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Laparoscopic ultrasound procedure can reduce residual myomas in laparoscopic myomectomy for multiple myomas
Takashi Mimura1, Junichi Hasegawa2, Tetsuya Ishikawa2
1Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. m-bonby@med.showa-u.ac.jp.
Purpose:
To clarify whether the use of laparoscopic ultrasound (LUS) during laparoscopic myomectomy could reduce the number of residual myomas after surgery.
Methods:
A cohort study was conducted. Subjects were women who underwent laparoscopic myomectomy for multiple uterine myomas for the first time. The subjects were assigned to one of two groups: LUS group or non-LUS group. All subjects underwent pelvic MRI 3 months before and 6 months after surgery, and the number of myomas on MRI was counted by radiodiagnosticians. The extraction rate and residual rate of uterine myomas were compared between the two groups.
Results:
Fourteen cases with and 30 cases without LUS were analyzed. Median operation times were 171 min (range 75-295) and 141 min (range 50-260) in cases with and without LUS, respectively (p = 0.077). Median extraction rates relative to the total number of myomas were 106 % (range 75-147 %) in subjects with LUS and 100 % (range 71-233 %) in subjects without LUS (p = 0.480). Numbers of residual myomas were 1 (range 0-3) in subjects with LUS and 2 (range 0-9) in subjects without LUS (p = 0.028). Median residual rates of myomas were 6.1 % (range 0-20 %) in subjects with LUS and 20.0 % (range 0-69 %) in subjects without LUS (p = 0.048). Myomas greater than 3 cm in diameter were not observed in either group.
Conclusions:
The number and residual rate of myomas were significantly less in subjects with LUS as compared with those without LUS.
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