Background: To compare intra- and postoperative surgical outcomes between transvaginal in-bag specimen extraction and standard transumbilical in-bag specimen morcellation after laparoscopic myomectomy. Methods: Retrospective analysis of prospectively collected data, between January 2004 and December 2018. The laparoscopic myomectomy was performed in a standard fashion. We subdivided patients into two groups: one underwent transvaginal in-bag specimen extraction; the other underwent standard transumbilical in-bag specimen morcellation. A careful gross inspection of bag integrity was always performed for both groups, filling the bag with saline solution. For each patient, we retrieved data about age, Body Mass Index (BMI), largest myoma size, myoma(s) weight, operative time, intraoperative blood loss and hospital stay. The study design was approved by an independent institutional review board and each patient signed informed consent to allow data collection for research purpose. Results: During the study period, we collected a total of 453 women who underwent laparoscopic myomectomy. Transvaginal in-bag specimen extraction was performed in 314 women and standard transumbilical in-bag specimen morcellation was performed in 113 patients. In the transvaginal group, the mean age was 35.7±6.7 years and mean BMI was 22.5±2.7. The mean largest myoma size was 67.5±18.9 mm, mean myoma(s) weight was 171.4±109.3 gr, mean operative time was 79.7±32.1 minutes, and mean blood loss was 167.8±154.1 ml. The median hospital stay was 2 (1–7) days. In the transabdominal group, the mean age was 36.8±5.9 years and mean BMI was 24.1±4.5. The mean largest myoma size was 63.8±22.7 mm, mean myoma(s) weight was 169.5±152.6 gr, mean operative time was 75.9±29.4 minutes and mean blood loss was 181.9±165.2 ml. The median hospital stay was 3 (1–7) days. The hospital stay was significantly reduced (p<0.001) in the transvaginal group respect to the transabdominal one, in a median of one day. We did not find significant differences for all the other analyzed parameters (age, BMI, largest myoma size, myoma(s) weight, operative time, intraoperative blood loss). Conclusions: The transvaginal in-bag specimen extraction after laparoscopic myomectomy seems to reduce the hospital stay.

Transvaginal in-bag specimen extraction after laparoscopic myomectomy seems to reduce postoperative hospital stay compared to transumbilical in-bag specimen morcellation

Antonio Simone Laganà;
2019-01-01

Abstract

Background: To compare intra- and postoperative surgical outcomes between transvaginal in-bag specimen extraction and standard transumbilical in-bag specimen morcellation after laparoscopic myomectomy. Methods: Retrospective analysis of prospectively collected data, between January 2004 and December 2018. The laparoscopic myomectomy was performed in a standard fashion. We subdivided patients into two groups: one underwent transvaginal in-bag specimen extraction; the other underwent standard transumbilical in-bag specimen morcellation. A careful gross inspection of bag integrity was always performed for both groups, filling the bag with saline solution. For each patient, we retrieved data about age, Body Mass Index (BMI), largest myoma size, myoma(s) weight, operative time, intraoperative blood loss and hospital stay. The study design was approved by an independent institutional review board and each patient signed informed consent to allow data collection for research purpose. Results: During the study period, we collected a total of 453 women who underwent laparoscopic myomectomy. Transvaginal in-bag specimen extraction was performed in 314 women and standard transumbilical in-bag specimen morcellation was performed in 113 patients. In the transvaginal group, the mean age was 35.7±6.7 years and mean BMI was 22.5±2.7. The mean largest myoma size was 67.5±18.9 mm, mean myoma(s) weight was 171.4±109.3 gr, mean operative time was 79.7±32.1 minutes, and mean blood loss was 167.8±154.1 ml. The median hospital stay was 2 (1–7) days. In the transabdominal group, the mean age was 36.8±5.9 years and mean BMI was 24.1±4.5. The mean largest myoma size was 63.8±22.7 mm, mean myoma(s) weight was 169.5±152.6 gr, mean operative time was 75.9±29.4 minutes and mean blood loss was 181.9±165.2 ml. The median hospital stay was 3 (1–7) days. The hospital stay was significantly reduced (p<0.001) in the transvaginal group respect to the transabdominal one, in a median of one day. We did not find significant differences for all the other analyzed parameters (age, BMI, largest myoma size, myoma(s) weight, operative time, intraoperative blood loss). Conclusions: The transvaginal in-bag specimen extraction after laparoscopic myomectomy seems to reduce the hospital stay.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11570/3145000
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