Endometrial myomectomy: a novel surgical method during cesarean section

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Uterine fibroids (leiomyomas) are common and can complicate cesarean sections.
• Surgical options for myomectomy during cesarean delivery include serosal myomectomy (SM).
• A novel technique, endometrial myomectomy (EM), has been developed.

Purpose of the Study:

• To compare the surgical outcomes of endometrial myomectomy (EM) with serosal myomectomy (SM) when performed during cesarean section (CS).

Main Methods:

• Retrospective cohort study (Level II-1 evidence) conducted in a private hospital.
• Compared 22 consecutive EM cases (Group 1) with matched SM cases (Group 2) performed between 2013 and 2016.
• Key outcomes included operative time, intraoperative bleeding, blood transfusion needs, and hospital stay duration.

Main Results:

• The median number of leiomyomas was higher in the EM group (p=0.001).
• Endometrial myomectomy (EM) demonstrated significantly less intraoperative bleeding (p=0.001) and shorter procedure times (p=0.005) compared to serosal myomectomy (SM).
• No significant differences were observed in other measured variables between the groups.

Conclusions:

• Endometrial myomectomy (EM) is a safe and feasible surgical technique for myomectomy during cesarean section.
• EM offers the advantage of reduced intraoperative blood loss compared to SM.
• The technique may also decrease the risk of postoperative abdominal adhesion formation.