دورية أكاديمية
أعرض في EDS

Factors Associated with the Complications of Hysteroscopic Myomectomy.

التفاصيل البيبلوغرافية
العنوان: Factors Associated with the Complications of Hysteroscopic Myomectomy.
عنوان ترانسليتريتد: Fatores associados às complicações da miomectomia por histeroscopia.
المؤلفون: Lima MPJS; Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil., Costa-Paiva L; Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil., Brito LGO; Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil., Baccaro LF; Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
المصدر: Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia [Rev Bras Ginecol Obstet] 2020 Aug; Vol. 42 (8), pp. 476-485. Date of Electronic Publication: 2020 Sep 08.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Federação das Sociedades de Ginecologia e Obstetrícia Country of Publication: Brazil NLM ID: 9214757 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1806-9339 (Electronic) Linking ISSN: 01007203 NLM ISO Abbreviation: Rev Bras Ginecol Obstet Subsets: MEDLINE
أسماء مطبوعة: Publication: 2024- : São Paulo : Federação das Sociedades de Ginecologia e Obstetrícia
Original Publication: [São Paulo, Brazil] : Medisa Editora
مواضيع طبية MeSH: Intraoperative Complications*, Leiomyoma/*surgery , Uterine Myomectomy/*adverse effects , Uterine Neoplasms/*surgery, Adult ; Aged ; Blood Loss, Surgical ; Cross-Sectional Studies ; Female ; Humans ; Middle Aged ; Postoperative Complications
مستخلص: Objective:  To evaluate the factors associated with complete myomectomy in a single surgical procedure and the aspects related to the early complications.
Methods:  A cross-sectional study with women with submucous myomas. The dependent variables were the complete myomectomy performed in a single hysteroscopic procedure, and the presence of early complications related to the procedure.
Results:  We identified 338 women who underwent hysteroscopic myomectomy. In 89.05% of the cases, there was a single fibroid to be treated. According to the classification of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French), most fibroids were of grade 0 (66.96%), followed by grade 1 (20.54%), and grade 2 (12.50%). The myomectomies were complete in 63.31% of the cases, and the factors independently associated with complete myomectomy were the diameter of the largest fibroid (prevalence ratio [PR]: 0.97; 95% confidence interval [95%CI]: 0.96-0.98) and the classification 0 of the fibroid according to the FIGO (PR: 2.04; 95%CI: 1.18-3.52). We observed early complications in 13.01% of the hysteroscopic procedures (4.44% presented excessive bleeding during the procedure, 4.14%, uterine perforation, 2.66%, false route, 1.78%, fluid overload, 0.59%, exploratory laparotomy, and 0.3%, postoperative infection). The only independent factor associated with the occurrence of early complications was incomplete myomectomy (PR: 2.77; 95%CI: 1.43-5.38).
Conclusions:  Our results show that hysteroscopic myomectomy may result in up to 13% of complications, and the chance of complete resection is greater in small and completely intracavitary fibroids; women with larger fibroids and with a high degree of myometrial penetration have a greater chance of developing complications from hysteroscopic myomectomy.
