350 rub
Journal Science Intensive Technologies №1 for 2016 г.
Article in number:
The results of robot-assisted laparoscopic myomectomy in women of reproductive age in the postoperative period
Authors:
E.F. Kira - Dr. Sc. (Med.), Professor, Main Gynecologist, Head of Department, Pirogov National Medical and Surgical Center (Moskow) A.K. Politova - Dr. Sc. (Med.), Head of Gynecology Department, Pirogov National Medical and Surgical Center (Moskow) V.A. Gudebskaya - Post-graduate Student, Pirogov National Medical and Surgical Center (Moskow). E-mail: victoriagudebskaya@yahoo.fr
Abstract:
Analysis of recurrence of uterine fibroids and the state of the postoperative scar in patients of reproductive age after laparoscopic robot-assisted myomectomy. Elective myomectomy using robotic da Vinci Si surgical system performed on 44 patients. 17 patients had recurrence of uterine fibroids. After 6 months - in 4 patients, after 1 year - in 8, after 2 years - in 5. In 13 case - the growth of a single node, in a 4 - multiple uterine fibroids. The correlational analysis demonstrates a moderate positive connection be-tween the risk of recurrence of uterine fibroids and age of the patient, and the number of nodes that are removed. 11 patients became pregnant. In one patient occurred normal delivery. Elective caesarean section performed on 4 patients. Intraope-ratively - myometrium in the scar has not been thinned. Currently we have 2 pregnant women (22 and 24 weeks of gestation). In the course of ultrasound examination in the second trimester of pregnancy - a scar after myomectomy wealthy. Robot-assisted laparoscopic myomectomy should be considered as an effective method of organ-preserving reconstructive treatment of uterine fibroids in female patients of reproductive age who plan future implementation of the generative function.
Pages: 48-53
References

 

  1. Bujanova S.N., Logutova L.S., Babunashvili E.L., Gorbunova T.N. Reproduktivnyjj prognoz pri miome matki // Akusherstvo i ginekologija. 2002. № 2. S. 12−16.
  2. Ckhajj V.B., SHtokh E.A. Mioma matki i reproduktivnaja funkcija zhenshhiny. Svjaz miomy matki s besplodiem // Akusherstvo, ginekologija i reprodukcija. 2014. № 4. S. 42−47.
  3. Tikhomirov A.L., Lubnin D.M. Optimizacija lechenija bolnykh miomojj matki // Akusherstvo i ginekologija. 2005. T. 4. № 5−6. S. 2−8.
  4. Glukhov E.JU. Ispolzovanie sovremennykh ehnergijj pri laparoskopicheskojj i «otkrytojj» miomehktomii // Medicinskaja nauka i obrazovanie Urala. 2011. № 1. S. 89−93.
  5. Syam H.H. Pregnancy outcomes following laparoscopic myomectomy // World J. Laparoscop. Surg. 2008. V. 1. № 1. P. 35−40.
  6. Tal R., Segars G.H. The role of angiogenic factors in fibroid pathogenesis: potential implications for future therapy // Hum. Reprod. Update. 2014. V. 20. № 2. P. 194−216.
  7. Kalinina E.A., SHirokova D.V., Popov G.D., Lukin V.I., Korenev I.I., Kalinina I.I. Taktika vedenija pacientok s miomojj matki pri ehkstrakorporalnom oplodotvorenii // Problemy reprodukcii. 2005. № 1.
  8. Fatkullin I.F., Bakanova A.R. Primenenie antiprogestinov dlja profilaktiki recidivov posle konservativnojj miomehktomii // Akusherstvo i ginekologija. 2011. № 1. S. 101−104.
  9. Hanafi M. Predictors of leiomyoma recurrence after myomectomy // Obstet. Gynec. 2005. V. 105. № 4. P. 877−881.
  10. Petrakova S.A., Bujanova S.N., Mgeliashvili M.V. Vozmozhnosti miomehktomii v korrekcii reproduktivnogo zdorovja zhenshhin s miomojj matki // Rossijjskijj vestnik akushera-ginekologa. 2009. № 1. S. 30−35.
  11. Bhave Chittawar P., Franik S., Pouwer A.W., Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids // Cochrane Database Syst. Rev. 2014. 10: CD004638.
  12. Politova A.K., Zarubenko I.P., Kira E.F., Demkina I.V., Gajjtukieva R.A., Vjazmina K.JU., Popova M.N. Optimizacija metodiki laparoskopicheskojj miomehktomii // Vestnik Nacionalnogo mediko-khirurgicheskogo centra im. N.I. Pirogova. 2011. T. 6. № 2. S. 77−80.
  13. Nishiyama S., Saito M., Sato K., Kurishita M., Itasaka T., Shioda K. High recurrence rate of uterine fibroids on transvaginal ultrasound after abdominal myomectomy in Japanese women // Gynecol. Obstet. Invest. 2006. V. 61. № 3. P. 155−159.
  14. Yoo E.H., Lee P.I., Huh C.Y., Kim D.H., Lee B.S., Lee J.K., Kim D. Predictors of leiomyoma recurrence after laparoscopic myomectomy // J. Minim. InvasiveGynecol. 2007. V. 14. № 6. P. 690−697.
  15. Pitter M.C., Gargiulo A.R., Bonaventura L.M., Lehman J.S., Srouji S.S. Pregnancy outcomes following robot-assisted myomectomy // Hum. Reprod. 2013. V. 28. № 1. P. 99−108.
  16. Markuly S.N., Miller C.E., Szela K. Uterine rupture after robotic-assisted laparoscopic myomectomy. CRSLSe2014.00208. DOI10.4293/CRSLS.2014.00208.