Predictors of postoperative hemoglobin drop after laparoscopic myomectomy

Abstract

Introduction: Laparoscopic myomectomy (LM) can be associated with significant bleeding.

Aim: To identify factors influencing the postoperative hemoglobin (Hb) drop after LM.

Material and methods: This is a retrospective, single-center study. We evaluated data of 150 consecutive patients undergoing LM due to intramural myomas between 2010 and 2015.

Results: The median age of the patients was 37 (23-53) years. The mean diameter of the largest myoma was 5.7 ±2.3 (1.5-12) cm. The mean surgical time was 83 ±38 (35-299) min. The median number of sutures was 3 (1-11). The mean postoperative Hb drop was 1.6 ±1.2 (0-6) g/dl, and the mean estimated blood loss was 261 ±159 (50-1700) ml. In the univariate analysis, the postoperative Hb drop correlated with the duration of surgery (p < 0.001), diameter of the largest myoma (p < 0.001), cumulative myoma weight (p < 0.001), and number of sutures (p < 0.001), but not with patients' age or number of intramural myomas. In the multivariable analysis, the surgical time (β = 0.395, p < 0.001), diameter of the largest myoma (β = 0.292, p = 0.03) and preoperative Hb concentration (β = 0.299, p < 0.001) predicted the postoperative Hb change.

Conclusions: Surgical time and dominant myoma diameter are independent predictors of the postoperative Hb drop after LM.

Keywords: bleeding; gynecological laparoscopy; hemoglobin change; myomectomy; surgical time.