잠시만 기다려 주세요. 로딩중입니다.

Clinical experience of robotic myomectomy for fertility preservation using preoperative magnetic resonance imaging predictor

Obstetrics & Gynecology Science 2020년 63권 6호 p.726 ~ 734
박소연, 김주희, 정경아, 정성일, 허영민, 조은헤, 문혜성, 정혜원,
소속 상세정보
박소연 ( Park So-Yun ) - Ewha Womans University College of Medicine Ewha Womans University Seoul Hospital Department of Obstetrics and Gynecology
김주희 ( Kim Ju-Hui ) - Ewha Womans University College of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology
정경아 ( Jeong Kyung-Ah ) - Ewha Womans University College of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology
정성일 ( Jung Sung-Il ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Radiology
허영민 ( Hur Young-Min ) - Ewha Womans University College of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology
조은헤 ( Cho Eun-Hye ) - Ewha Womans University College of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology
문혜성 ( Moon Hye-Sung ) - Ewha Womans University College of Medicine Ewha Womans University Seoul Hospital Department of Obstetrics and Gynecology
정혜원 ( Chung Hye-Won ) - Ewha Womans University College of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology

Abstract


Objective: This study aimed to demonstrate the use of preoperative magnetic resonance imaging (MRI) findings to select the optimal surgical technique between single-site (SS) and multi-site (MS) robotic myomectomy based on clinical experience, for the preservation of fertility.

Methods: Ninety-eight patients who underwent SS or MS robotic myomectomy using the da Vinci® Si system after undergoing MRI were evaluated retrospectively. The correlation between preoperative MRI findings and the intraoperative or postoperative findings during robotic myomectomy for the preservation of fertility was analyzed. The reproductive outcome was investigated when the patient wished to conceive.

Results: The mean age of the patients was 35.68±5.04 years and 80 patients (81.6%) were nulliparous. The total diameter of myomas on MRI was 106.75±54.52 mm. The number of resected myomas was 4.31±4.39 (range, 1-27), and the total weight of resected myomas was 293.11±281.13 (range, 30-1,260) g. Myomas with high signal intensity on MRI required less time for resection. MS robotic myomectomy was performed for an increased number and total diameter of a myoma or a deep-seated myoma.Postoperatively, all patients resumed normal menstruation. Of the 15 patients who wished to conceive, 12 (80%) conceived successfully. Of these, uterine dehiscence occurred in 1 patient and 10 patients underwent an uneventful cesarean section.

Conclusion: SS or MS robotic myomectomy can be recommended for patients who wish to conserve fertility. However, the optimal surgical technique should be selected based on preoperative MRI findings to predict an effective surgical process and the successful preservation of fertility.

키워드

Uterine myomectomy; Magnetic resonance imaging; Fertility preservation

원문 및 링크아웃 정보

등재저널 정보