Email this article Organ-preserving laparoscopic myomectomy in atypical leiomyoma arrangement
- Authors: Ivanova D.A.1, Filippov O.S.2,3, Soloveva E.A.1, Chugunova N.A.1, Uryupina A.P.1, Utkina A.M.1
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Affiliations:
- Novorossiysk Clinical Center of the Federal Medical and Biological Agency
- Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency
- State Research Center – A.I. Burnazyan Federal Medical Biophysical Center of Federal Medical Biological Agency
- Issue: Vol 73, No 5 (2024)
- Pages: 24-29
- Section: Original study articles
- URL: https://bakhtiniada.ru/jowd/article/view/279768
- DOI: https://doi.org/10.17816/JOWD634241
- ID: 279768
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Abstract
BACKGROUND: Uterine fibroids are the most common cause of surgical treatment in women and total hysterectomy is performed in most cases to radically solve this problem. The organ-preserving approach aims to preserve fertility and the ability to reproduce in patients of reproductive age. The atypical location of leiomyomas complicates the possibility of performing an organ-preserving myomectomy.
AIM: The aim of this study was to assess the possibility of performing myomectomy for atypical leiomyoma using laparoscopic access in routine practice to preserve fertility and implement reproductive plans.
MATERIALS AND METHODS: This study included 213 patients of reproductive age with uterine fibroids. Myomectomy for typical or atypical leiomyomas was performed by laparoscopic access. A comparative analysis of surgical treatment and perioperative management of patients with atypically located fibroids and fibroids of other localization was carried out. The results of the achievement by the patients of their reproductive goals were evaluated. The duration of follow-up was 24 months.
RESULTS: Atypical node location was noted in 65 (30.5%) cases. When comparing the duration of surgical treatment, volume of blood loss, need for analgesics, presence of intraoperative and postoperative complications, duration of hospitalization and recovery period in patients with atypical leiomyoma, these parameters did not differ from those in the surgical treatment of patients with typical leiomyoma. Anatomical and functional results of surgical treatment were analyzed after one, three, six, 12, and 24 months. Of the 70 patients planning pregnancy, 26 (37%) women became pregnant on average 8.3 months after surgery. The location of the removed fibroids was atypical in ten cases.
CONCLUSIONS: The atypical location of leiomyoma does not affect the course of the surgical and postoperative periods and long-term results of surgical treatment. The possibility of routine organ-preserving treatment by laparoscopic access in patients with atypical fibroids leaves prospects for the implementation of the woman’s reproductive plans.
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##article.viewOnOriginalSite##About the authors
Darya A. Ivanova
Novorossiysk Clinical Center of the Federal Medical and Biological Agency
Email: daria.andreevna1995@mail.ru
ORCID iD: 0009-0006-1942-7516
MD
Russian Federation, 26 Sacco and Vanzetti St., Novorossiysk, Krasnodar Region, 353901Oleg S. Filippov
Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency; State Research Center – A.I. Burnazyan Federal Medical Biophysical Center of Federal Medical Biological Agency
Email: filippovolsem@yandex.ru
ORCID iD: 0000-0003-2654-1334
SPIN-code: 4404-4584
MD, Dr. Sci. (Medicine), Professor, Honored Doctor of the Russian Federation, University of Innovation and Continuing Education
Russian Federation, Moscow; MoscowElena A. Soloveva
Novorossiysk Clinical Center of the Federal Medical and Biological Agency
Author for correspondence.
Email: solovevaln@inbox.ru
ORCID iD: 0009-0004-9442-8645
SPIN-code: 3678-7099
MD, Cand. Sci. (Medicine)
Russian Federation, 26 Sacco and Vanzetti St., Novorossiysk, Krasnodar Region, 353901Nina A. Chugunova
Novorossiysk Clinical Center of the Federal Medical and Biological Agency
Email: nkc@nkc-fmba.ru
ORCID iD: 0009-0003-3345-579X
MD
Russian Federation, 26 Sacco and Vanzetti St., Novorossiysk, Krasnodar Region, 353901Anna P. Uryupina
Novorossiysk Clinical Center of the Federal Medical and Biological Agency
Email: anna.petra3@mail.ru
ORCID iD: 0009-0008-3348-3631
MD
Russian Federation, 26 Sacco and Vanzetti St., Novorossiysk, Krasnodar Region, 353901Anna M. Utkina
Novorossiysk Clinical Center of the Federal Medical and Biological Agency
Email: annautkina83@gmail.com
ORCID iD: 0009-0000-1757-0307
MD
Russian Federation, 26 Sacco and Vanzetti St., Novorossiysk, Krasnodar Region, 353901References
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