Journal of Gynecology and Obstetrics

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Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)

Received: 15 August 2019    Accepted: 18 September 2019    Published: 09 October 2019
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Abstract

To describe the epidemiological profile of patients, list myomectomy indications and report their prognosis at Loandjili General Hospital. A descriptive cross-sectional study conducted from 1 January 2016 to 31 December 2018 in the Gynecology Department of Loandjili General Hospital, including exhaustively all patients operated for myomectomy. The variables studied were pre (age, gestity, parity, indication), per (myoma measures, blood loss, intraoperative transfusion, complications and peroperative incidents) and postoperatively (hospital stay). Ninety-two patients had been received for surgical management of uterine fibroids out of a total of 1,455 gynecological procedures or 6.3%. The median age was 36.5 years [range 27 - 44] with a peak in the 36 to 40 age group (37%). The median gestity and parity were respectively 2 [range 0 - 12] and 1 [range 0 - 7]. More than half of the patients were nulliparous (51.1%). In 71.7% of cases (n = 66), myomectomy was performed in a context of desire for maternity. Indications for myomectomy were hemorrhage (46.7%), large uterus above the umbilicus (37%) and pelvic pain (16.3%). The polymyomectomy was performed in 64.1% of the cases (n = 59) with nuclei of size varying between 2 and 20 cm. The morbidity was marked on the one hand by anemia (n = 14 or 14%) secondary to an intraoperative haemorrhage which resulted in two cases in performing a hemostatic hysterectomy and in the other by rupture of the uterine cavity. Postoperative blood loss was estimated at 200 to 1400 ml, resulting in more than half of the patients receiving blood transfusions (58%). Myomectomy by laparotomy is often accompanied by significant blood spoliation thus increasing the postoperative morbidity. Techniques that minimize intraoperative blood loss should be used for laparotomy myomectomy.

DOI 10.11648/j.jgo.20190705.15
Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 5, September 2019)
Page(s) 145-148
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Myomectomy, Laparotomy, Epidemiology, Indications, Prognosis, Pointe Noire

References
[1] Villot A, Cheret-Benoist A, Creveuil C, Turck M, Dreyfus M, Benoist G. After Myomectomy, Do Patients Have the Right to Deliver Vaginally? Result of the Monocentric Study. Gynecol Obst and Fert. 2015; 43 (7-8) 496-501.
[2] Bendifallah S, Brun JL, Fernandez H. Place of Myomectomy in a Patient in a Situation of Infertility. J Gynecol Obstet Reprod Biol 2011; (40): 885, 901.
[3] Chen I, Lisonkova S, Joseph KS, Williams C, Yong P, Allaire C. Laparoscopic versus Abdominal Myomectomy: Practice Patterns and Health Care Use in British Colombia. JOGC 2014; (7): 817-23.
[4] Ahdad-Yata N, Fernandez H, Nazac A, Lesavre M, Pourcelot AG, Capmas P. Fertility After Hysteroscopic Resection of Submucosal Myoma in Infertile Women. J Gynecol Obstet Biol Reprod 2016; 45 (6): 563-70.
[5] Vilos GA, Allaire C, Laberge P-Y, Leyland N. Management of Uterine Leiomyomas. SOGC Clinical Guideline. J Obstet Gynaecol Can 2015; 37 (2): 179-81.
[6] Heike W, Bernhard F-F. Myoma. Swiss Medical Forum 2018; 18 (24): 503-8.
[7] Carranza-Mamane B, Havelock J, Hemmings R. Management of Uterine Fibroids in the Presence of Otherwise Unexplained Infertility. SOGC Clinical Guideline. J Obstet Gynaecol Can 2015; 37 (3): 286-8.
[8] Fukuda M, Tanaka T, Kamada M and al. Comparison of the Perinatal Outcomes after Laparoscopic Myomectomy. Gynecol Obstet invest 2013; 76: 203-8
[9] Marret H, Fritel X, Ouldamer L and al. Therapeutic Management of Uterine Fibroid Tumors: Updated French Guidelines. Eur J Obstet Gynecol Reprod Biol 2012; 165: 156-64.
[10] Véibel HS, Jarcevie R, Gagnon R, Tulandi T. Perspective of Obstetrician on Labor Delivery after Abdominal or Laparoscopic Myomectomy. J Obstet Gynecol Can 2014; 36 (2): 128-38.
[11] Bao J, Simpson AN, Hare GMT, Sholzberg M, Robertson D. Delphi Approach for the Design of an Intraoperative Blood Conservation Pathway for Open Myomectomy. J Obstet Gynaecol Can 2019; S1701-2163 (19) 30531-6.
[12] Fusca L, Perelman I, Fergusson D, Boutet M, Chen I. The Effectiveness of Tranexamic Acid at Reducing Blood Loss and Transfusion Requirement for Women Undergoing Myomectomy: A Systematic Review and Meta-analysis. J Obstet Gynaecol Can 2019; 41 (8): 1185-92.
[13] Fanny M, Fomba M, Aka E and al. Prevention of Bleeding During Laparotomic Myomectomy in Sub-Saharan Africa: Contribution to the Tourniquet on the Uterine Isthmus. Gynecol Obstet Fertil Senol 2018; 46 (10-11): 681-5.
[14] Itoua C, Eouani LME, Obara Ngoli Mbongui P, Koko PS, Iloki LH. Abscence of Dressing versus Dressing in Gynaecological and Obstetrical Surgery at the University Hospital of Brazzaville. Open Journal of Obstetrics and Gynecology 2018; (8): 247-52.
Author Information
  • Obstetrics and Gynecology Department, Loandjili General Hospital, Pointe Noire, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Obstetrics and Gynecology Department, Brazzaville University Hospital, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

