Feasibility Study And Surgical Technique Sharing Of Myomectomy For Intramural Myoma Greater Than 8cm During Cesarean Section

Objective: To explore the feasibility and safety of cesarean myomectomy in large interstitial myoma. Methods: A total of 124 cases of pregnancy who underwent cesarean section in Ningbo Women's and Children's Hospital were selected. 79 patients were complicated with intramural uterine leiomyoma, and 43 patients underwent cesarean myomectomy (Study group), and 36 patients did not undergo myomectomy during cesarean section (regular group). No uterine leiomyoma was found in the other 45 patients during cesarean section (control group). The intraoperative conditions were compared, including operation time, intraoperative blood loss and uterine balloon packing rate. The short-term recovery after operation was compared, including the time of use of antibiotics, postoperative hospital stay, postoperative fever rate and anal exhaust time. Long-term recovery after discharge was followed up by telephone. Results: Compared with the operation time of the three groups, the operation time of the study group was significantly longer than that of the regular group and the control group[75(60, 150) min vs 69.5(40, 100) min vs 58(41, 70) min, P<0.001]. In the control group, the study group and the regular group, the intraoperative blood loss was 400（350，600）ml vs 600（400,2500）ml vs 550（400,1300）ml, P <0.001], antibiotic use time [2(1,3) days vs 3(2,5) days vs 3 (2,12) days, P <0.001], postoperative hospital stay [4(3,5) days vs 5(4,6) days vs 5(4,14) days, P <0.001], anal exhaust time [1(1,1) day vs 1(1,5) day vs 1(1,3) day, P 0.05). Compared with the study group and the control group, the balloon implantation rate of the regular group was the highes (33.3% vs 11.65% vs 0%, P 38℃) among the three groups. Conclusions: For pregnancy complicated with large uterine leiomyoma, it is safe and feasible to be resected by experienced obstetricians and gynaecologists at the same time of cesarean section.