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Obstet Gynecol Sci > Volume 55(3); 2012 > Article
Korean Journal of Obstetrics & Gynecology 2012;55(3):172-179.
DOI: https://doi.org/10.5468/KJOG.2012.55.3.172    Published online March 1, 2012.
Laparoscopic myomectomy: Presurgical classification to evaluate the validity of laparoscopic surgical treatment.
Hyun Hee Cho, Yun Ji Jung, Mee Ran Kim, Jang Heub Kim, Min Jung Kim, In Chul Jung, Young Ok Rhew, En Jung Kim, Gun Yung Chun, Yong Taek Lim, Dong Jin Kwon, Jae Yean Song
Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea. janghkim@catholic.ac.kr
Abstract
OBJECTIVE
To evaluate if the preoperative scoring system effect the post operative prognosis and type of operation. METHODS: Patients who took myomectomy in Seoul St. Mary's Hospital were enrolled this study. Retrospective analysis of preoperative leiomyoma scroings with imaging study were done. Prognostic factors were as follows: hospital days, bleeding amount, transfusion rate, operation time. Catholic Medical Center fibroid score system (CMFS) was used for analysis of fibroid. RESULTS: Patients were grouped into three as CMFS total score. Group I: scores<11, group II: 11-20, group III: 20<. Bleeding amount was 106.0 mL in group I, 132.3 mL in group II and 135.6 mL in group III. The bleeding amount and transfusion rate were significantly low in group I (P<0.05). Total score of CMFS had significant effect to type of operation (odds ratio, 1.339; 95% confidence interval, 1.237 to 1.449, P<0.0001; area under curve, 0.810) and accuracy was 76.6%. Topographic score and size score effect significantly to bleeding amount and operation time Topography score coefficient of determination (CD, 0.90, 0.82, P<0.01; size score CD, 1, 0.98, P<0.01). Repair score showed significant correlation with operation time, but showed no correlation with bleeding amount and operation time. Topographic score, size score, repair score showed significant effect on type of operation (P<0.01). CONCLUSION: Systematic scoring systems like CMFS help to predict the difficulties and bleeding complications after myomectomy. Further study about preoperative the prognostic factors and accurate presurgical scoring system were helpful for the decision of type of operation.
Key Words: Myomectomy, Prognosis, Scoring


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