Competing Interests: The authors have no conflict of interests to declare.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)
References: Best Pract Res Clin Obstet Gynaecol. 2015 Oct;29(7):982-93. (PMID: 25937555)
J Minim Invasive Gynecol. 2011 Sep-Oct;18(5):569-81. (PMID: 21783430)
Eur J Obstet Gynecol Reprod Biol. 2002 Sep 10;104(2):160-4. (PMID: 12206931)
Fertil Steril. 2011 May;95(6):2073-7. (PMID: 21333985)
J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):575-80. (PMID: 22819007)
Obstet Gynecol. 2000 Aug;96(2):266-70. (PMID: 10908775)
Acta Obstet Gynecol Scand. 2017 Dec;96(12):1399-1403. (PMID: 28832907)
Best Pract Res Clin Obstet Gynaecol. 2015 Oct;29(7):920-9. (PMID: 25937553)
Science. 1965 Oct 1;150(3692):67-9. (PMID: 5833538)
Obstet Gynecol. 1994 Mar;83(3):414-8. (PMID: 8127535)
J Minim Invasive Gynecol. 2010 Jan-Feb;17(1):59-65. (PMID: 20129334)
Obstet Gynecol Clin North Am. 2010 Sep;37(3):399-425. (PMID: 20674783)
Obstet Gynecol. 2000 Dec;96(6):890-4. (PMID: 11084173)
Obstet Gynecol. 2000 Oct;96(4):517-20. (PMID: 11004351)
N Engl J Med. 2013 Oct 3;369(14):1344-55. (PMID: 24088094)
Int J Gynaecol Obstet. 2011 Apr;113(1):3-13. (PMID: 21345435)
J Minim Invasive Gynecol. 2008 Jan-Feb;15(1):74-7. (PMID: 18262148)
Hum Reprod Update. 2008 Mar-Apr;14(2):101-19. (PMID: 18063608)
Am J Obstet Gynecol. 2003 Jan;188(1):100-7. (PMID: 12548202)
Clin Obstet Gynecol. 2006 Dec;49(4):811-20. (PMID: 17082675)
Menopause. 2011 Apr;18(4):434-6. (PMID: 21701429)
Minerva Ginecol. 2014 Feb;66(1):35-47. (PMID: 24569403)
Int J Surg. 2015 Oct;22:10-4. (PMID: 26277533)
J Minim Invasive Gynecol. 2018 May - Jun;25(4):706-714. (PMID: 29180306)
Menopause. 2018 Jul;25(7):789-794. (PMID: 29438271)
فهرسة مساهمة: Local Abstract: [Publisher, Portuguese]  Avaliar os fatores associados a miomectomia por histeroscopia completa em um único procedimento e as suas complicações. MéTODOS:  Estudo de corte transversal com mulheres submetidas a histeroscopia para exérese de miomas submucosos. As variáveis dependentes foram a miomectomia completa realizada em um tempo cirúrgico único, e a presença de complicações precoces relacionadas ao procedimento. [Publisher, Portuguese]  Analisamos 338 mulheres que foram submetidas a miomectomia histeroscópica. Em 89,05% dos casos, o mioma a ser tratado era único. Quanto à classificação da Federação Internacional de Ginecologia e Obstetrícia (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, em francês), a maioria era de grau 0 (66,96%), seguidos pelos graus 1 (20,54%) e 2 (12,50%). As miomectomias foram completas em 63,31% das mulheres, sendo que os fatores independentemente associados à miomectomia completa foram o diâmetro do maior mioma (razão de prevalência [RP]: 0,97; intervalo de confiança de 95% [IC95%]: 0,96–0,98) e a classificação FIGO grau 0 (RP: 2,04; IC95%: 1,18–3,52). Foram observadas complicações precoces em 13,01% dos procedimentos (4,44% apresentaram sangramento excessivo durante o procedimento, 4,14%, perfuração uterina, 2,66%, falso pertuito, 1,78%, intoxicação hídrica, 0,59%, laparotomia exploradora, e 0,3%, infecção pós-operatória). O único fator independentemente associado à ocorrência de complicações precoces foi a realização de miomectomia incompleta (RP: 2,77; IC95%: 1,43–5,38). CONCLUSãO:  Nossos resultados mostram que as complicações da miomectomia por histeroscopia podem ocorrer em até 13% dos procedimentos. A chance de ressecção completa é maior em miomas pequenos e completamente intracavitários; mulheres com miomas maiores e com maior grau de penetração miometrial têm maiores chances de desenvolver complicações.
تواريخ الأحداث: Date Created: 20200908 Date Completed: 20210809 Latest Revision: 20230728
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10309217
DOI: 10.1055/s-0040-1713915
PMID: 32898912
قاعدة البيانات: MEDLINE
الوصف
تدمد:1806-9339
DOI:10.1055/s-0040-1713915