The actual circumstances of blood loss in the laparoscopic myomectomy: Anemia after laparoscopic myomectomy / 대한산부인과내시경학회지

ABSTRACT

OBJECTIVE: This study was designed to assess the actual circumstances of post-operative anemia and associating factors, during the laparoscopic myomectomy. METHODS: A retrospective chart review of 172 patients who underwent laparoscopic myomectomy from 2008 to 2009 was performed. Characteristics of patients (age, parity, body mass index, and preoperative gonadotropin releasing hormone agonists injection) and fibroids (the largest diameter, number, width, type and location), and surgical outcomes (operating time, pre- and post-operative hemoglobin level, blood loss, hospital stay, and complications, including transfusion) were retrieved. RESULTS: One patient (0.6 %) required transfusion and significant hemoglobin change (> or =2.0 g/dL) occurred in 45 patients, after laparoscopic myomectomy. The largest diameter, width, type, and location of fibroids, and pre-operative gonadotropin releasing hormone agonist injection were not associated with the hemoglobin change (p=0.193, 0.172, 0.764, 0.741, and 0.954 respectively). Multivariate analysis revealed that nulliparity (p=0.195, 95% confidence interval (CI) 0.286-1.291) was not a risk factor, but long operating time (> or =90 min; p=0.048, 95% CI 1.008-5.054) and multiple myoma (> or =3 in number; p=0.009, 95% CI 1.320-6.717) were independent risk factors for significant hemoglobin change. CONCLUSION: In our data, symptomatic anemia after laparoscopic myomectomy was uncommon. In addition, the only useful predictive factor for hemoglobin change during the laparoscopic myomectomy was a multiplicity of myoma.