Korean J Obstet Gynecol.  2012 Mar;55(3):172-179. 10.5468/KJOG.2012.55.3.172.

Laparoscopic myomectomy: Presurgical classification to evaluate the validity of laparoscopic surgical treatment

• Cho HH
• Jung YJ
• Kim MR
• Kim JH
• Kim MJ
• Jung IC
• Rhew YO
• Kim EJ
• Chun GY
• Lim YT
• Kwon DJ
• Song JY

• KMID: 2274122
• DOI: http://doi.org/10.5468/KJOG.2012.55.3.172

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.

Keyword

Myomectomy; Prognosis; Scoring

MeSH Terms

Area Under Curve
Hemorrhage
Humans
Leiomyoma
Prognosis
Retrospective Studies

Figure

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  Fig. 1 Method of myomectomy according to total Catholic Medical Center fibroid scoring system score.

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  Fig. 2 Coefficient of determination of topography score vs operation time and estimated blood loss. R2, coefficient of determination; Time, operation time; EBL, estimated blood loss.

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  Fig. 3 Coefficient of determination of size vs operation time and estimated blood loss. R2, coefficient of determination; Time, operation time; EBL, estimated blood loss.

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