クマキリ　ジユン   熊切　順    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy.
掲載誌名	正式名：Acta obstetricia et gynecologica Scandinavica 略　 称：Acta Obstet Gynecol Scand ISSNコード：16000412/00016349
掲載区分	国外
巻・号・頁	89(8),pp.1078-83
著者・共著者	Kumakiri Jun†*, Kikuchi Iwaho, Kitade Mari, Kumakiri Yuko, Kuroda Keiji, Matsuoka Shozo, Tokita Sachiko, Takeda Satoru
担当区分	筆頭著者,責任著者
発行年月	2010/08
概要	OBJECTIVE:To evaluate factors contributing to uterine scar formation after laparoscopic myomectomy (LM) and to estimate whether uterine scarring indicated risk of uterine rupture.DESIGN:Retrospective study.SETTING:University-affiliated hospital.POPULATION:A total of 692 patients who underwent second-look laparoscopy (SLL) after LM.METHOD:Video-tape recording during SLL to evaluate the conditions of uterine suture wound healing, with univariate and logistic regression analysis.MAIN OUTCOME MEASURES:Correlation between scar formation and operative findings at LM. Factors influencing scar formation in 305 patients with an enucleated solitary myoma.RESULTS:SLL revealed that 628 patients (90.8%) had a normal uterus and 64 patients (9.2%) had a scarred uterus. Deformation of the endometrium found by preoperative imaging and complete myometrial penetration during LM had a positive correlation and the number of enucleated myomas a negative correlation with scar formation. Significant factors associated with scar formation were complete myometrial penetration (odds ratio, 2.53; 95% confidence interval, 1.30-4.93; p = 0.006) and enucleation of a subserosal myoma (odds ratio, 0.23; 95% confidence interval, 0.08-0.70; p = 0.009). Of the 98 patients who delivered, none suffered a uterine rupture regardless of the presence of a uterine scar.CONCLUSIONS:Uterine scar formation after LM correlated with the degree of myometrial penetration. However, the presence of a uterine scar did not appear to influence the delivery outcome.
DOI	10.3109/00016349.2010.498498
PMID	20636246