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| The influence of laparoscopic and hysteroscopic surgery to remove uterine intermural fibroids of patients on their later pregnancy outcomes and the analysis of related factors of residual fibroids recurrence after surgery |
| Shenzhen Longhua People's Hospital, Guangdong Province, 518109 |
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Abstract To explore the influence of laparoscopic and hysteroscopic surgery to remove uterine intermural fibroids of patients on their later pregnancy outcomes, and to analyze the related factors of residual fibroids recurrence after surgery. Methods: The clinical data of 150 patients with uterine intermural fibroids from January 2015 to January 2020 were analyzed retrospectively. These patients were divided into group A (82 cases with laparoscopic surgery) and group B (68 cases with hysteroscopy surgery) according to different surgical method. The pregnancy outcomes of the patients were compared between the two groups. The situation of residual fibroids recurrence after surgery was obtained after followed up for post operative 12 months. Multivariate Logistic regression analysis was used to analyze the factors related to residual fibroids recurrence after surgery. Results: There were no significant differences in the postoperative pregnancy rate, the pregnancy loss rate, the full-term cesarean section rate, and the rate of cesarean section due to myomectomy history of the patients between the two groups (all P＞0.05). The time from remove uterine intermural fibroids to pregnancy of the patients in group B was significantly shorter than that of the patients in group A (P＜0.05). There was no significant different in postoperative residual fibroids recurrence rate (25.6% vs. 29.4%) of the patients between the two groups (P＞0.05). Multivariate analysis had showed that age ≥40 years old was an independent protective factor of postoperative fibroids residual recurrence (OR=0.406, 95%CI 0.166-0.994). Premenopausal (OR=3.356, 95%CI 1.275-8.830), fibroid diameter ≥4cm (OR=4.430, 95%CI 1.787-10.983), and without postoperative drug therapy (OR=2.811, 95%CI 1.180-6.699) were the independent risk factors of postoperative fibroids residual recurrence. Conclusion: Laparoscopic and hysteroscopic surgery to remove uterine intermural of patients have similar later pregnancy outcomes. The related factors of residual fibroids recurrence after surgery include age, menopausal status, fibroids diameter, postoperative drug treatment, etc, which indicate relevant intervention measures should be adopted to reduce the risk of residual fibroids recurrence after surgery.
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