Endometrial myomectomy: a novel surgical method during cesarean section

Study objective: Comparing surgical outcomes of a novel surgical technique endometrial myomectomy (EM) to serosal myomectomy (SM) during ceserean section (CS). Design: Retrospective cohort study (Canadian task force classification level II 1). Setting: Private hospital. Patients: Fourty-six women with leiomyomas during cesarean section Interventions: Endometrial myomectomy and serosal myomectomy during cesarean section between 2013 and 2016. Main outcome measures: Total 22 consequtive cases (Group 1) underwent EM in the last 2 years. The control group created from SM (Group 2) cases performed before EM implemented in our practice. Group 2 was matched based on anteriorly located intramural or submucosal leiomyoma. The size, location and number of leiomyoma, hematological course during pre- and postoperative period, the need for blood transfusion, duration of surgery, and any prolongation of hospital stay also documented. Results: Median number of leiomyoma was higher in EM than in SM (p = 0.001). Median myomectomy procedure time and amount of intra-operative bleeding in SM were higher than EM (respectively, p = 0.005 and p = 0.001). In terms of other variables, there is no difference between the two myomectomy groups (p > 0.05). Conclusion: This novel technique EM is a safe, feasible surgical technique compared with SM. Besides the less intra-operative blood loss, it also has the potential to diminish the risk of abdominal adhesion formation.