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Zhonghua yi xue za zhi 2005-Jan

[Transcervical resection of myoma in treatment of hysteromyoma, experience in 962 x\cases].

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En-lan Xia
Hua Duan
Xiao-wu Huang
Jie Zheng
Dan Yu

Keywords

Abstract

OBJECTIVE

To study the technique and effect of transcervical resection of myoma (TCRM) in treatment of hysteromyoma.

METHODS

962 women suffering type 0 hysteromyoma (n = 281), 316 type 1 hysteromyoma (n = 316), type 2 hysteromyoma (n = 282), submucous and intramural myoma (n = 34), cervical myoma (n = 11), prolapse myoma (n = 23), and adenomyoma (n = 15) underwent TCRM with "five-step technique", monitored by B-ultrasound or laparoscopy, Follow-up lasted more than 6 months.

RESULTS

The primary operation successful rate was 99.77%. The mean size and depth of uterus were 7.44 +/- 1.3 gestation weeks and (8.31 +/- 1.43) cm, the diameter of the biggest myoma was 7.2 cm. The mean weight of the resected tissues was (22.63 +/- 31.41) g, and the mean operation time and blood loss during the operation were 32.50 +/- 172.72 minutes and (7.75 +/- 19.49) ml. No transfusion was needed. The complications included postoperative fever (3 cases), uterine bleeding (1 case), uterine perforation (1 case), and TURP syndrome (2 cases). Postoperative scanty menstrual rate was 100% in the type 0 hysteromyoma group, 99.1% in the type I hysteromyoma group, 94.02% in the type II hysteromyoma group, 100% in the cervical myoma and prolapse myoma group, 84% in the multiple myoma and intramural myoma group, and 87% in the adenomyoma group respectively. The alleviation rates of dysmenorrhea and anemia were 78% and 82.95% respectively. Those who have severe complications of internal medicine showed obvious improvement. The residual myoma of 2 cases were resected during the secondary operation 9 days and 3 months after the primary operation. 455 cases (52.17%) resumed their work in 1 month postoperatively. 32 living infants were delivered.

CONCLUSIONS

Safe and highly effective, TCRM can be the first choice in treatment of submucous and intramural hysteromyoma.

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