Risk Factors for Uterine Rupture after Laparoscopic Myomectomy

被引:155
作者
Parker, William H. [1 ]
Einarsson, Jon [2 ]
Istre, Olav [2 ]
Dubuisson, Jean-Bernard [3 ]
机构
[1] St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA 90401 USA
[2] Harvard Univ, Sch Med, Dept Obstet & Gynecol, Boston, MA USA
[3] Hop Cantonal Univ Geneva, Dept Obstet & Gynecol, Geneva, Switzerland
关键词
Uterine rupture; Laparoscopic myomectomy; ABDOMINAL MYOMECTOMY; 3RD TRIMESTER; PREGNANCY; DEHISCENCE; SEGMENT; SUBSEQUENT; DELIVERY; UTERUS; IMPACT; SCAR;
D O I
10.1016/j.jmig.2010.04.015
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Case reports for uterine rupture subsequent to laparoscopic myomectomy were reviewed to determine whether common causal factors could be identified. Published cases were identified via electronic searches of PubMed, Google Scholar, and hand searches of references, and unpublished cases were obtained via E-mail queries to the AAGL membership and AAGL Listserve participants. Nineteen cases of uterine rupture after laparoscopic myomectomy were identified. The removed myomas ranged in size from 1 through 11 cm (mean, 4.5 cm). Only 3 cases involved multilayered closure of uterine defects. Electrosurgery was used for hemostasis in all but 2 cases. No plausible contributing factor could be found. It seems reasonable for surgeons to adhere to techniques developed for abdominal myomectomy including limited use of electrosurgery and multilayered closure of the myometrium. Nevertheless, individual wound healing characteristics may predispose to uterine rupture. Journal of Minimally Invasive Gynecology (2010) 17, 551-554 (C) 2010 AAGL. All rights reserved.
引用
收藏
页码:551 / 554
页数:4
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