83, pp.1~23 (2005)[DOI]
- Ascher-Walsh CJ, "Robot-assisted laparoscopic myomectomy is an improvement over laparotomy in women with a limited number of myomas", J Minim Invasive Gynecol, 17, pp.306~310 (2010)[DOI]
- Chiou HY, "Comparing robotic surgery with laparoscopy and laparotomy for endometrial cancer management: a cohort study", Int J Surg, 13, pp.17~22 (2015)[DOI]
- Dubuisson J, "Incidence of intraabdominal adhesions in a continuous series of 1000 laparoscopic procedures", Am J Obstet Gynecol, 203, pp.111.e1~111.e3 (2010)[DOI]
- Advincula AP, "Robotassisted laparoscopic myomectomy versus abdominal myomectomy: a comparison of short-term surgical outcomes and immediate costs", J Minim Invasive Gynecol, 14, pp.698~705 (2007)[DOI]
- Parker WH, "Risk factors for uterine rupture after laparoscopic myomectomy", J Minim Invasive Gynecol, 17, pp.551~554 (2010)[DOI]
- Nezhat C, "Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy--a retrospective matched control study", Fertil Steril, 91, pp.556~559 (2009)[DOI]
- Ten Broek RP, "Different surgical techniques to reduce postoperative adhesion formation: a systematic review and meta-analysis", Hum Reprod Update, 19, pp.12~25 (2013)[DOI]
- Advincula AP, "The role of robotic surgery in gynecology", Curr Opin Obstet Gynecol, 19, pp.331~336 (2007)[DOI]