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Long-term outcomes of single-port laparoscopic myomectomy using a modified suture technique

Obstetrics & Gynecology Science 2020년 63권 2호 p.164 ~ 172
 ( Kang Mina ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology

 ( Kim Ji-Hye ) - Dankook University Hospital Department of Obstetrics and Gynecology
김태중 ( Kim Tae-Joong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynaecology
이정원 ( Lee Jeong-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynaecology
김병기 ( Kim Byoung-Gie ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology
배덕수 ( Bae Duk-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology
최철훈 ( Choi Chel-Hun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology

Abstract


Objective: To evaluate the long-term outcomes, including the pregnancy outcome and recurrence rate after single-port laparoscopic myomectomy (LM) using a modified suture technique with a Hem-o-lok clip (Choi's LM) and conventional 4-port LM.

Methods: A retrospective study of patients who underwent Choi's LM (n=55) and 4-port LM (n=102) in a single institutional hospital was conducted. Patients with <3 symptomatic myomas sized <10 cm each and operated on by a single surgeon were included. Recurrence was confirmed when a myoma measuring ≥3 cm was detected.

Results: The patients in both groups had similar demographic characteristics. Single (76.4% vs. 62.7%) and intramural (52.7% vs. 56.9%) tumors were commonly detected in both groups in the mean diameter (6.8±1.5 cm vs. 7.0±1.6 cm; P=0.40). In Choi's LM, 16 patients (29.1%) needed an additional port; those who were nulliparous and/or had a large leiomyoma more frequently required an additional port (P=0.023 and 0.04, respectively). During a median follow-up period of 69 months, 17 patients (7.1% vs. 14.6%) had recurrence. The size of dominant myomas at recurrence was significantly smaller in patients who underwent Choi's LM (3.4±0.7 cm vs. 5.7±2.4 cm; P=0.004). All 13 patients in both groups who successfully conceived had a full-term delivery. No major complications occurred during pregnancy.

Conclusion: Although an additional port was frequently used, the long-term outcomes of patients who experienced recurrence and pregnancy after Choi's LM were acceptable. Considering its usability, Choi's LM is feasible for the treatment of uterine leiomyoma.

키워드

Laparoscopic myomectomy; Modified suture technique; Pregnancy; Single port; Uterine leiomyoma
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