Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question

Objective To evaluate the feasibility of the hysteroscopic resection of type II submucous fibroids regardless of the myometrial free margin separating them from the serosa and to report the dynamic changes the margin undergoes after the various phases of resection. Design A prospective observational...

Full description

Saved in:
Bibliographic Details
Published in:Fertility and sterility 2011-04, Vol.95 (5), p.1764-1768.e1
Main Authors: Casadio, Paolo, M.D, Youssef, Aly M., M.D, Spagnolo, Emanuela, M.D, Rizzo, Maria Antonietta, M.D, Talamo, Maria Rita, M.D, De Angelis, Denise, M.D, Marra, Elena, M.D, Ghi, Tullio, M.D, Savelli, Luca, M.D, Farina, Antonio, M.D, Pelusi, Giuseppe, Prof, Mazzon, Ivan, M.D
Format: Article
Language:English
Subjects:
Adult
Ambulatory Surgical Procedures - adverse effects
Ambulatory Surgical Procedures - methods
Biological and medical sciences
Feasibility Studies
Female
Gynecology. Andrology. Obstetrics
Humans
hysteroscopy
Hysteroscopy - adverse effects
Hysteroscopy - methods
Hysteroscopy - standards
Internal Medicine
Leiomyoma - diagnostic imaging
Leiomyoma - pathology
Leiomyoma - surgery
Limit of Detection
margin of safety
Medical sciences
Middle Aged
Mucous Membrane - diagnostic imaging
Mucous Membrane - pathology
Mucous Membrane - surgery
myomectomy
myometrial free margin
Myometrium - diagnostic imaging
Myometrium - pathology
Myometrium - surgery
observational studies
Obstetrics and Gynecology
Operating Rooms - methods
patients
postoperative complications
resection
serosa
Submucous fibroids
ultrasonics
Ultrasonography
ultrasound
Uterine Neoplasms - diagnostic imaging
Uterine Neoplasms - pathology
Uterine Neoplasms - surgery
women
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To evaluate the feasibility of the hysteroscopic resection of type II submucous fibroids regardless of the myometrial free margin separating them from the serosa and to report the dynamic changes the margin undergoes after the various phases of resection. Design A prospective observational study. Setting A tertiary-level university hospital. Patient(s) Thirteen women with single type II submucous fibroids of ≤5 cm in diameter regardless of the myometrial free margin. Intervention(s) Hysteroscopic myomectomy and ultrasound evaluation of myometrial free margin before and after each phase of the procedure. Main Outcome Measure(s) The possibility of a complete one-step resection, the incidence of intraoperative or postoperative complications, and the analysis of the dynamic changes occurring in myometrial free margin. Result(s) Complete resection was performed successfully in all patients. No complications were registered. The myometrial free margin decreased on the distension of the uterine cavity and then increased progressively and significantly after the various phases of resection. Conclusion(s) In selected cases and in experienced hands, hysteroscopic myomectomy of type II submucous fibroids may be performed successfully and safely regardless of the myometrial free margin. Myometrial free margin increases progressively with each step of the procedure probably leading to an increasing margin of safety.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2011.01.033