熊切　順
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Evaluation of factors contributing to uterine scar formation after laparoscopic myomectomy.
Journal Formal name：Acta obstetricia et gynecologica Scandinavica
Abbreviation：Acta Obstet Gynecol Scand
ISSN code：16000412/00016349
Domestic / ForeginForegin
Volume, Issue, Page 89(8),pp.1078-83
Author and coauthor Kumakiri Jun†*, Kikuchi Iwaho, Kitade Mari, Kumakiri Yuko, Kuroda Keiji, Matsuoka Shozo, Tokita Sachiko, Takeda Satoru
Authorship Lead author,Corresponding author
Publication date 2010/08
Summary 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