Abstract
Objective: Myomectomy is the most popular treatment option for women who have symptomatic myoma nodules and desire to preserve their child-bearing potential. Laparoscopic myomectomy (LM) has been increasingly performed owing to the advances in laparoscopic techniques and instruments. Whether the risk of uterine rupture is greater in LM than in abdominal myomectomy (AM) is yet to be clarified. This study was conducted to evaluate the vascularity of myometrial closure by using magnetic resonance imaging (MRI) and follow the healing process after myomectomy.
Methods: Between June 2013 and July 2014, 4 patients underwent AM and 28 women underwent LM. In all the AM cases (AM group), single interrupted or figure-8 sutures were used. On the other hand, continuous sutures were used in 12 LM cases (group LMa); and single interrupted sutures, in 16 (group LMb). After surgery, contrast-enhanced MRI was performed after obtaining informed consent from the patients. We evaluated the ratio of avascular-to-cross-sectional area of the myoma.
Results: Contrast-enhanced MRI performed 3 months after surgery revealed that the median (range) ratio of avascular-to-cross-sectional area in LMa was 5.0% (2.1%–9.0%), which was significantly larger than those in LMb (1.2%) and AM (0.4%). Although the ratio in LMa at 6 months after surgery was significantly reduced from that at 3 months after surgery, it was still larger than that at 3 months after surgery in LMb.
Conclusion: Vascularization of the myometrium was faster with interrupted sutures than with continuous sutures. We consider contrast-enhanced MRI as an effective examination method for evaluating myometrial vascularity after myomectomy.
