Uterine myomas: management

Parker, William H.

doi:10.1016/j.fertnstert.2007.06.044

Cited by 201 publications

(145 citation statements)

References 138 publications

(126 reference statements)

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“…The pathophysiology of adhesion formation is complex and unpredictable as to site and intensity 1,[3][4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

“…Videolaparoscopic surgery has been considered more convenient for the patient than laparotomy, since it causes less trauma, less manipulation of the tissues, less exposure to foreign bodies, and is also associated with less inflammatory response, less likelihood of postoperative infection, and, presumably, less risk of adhesions 1,4,5,8,9 . However, adhesions have been described in laparoscopic approaches, especially in long duration surgeries, with high insufflation pressures.…”

Section: Introductionmentioning

confidence: 99%

“…However, adhesions have been described in laparoscopic approaches, especially in long duration surgeries, with high insufflation pressures. There is still, therefore, the need to use adhesion prevention mechanisms, for instance in myomectomies 3,4,10 , in larger areas of peritoneal resection to approach tumors in the retroperitoneum 1 , in endometriosis 9 , and in surgery using monopolar energy.…”

Section: Introductionmentioning

confidence: 99%

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Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits

Balbinotto

Trindade²,

Müller³

et al. 2010

Acta Cir. Bras.

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Purpose:To verify the frequency of postsurgical pelvic adhesion formation in an experimental animal model using videolaparoscopy. Methods: Experimental study in a sample of 11 non-pregnant female rabbits, aged 5 to 7 months. After general anesthesia, access to the abdominal cavity was performed by an open puncture technique, with 10mm optics, placing two other 5 mm trochars under direct visualization, in the iliac fossae. Then a fragment of peritoneum was resected, followed by electrocauterization. In 21 days, the videolaparoscopy was repeated, and adhesion formation and score was looked at, with biopsies at the surgical site. Results: 54 % of adhesion formation was observed, and the median score of adhesions was 6 (minimum of 3 and maximum of 10), all of them found in the bladder and the anterior abdominal wall. Conclusion: The method used presents a high frequency of intra-abdominal adhesion formation. Key words: Adhesions. Laparoscopy. Surgery. Rabbits. RESUMOObjetivo: Verificar a freqüência da formação de aderências pélvicas pós-cirúrgicas, em um modelo experimental animal, por videolaparoscopia. Métodos: Estudo experimental, em uma amostra de 11 coelhas, não prenhas, com idade entre cinco e sete meses. Após anestesia geral, o acesso da cavidade abdominal foi efetuado por técnica de punção aberta, com óptica de 10 mm, colocando-se outros dois trocateres de 5 mm, sob visão direta, nas fossas ilíacas. Realizou-se, então, ressecção de fragmento de peritônio, seguida de cauterização com eletrocautério. Em 21 dias, foi repetida a videolaparoscopia, verificando-se a formação e escore de aderências e realizando-se biópsias do local da cirurgia. Resultados: Observou-se 54,5% de formação de aderências, sendo o escore total mediano de aderências seis (mínimo de três e máximo de 10), todas encontradas na bexiga e na parede abdominal anterior. Conclusão: O procedimento utilizado apresentou alta freqüência de formação de aderências intra-abdominais. Descritores: Aderências. Laparoscopia. Cirurgia. Coelhos.

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“…The pathophysiology of adhesion formation is complex and unpredictable as to site and intensity 1,[3][4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits

Balbinotto

Trindade²,

Müller³

et al. 2010

Acta Cir. Bras.

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“…La sintomatología que origina consulta asociada a esta entidad, habitualmente se manifiesta durante los últimos años de vida reproductiva de la mujer, siendo la hipermenorrea y la anemia secundaria junto con el algia pelviana por compresión de estructuras vecinas secundario al tamaño que adquiere el tumor (1). Con el advenimiento de la ultrasonografía pelviana y su uso frecuente como parte de la evaluación rutinaria, se ha producido un incremento significativo de casos, diagnosticados en etapa asintomática, generando nuevas necesidades de manejo y seguimiento de la enfermedad (2).…”

Section: Introductionunclassified

“…En pacientes con deseos de fertilidad futura, las opciones más usadas son la miomectomía con o sin uso previo de agonistas GNRH y para aquellas que desean preservar su útero, además de la miomectomía, la embolización de las arterias uterinas, el ultrasonido focalizado, la ablación endometrial y la miolisis (2). Específicamente, en nuestro país, existen pocos trabajos que hayan analizado los resultados obtenidos con el manejo quirúrgico conservador del mioma uterino en cuanto a complicaciones derivadas de la cirugía y fertilidad futura.…”

Section: Introductionunclassified

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

Sigüenza²,

et al. 2009

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: Múltiples pacientes requieren un manejo conservador del mioma uterino. Muchas de ellas no han completado su paridad, y otras no desean la remoción del útero preocupadas del impacto que esa alternativa tenga en su vida sexual. Objetivos: Evaluar nuestra experiencia en pacientes miomectomizadas mediante laparoscopia o laparotomía y revisar la literatura para definir las ventajas de cada técnica y recomendaciones para su indicación. Método: Estudio prospectivo, no randomizado, de pacientes miomectomizadas en el Servicio de Ginecología del Hospital Clínico de la Universidad Católica de Chile, durante el período noviembre de 2007 y mayo de 2008. Resultados: La población incluida fue de 43 casos; 16 casos correspondieron a miomectomía laparoscópica (37,2%) y 27 a miomectomía por laparotomía (67,8%). La miomectomía por laparotomía se realizó en 40% de los casos utilizando una incisión transversa mínima. Esta vía de abordaje fue más frecuentemente utilizada cuando se trataba de miomas de gran tamaño o de múltiples miomas. En nuestra serie, la miomectomía laparoscópica se asociaría a un menor requerimiento de analgesia. No hay diferencias en la frecuencia de complicaciones, tiempo operatorio y estadía hospitalaria entre ambas técnicas, cuando se trata de miomas operados menores de 5 cm. Conclusión: Nuestros resultados sugieren que la miomectomía por laparotomía es una técnica segura que debiese privilegiarse cuando se trata de miomas grandes y múltiples. La laparoscopia es igualmente segura reservada para casos bien seleccionados y cirujanos experimentados en el procedimiento.PALABRAS CLAVE: Mioma, miomectomía, cirugía, laparoscopia, complicaciones SUMMARY Background: Multiple patients ask for a conservative management of uterine fibroids. Some of the patients have not completed their parity at the time of surgery, and others do not want an hysterectomy worried about de impact of this procedure in their sexual life. Objectives: The objective of this study was to evaluate our experience in the short term surgical results of patients undergoing a laparoscopic or abdominal myomectomy. We also did a literature review to define the advantages for each technique and their indications. Methods: A prospective, non-randomized study comparing short term surgical outcomes in patients undergoing laparoscopic versus abdominal myomectomy in the Gynecology Service of the Clinical Hospital of the Pontificia Universidad Católica de Chile, between November 2007 and May 2008. Results: Forty-three patients undergoing myomectomy in our centre were analyzed. 16 of them were approached by laparoscopy (37.2%)

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Use of Electric Power Morcellation and Prevalence of Underlying Cancer in Women Who Undergo Myomectomy

et al. 2015

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Uterine myomas: management

Cited by 201 publications

References 138 publications

Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits

Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

Use of Electric Power Morcellation and Prevalence of Underlying Cancer in Women Who Undergo Myomectomy

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