Laparoscopic myomectomy in the treatment of large myomas – unnecessary risk or effective method?

Alicja Maria Ozga, Aleksandra Obuchowska, Arkadiusz Standyło, Justyna Wójcik, Paweł Skorupski

DOI: http://dx.doi.org/10.12775/JEHS.2020.10.09.104

Abstract


Introduction:

Mięśniaki macicy są najczęstszymi łagodnymi guzami macicy. Większość mięśniaków przebiega bezobjawowo i nie wymaga interwencji lekarskiej, jednak jeśli tak się dzieje, podstawą terapii pozostaje dostęp chirurgiczny. Miomektomia to jedna z chirurgicznych metod usuwania mięśniaków dla osób chcących zachować płodność. W dzisiejszych czasach udoskonalono techniki operacyjne i opracowano metody mniej inwazyjne, takie jak laparoskopowa miomektomia (LM). Jednak bezpieczeństwo i skuteczność LM jest dobrze udokumentowana w przypadku mięśniaków średniej wielkości. Dostęp laparoskopowy w przypadku większych guzów macicy (średnica> 10 cm) może budzić kontrowersje i może stanowić wyzwanie ze względu na możliwe trudności.

 

Cel, powód:

Ocena skuteczności, wyzwań technicznych i powikłań LM w leczeniu dużych mięśniaków.

 

Materiały i metody:

Przeszukaliśmy bazy danych Pubmed, Springer Link i ResearchGate.

 

Wyniki:

Systematyczne analizy zakwalifikowane do tego przeglądu sugerowały, że pomimo wielu możliwych komplikacji i trudności, metoda może być z powodzeniem stosowana przez doświadczonego specjalistę. Jednak leczenie LM w dużych mięśniakach jest nadal rzadkie, a dane na ten temat są nadal ograniczone.

 

Wnioski:

Miomektomia laparoskopowa może być alternatywną metodą leczenia dużych mięśniaków. Chirurgia laparoskopowa dużych mięśniaków LM może stanowić wyzwanie, a skuteczność takiego leczenia zależy od umiejętności chirurga. Metoda jest również przydatna u kobiet rozważających ciążę. 


Keywords


laparoscopic; myomectomy; myoma; tumor

Full Text:

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References


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