Abdominal myomectomy in women with very large uterine size

Abstract

Objective: To evaluate feasibility and safety of abdominal myomectomy with uterine myomas equal to or greater than 16 weeks in size.

Design: Retrospective chart review.

Setting: Private hospital.

Patient(s): Women with uterine fibroids equal to or larger than 16 weeks in size.

Intervention(s): Abdominal myomectomy performed by one surgeon between March 1, 1998-February 28, 2003.

Main outcome measure(s): Operating time, estimated blood loss, transfusion, cell-saver use, number and weight of fibroids removed, complications, pathology, and hospital stay were evaluated.

Result(s): Ninety-one abdominal myomectomies met criteria. Mean operating time was 236 minutes (range, 120-390 minutes). Mean estimated blood loss was 794 mL (range, 50-3,000 mL). Seven (8%) women required homologous transfusion. Complications included one bowel injury, one bladder injury, one wound infection, and one reoperation for incarcerated small bowel. No woman had a uterine sarcoma or adenocarcinoma, and none required conversion to hysterectomy.

Conclusion(s): Large uterine size does not preclude abdominal myomectomy and the results compare favorably with prior studies of hysterectomy for similar size uteri.