Abstract：
OBJECTIVE: To investigate postoperative surgical and non-surgical complications that occur within 30 days following myomectomy procedures, whether laparoscopic or via open surgery.
METHODS: Prospective cohort study SETTING: Del Ponte Women\'s and Children\'s Hospital, Varese, Italy.
METHODS: Women undergoing myomectomy either with laparoscopic or open surgery from July 2020 to June 2023 INTERVENTIONS: Data of consecutive patients who underwent abdominal myomectomy procedures, either via laparoscopy or open abdominal surgery were collected. The study examined patient characteristics, size and location of fibroids, surgical data, and complications. Univariate and multivariable analyses were employed to identify factors contributing to postoperative Clavien-Dindo grade ≥ II complications.
RESULTS: Overall 383 patients were included in the study. The univariate analysis showed intramural fibroid type (p = .0009), large fibroid size (p = .03), and extended operative times (p = .05) were associated with postoperative complications. Open surgical approach (p <.001) and uterine cavity opening (p = .02) also contributed to complications. Postoperative anemia emerged as the most prevalent complication. In the multivariable analysis, the open surgical approach emerged as the only independent factor associated with an increased risk of grade ≥ II complications (odds ratio 7.37; p <.0001).
CONCLUSIONS: In this study we found an increased likelihood of complications in case of open myomectomy. While the presence of potential selection bias may have impacted this finding, it could provide valuable insights for clinicians and surgical teams in the strategic planning of myomectomy procedures.
METHODS: Prospective cohort study SETTING: Del Ponte Women\'s and Children\'s Hospital, Varese, Italy.
METHODS: Women undergoing myomectomy either with laparoscopic or open surgery from July 2020 to June 2023 INTERVENTIONS: Data of consecutive patients who underwent abdominal myomectomy procedures, either via laparoscopy or open abdominal surgery were collected. The study examined patient characteristics, size and location of fibroids, surgical data, and complications. Univariate and multivariable analyses were employed to identify factors contributing to postoperative Clavien-Dindo grade ≥ II complications.
RESULTS: Overall 383 patients were included in the study. The univariate analysis showed intramural fibroid type (p = .0009), large fibroid size (p = .03), and extended operative times (p = .05) were associated with postoperative complications. Open surgical approach (p <.001) and uterine cavity opening (p = .02) also contributed to complications. Postoperative anemia emerged as the most prevalent complication. In the multivariable analysis, the open surgical approach emerged as the only independent factor associated with an increased risk of grade ≥ II complications (odds ratio 7.37; p <.0001).
CONCLUSIONS: In this study we found an increased likelihood of complications in case of open myomectomy. While the presence of potential selection bias may have impacted this finding, it could provide valuable insights for clinicians and surgical teams in the strategic planning of myomectomy procedures.
摘要：
目的：研究子宫肌瘤切除术后30天内发生的手术和非手术并发症，无论是腹腔镜还是开腹手术。
方法：前瞻性队列研究设置：德尔庞特妇女儿童医院，瓦雷泽,意大利患者：2020年7月至2023年6月接受腹腔镜或开腹子宫肌瘤切除术的妇女干预：接受腹部子宫肌瘤切除术的连续患者数据，无论是通过腹腔镜或开腹手术收集。这项研究检查了患者的特征，肌瘤的大小和位置，手术数据,和并发症。采用单变量和多变量分析来确定导致术后Clavien-Dindo≥II级并发症的因素。
结果：共383例患者纳入研究。单变量分析显示壁内肌瘤类型（p=0.0009），大肌瘤大小（p=0.03），延长手术时间（p=0.05）与术后并发症有关。开放手术方式（p<0.001）和子宫腔开放（p=0.02）也导致了并发症。术后贫血是最常见的并发症。在多变量分析中，开放手术方式是导致≥II级并发症风险增加的唯一独立因素(比值比7.37;p<0.0001).
结论：在这项研究中，我们发现在开腹子宫肌瘤切除术的情况下并发症的可能性增加。虽然潜在选择偏差的存在可能影响了这一发现，它可以为临床医生和手术团队在子宫肌瘤切除术的战略规划中提供有价值的见解.
方法：前瞻性队列研究设置：德尔庞特妇女儿童医院，瓦雷泽,意大利患者：2020年7月至2023年6月接受腹腔镜或开腹子宫肌瘤切除术的妇女干预：接受腹部子宫肌瘤切除术的连续患者数据，无论是通过腹腔镜或开腹手术收集。这项研究检查了患者的特征，肌瘤的大小和位置，手术数据,和并发症。采用单变量和多变量分析来确定导致术后Clavien-Dindo≥II级并发症的因素。
结果：共383例患者纳入研究。单变量分析显示壁内肌瘤类型（p=0.0009），大肌瘤大小（p=0.03），延长手术时间（p=0.05）与术后并发症有关。开放手术方式（p<0.001）和子宫腔开放（p=0.02）也导致了并发症。术后贫血是最常见的并发症。在多变量分析中，开放手术方式是导致≥II级并发症风险增加的唯一独立因素(比值比7.37;p<0.0001).
结论：在这项研究中，我们发现在开腹子宫肌瘤切除术的情况下并发症的可能性增加。虽然潜在选择偏差的存在可能影响了这一发现，它可以为临床医生和手术团队在子宫肌瘤切除术的战略规划中提供有价值的见解.
