İSMET HORTU, Feride ALGÜL, Büşra DURMAZ, Ali AKDEMİR, Cagdas SAHİN, Ahmet Mete ERGENOĞLU, Fuat AKERCAN

Myomectomy during cesarean section: Evaluation of perioperative results

Aim: To compare the perioperative outcomes between patients who underwent myomectomy during cesarean section and those without myomectomy during cesarean section retrospectively. Materials and Methods: In our study, a total of 187 patients, including 125 patients who underwent myomectomy (case) during cesarean section and 62 patients who had not undergone myomectomy (control) during cesarean section, were included in our clinic between February 2015- October 2019. Basic demographic characteristics of the patients, gestational week at the time of operation, the mean number of myoma and size, locations of myoma, mean differences between hemoglobin and hematocrit levels postoperatively, mean operation time, need for erythrocyte transfusion, and mean hospitalization time were retrospectively evaluated. Results: The mean diameter of the myoma in the control group is significantly higher than that of the myomectomy group (5.75 ± 3.71 cm and 4.73 ± 3.76 cm, respectively; p:0.0057). The mean operation time was 82.81 ± 28.69 min. and 70.08 ± 17.89 min. in the myomectomy and control groups, respectively (p: 0.003). There was no statistically significant difference between the two groups in the other parameters (Mean Hb, Htc differences postoperatively, mean hospitalization time, etc.). Conclusion: Our results support that myomectomy performed during the cesarean section does not increase perioperative morbidity and may be useful when it is performed by experienced surgeons. In addition, myomectomy during cesarean section can decrease the need for secondary surgery due to the myoma.

Sezaryen sırasında miyomektomi: Perioperatif sonuçların değerlendirilmesi

Amaç: Sezaryen sırasında miyomektomi yapılan (olgu) ve miyomektomi yapılmayan (kontrol) hastalar arasındaki perioperatif sonuçları retrospektif olarak kıyaslamak. Gereç ve Yöntem: Çalışmamıza kliniğimizde Şubat 2015 – Ekim 2019 tarihleri arasındaki sezaryen sırasında miyomektomi yapılan (olgu) 125 hasta ve sezaryen esnasında miyomektomi yapılmayan (kontrol) 62 hasta olmak üzere toplam 187 hasta dahil edildi. Hastaların temel demografik özellikleri, gebelik haftaları, miyom sayı ve ortalama çapları, yerleşim yerleri, postoperatif hemoglobin ve hematokrit değişiklikleri, operasyon süreleri, eritrosit transfüzyon ihtiyaçları ve hastanede kalış süreleri kıyaslanmıştır. Bulgular: Her iki gruptaki hastalar karşılaştırıldığında miyomektomi yapılmayan gruptaki hastaların ortalama miyom çapları daha yüksek olarak bulundu (miyomektomi yapılanlarda: 4,73 ±3,76 cm, miyomektomi yapılmayanlarda: 5,75 ±3,71 cm; p:0,0057). Operasyon süresi ise miyomektomi yapılan grupta 82,81 ±28,69 dk. iken miyomektomi yapılmayan grupta 70.08 ±17.89 dk. olarak bulundu (p: 0,003). İki grup arasında diğer parametrelerde (ortalama hemoglobin, hematokrit değişiklikleri, hastanede kalış süresi, vb.) istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Sezaryen operasyonu sırasında gerçekleştirilen miyomektominin perioperatif morbiditeyi arttırmadığı ve uygun hasta grubunda tecrübeli ekip tarafından yapıldığında hastanın ikincil bir cerrahi operasyona ihtiyacının azaltması açısından faydalı bir uygulama olabileceği gösterilmiştir.

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