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    Eouani Levy Max Emery, Mokoko Jules Cesar, Buambo Gauthier Regis Jostin, Potokoue Mpia Sekangue Samantha Nuely, Itoua Clautaire, et al. (2019). Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo). Journal of Gynecology and Obstetrics, 7(5), 145-148. https://doi.org/10.11648/j.jgo.20190705.15

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    ACS Style

    Eouani Levy Max Emery; Mokoko Jules Cesar; Buambo Gauthier Regis Jostin; Potokoue Mpia Sekangue Samantha Nuely; Itoua Clautaire, et al. Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo). J. Gynecol. Obstet. 2019, 7(5), 145-148. doi: 10.11648/j.jgo.20190705.15

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    AMA Style

    Eouani Levy Max Emery, Mokoko Jules Cesar, Buambo Gauthier Regis Jostin, Potokoue Mpia Sekangue Samantha Nuely, Itoua Clautaire, et al. Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo). J Gynecol Obstet. 2019;7(5):145-148. doi: 10.11648/j.jgo.20190705.15

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  • @article{10.11648/j.jgo.20190705.15,
      author = {Eouani Levy Max Emery and Mokoko Jules Cesar and Buambo Gauthier Regis Jostin and Potokoue Mpia Sekangue Samantha Nuely and Itoua Clautaire and Iloki Leon Herve},
      title = {Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {7},
      number = {5},
      pages = {145-148},
      doi = {10.11648/j.jgo.20190705.15},
      url = {https://doi.org/10.11648/j.jgo.20190705.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.jgo.20190705.15},
      abstract = {To describe the epidemiological profile of patients, list myomectomy indications and report their prognosis at Loandjili General Hospital. A descriptive cross-sectional study conducted from 1 January 2016 to 31 December 2018 in the Gynecology Department of Loandjili General Hospital, including exhaustively all patients operated for myomectomy. The variables studied were pre (age, gestity, parity, indication), per (myoma measures, blood loss, intraoperative transfusion, complications and peroperative incidents) and postoperatively (hospital stay). Ninety-two patients had been received for surgical management of uterine fibroids out of a total of 1,455 gynecological procedures or 6.3%. The median age was 36.5 years [range 27 - 44] with a peak in the 36 to 40 age group (37%). The median gestity and parity were respectively 2 [range 0 - 12] and 1 [range 0 - 7]. More than half of the patients were nulliparous (51.1%). In 71.7% of cases (n = 66), myomectomy was performed in a context of desire for maternity. Indications for myomectomy were hemorrhage (46.7%), large uterus above the umbilicus (37%) and pelvic pain (16.3%). The polymyomectomy was performed in 64.1% of the cases (n = 59) with nuclei of size varying between 2 and 20 cm. The morbidity was marked on the one hand by anemia (n = 14 or 14%) secondary to an intraoperative haemorrhage which resulted in two cases in performing a hemostatic hysterectomy and in the other by rupture of the uterine cavity. Postoperative blood loss was estimated at 200 to 1400 ml, resulting in more than half of the patients receiving blood transfusions (58%). Myomectomy by laparotomy is often accompanied by significant blood spoliation thus increasing the postoperative morbidity. Techniques that minimize intraoperative blood loss should be used for laparotomy myomectomy.},
     year = {2019}
    }
    

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    T1  - Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)
    AU  - Eouani Levy Max Emery
    AU  - Mokoko Jules Cesar
    AU  - Buambo Gauthier Regis Jostin
    AU  - Potokoue Mpia Sekangue Samantha Nuely
    AU  - Itoua Clautaire
    AU  - Iloki Leon Herve
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    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
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    EP  - 148
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20190705.15
    AB  - To describe the epidemiological profile of patients, list myomectomy indications and report their prognosis at Loandjili General Hospital. A descriptive cross-sectional study conducted from 1 January 2016 to 31 December 2018 in the Gynecology Department of Loandjili General Hospital, including exhaustively all patients operated for myomectomy. The variables studied were pre (age, gestity, parity, indication), per (myoma measures, blood loss, intraoperative transfusion, complications and peroperative incidents) and postoperatively (hospital stay). Ninety-two patients had been received for surgical management of uterine fibroids out of a total of 1,455 gynecological procedures or 6.3%. The median age was 36.5 years [range 27 - 44] with a peak in the 36 to 40 age group (37%). The median gestity and parity were respectively 2 [range 0 - 12] and 1 [range 0 - 7]. More than half of the patients were nulliparous (51.1%). In 71.7% of cases (n = 66), myomectomy was performed in a context of desire for maternity. Indications for myomectomy were hemorrhage (46.7%), large uterus above the umbilicus (37%) and pelvic pain (16.3%). The polymyomectomy was performed in 64.1% of the cases (n = 59) with nuclei of size varying between 2 and 20 cm. The morbidity was marked on the one hand by anemia (n = 14 or 14%) secondary to an intraoperative haemorrhage which resulted in two cases in performing a hemostatic hysterectomy and in the other by rupture of the uterine cavity. Postoperative blood loss was estimated at 200 to 1400 ml, resulting in more than half of the patients receiving blood transfusions (58%). Myomectomy by laparotomy is often accompanied by significant blood spoliation thus increasing the postoperative morbidity. Techniques that minimize intraoperative blood loss should be used for laparotomy myomectomy.
    VL  - 7
    IS  - 5
    ER  - 

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