A multicenter study comparing surgical outcomes and ultrasonographic evaluation of scarring after laparoscopic myomectomy with conventional versus barbed sutures

Tinelli, Andrea; Litta, Pietro; Angioni, Stefano; Bettocchi, Stefano; Leo, Livio; Landi, Stefano; Cicinelli, Ettore

doi:10.1016/j.ijgo.2015.10.029

Cited by 15 publications

(10 citation statements)

References 22 publications

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“…Tinelli et al [32] in a multicenter retrospective study, with the largest number of patients, investigate clinical outcomes after laparoscopic myomectomy related to the use of traditional interrupted sutures or continuous barbed suture. This trial demonstrated that the use of barbed filaments is a valid opportunity in the treatment of symptomatic myoma during laparoscopic procedure, especially in case of 3 or more uterine myomas.…”

Section: Resultsmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

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Background: This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy. Methods: Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017. Results: Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] –0.650, 95% CI –1.420 to –0.119, p = 0.098, test for heterogenity p < 0.0001, I² = 95.54%), Hb drop (SMD –1.452, 95% CI –3.590 to 0.687, p = 0.183, test for heterogenity p < 0.0001, I² = 99.08%), suturing difficulty (SMD –0.638, 95% CI –0.935 to –0.342, p ≤ 0.001, test for heterogenity p = 0.25, I² = 27.84%), suturing time (SMD –1.197, 95% CI –1.848 to –0.549, p ≤0.001, test for heterogenity p = 0.0001, I² = 83.30%) and total operative time (SMD –0.687, 95% CI –0.804 to –0.569, p ≤ 0.001, test for heterogenity p = 0.292, I² = 17.44%). Barbed suture demonstrated to be better in comparison with the control group even with regard to the length of hospitalization (SMD –0.278, 95% CI –0.543 to 0.012, p = 0.040, test for heterogenity p = 0.025, I² = 61.85%), and to perioperative complications (SMD 0.708, 95% CI 0.503–0.996, p = 0.048, test for heterogenity p = 0.79, I² = 0%). Conclusion: Barbed suture significantly facilitates laparoscopic myomectomy by reducing the total operative/suturing time, estimated blood loss/Hb drop, and reduction of perioperative complications.

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Section: Resultsmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

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“…Another conflicting factor is the type of the suture material. It is widely known that using barbed suture during myomectomy makes the duration of operation shorter with less hemorrhage, and it is shown that using barbed suture has no negative impact on myomectomy scar healing in a multicenter study [10]. In our study, we used both types of the suture and we could not analyze the effect of the suture type on LM complications.…”

Section: Discussionmentioning

confidence: 90%

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

et al. 2020

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Objective: To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy. Background: Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury, and conversion to laparotomy may be seen in laparoscopic myomectomy. We do not know whether the fibroid location affects these complications. Materials and methods: Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4, or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e., anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery and complication rates were compared across categories. Results: Two hundred nineteen women with a mean age of 35.7 ± 6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. The other ten women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior, and posterior groups, respectively (p = 0.9). The median (25th-75th percentile) changes in hemoglobin levels were 1.5 (0.8-2.2), 1.3 (0.6-2.1), and 1.3 (0.9-2) g/dl in fundal, anterior, and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion: The incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.

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“…It's widely known that using barbed suture during myomectomy makes the duration of operation shorter with less hemorrhage and it's shown that using barbed suture has no negative impact on myomectomy scar healing in a multicenter study. [10] In our study, we used both types of the suture and we couldn't analyze the effect of the suture type on LM complications.…”

Section: Discussionmentioning

confidence: 99%

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

Aslan

Orhan

Türkgeldi

et al. 2020

Preprint

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Objective To determine whether hemorrhage and complication rates vary according location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury and conversion to laparotomy may be seen in laparoscopic myomectomy. We don’t know whether fibroid location effect these complications. Materials & Methods Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4 or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e. anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery, and complication rates were compared across categories. Results 219 women with mean age of 35.7 +/-6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. Other 10 women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior and posterior groups, respectively (p=0.9). The median (25 th – 75 th percentile) changes in hemoglobin levels were 1.5 (0.8 – 2.2), 1.3 (0.6 – 2.1), and 1.3 (0.9 – 2) g/dl in fundal, anterior and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion Incidence of hemorrhage or complication does not seem to vary depending on fibroid location. However, the sample size was limited, the observed values suggest that fibroid location does not affect hemorrhage and complication rates.

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A multicenter study comparing surgical outcomes and ultrasonographic evaluation of scarring after laparoscopic myomectomy with conventional versus barbed sutures

Abstract: Laparoscopic myomectomy using CBS is a suitable alternative to TIS in the treatment of uterine myomas for women with up to three tumors.

Cited by 15 publications

References 22 publications

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?

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