RESUMO
Background The aim of this study was to broaden our knowledge regarding the complications of myomectomy to better understand how to prevent them from occurring. Another aim was to compare surgical approaches, especially with the current research limitations surrounding this topic in Saudi Arabia. Methods This retrospective study was conducted in a cohort of 263 women who underwent surgical myomectomy, without any exclusion criteria. We used our hospital electronic medical records program called Phoenix to obtain all the data regarding clinical presentation, intraoperative findings, intraoperative and postoperative complications, and hospital stay, and then statistically analyzed these findings. Results Results were divided depending on the type of surgery. The mean age of open, laparoscopic, and hysteroscopic myomectomy groups were 40.82 years, 42.05 years, and 44.43 years, respectively. There were 213 (80.98%) open, 34 (12.93%) laparoscopic, and 16 (6.09%) hysteroscopic myomectomies. The most common indication in all groups was bleeding. The mean estimated blood loss and duration of surgery for open, laparoscopic, and hysteroscopic myomectomy groups were: 576.13 mL and 103.05 min, 333.21 mL and 56.91 min, and 306.29 mL and 104.19 min, respectively. The total complication rate for each group was 10.8% in open, 2.94% in laparoscopic, and 6.25% in hysteroscopic myomectomies. Conclusion Laparoscopy is considered the more effective option for myomectomy than both laparotomy and hysterectomy in terms of surgery duration, hospital stay, and prevalence of complications. However, it is a technically challenging operation that requires experienced surgeons to perform. Based on the information we gathered, we recommend our institute to implement laparoscopy instead of laparotomy myomectomy, which is the current standard procedure in our hospital.
RESUMO
Background Patients increasingly express the desire to be involved in their treatment decisions, especially in critical situations, such as cancer chemotherapy that increase a doctor's responsibility toward fulfilling these needs. This process may require more than one meeting with the patient to meet their expectations and satisfaction levels. This study aimed to assess the satisfaction levels in cancer patients, who received chemotherapy, about their decision-making and if they were able to make this decision during the first meeting with their physicians. Methods A cross-sectional study was conducted in 2017 on 106 cancer patients aged 18 years or above who were receiving chemotherapy at the day-care unit of King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. The data were collected by a direct or telephonic interview using a structured questionnaire. The variables were studied across two groups of patients based on the patient's ability to make decision in the first meeting with their physician. Data were expressed as frequencies (percentage) and Pearson Chi-Square test was used to assess the categorical variables. Results Out of the 106 patients, 42 (39.6%) of them were male. Ninety-one (85.8%) patients took the decision by themselves. Regarding the decision-making 90 (84.9%) patients were able to make the decision from the first meeting. Sixty-eight (64.2%) patients felt more satisfied if they had an additional session. There was a significant association between patients with the ability to make the decision during the first meeting and patients who took the decision by themselves (P = 0.033), patients with consideration of changing their decision if they had more meetings (P = 0.005), patients with consideration of withholding from chemotherapy in their mind (P = 0.019) and patients with thought that chemotherapy is affecting their life (P = 0.044). Conclusion The majority of the patients felt that more than one meeting with their doctors would be helpful in improving their satisfaction level during the decision-making process, consideration of withholding from chemotherapy in mind and that chemotherapy is affecting their life style. Future protocol in which the patients will be encouraged to have a confidence role on their treatment decision is recommended.
