Operative Strategien bei Uterusmyomen

Uterusmyome zählen zu den häufigsten benignen Tumoren der Frau mit einem Lebenszeitrisiko von 70 – 80% [1]. Dennoch wird nur jede 5. Frau im reproduktiven Alter symptomatisch und die meisten der diagnostizierten Myome müssen nicht behandelt werden. Im Falle einer Behandlung stehen jedoch nach konservativem Therapieversagen mehrere operative Methoden zur Verfügung.

Schlüsselwörter

Uterusmyome - Myomenukleation - Hysterektomie - Myomektomie - Laparotomie

• Literatur

• 1 Stewart EA, Laughlin-Tommaso SK, Catherino WH. et al. Uterine fibroids. Nat Rev Dis Primers 2016; 2: 16043
• 2 Stang A, Merrill RM, Kuss O. Hysterectomy in Germany: a DRG-based nationwide analysis, 2005–2006. Dtsch Arztebl Int 2011; 108: 508-514
• 3 Vilos GA, Allaire C, Laberge PY. et al. The management of uterine leiomyomas. J Obstet Gynaecol Can 2015; 37: 157-178
• 4 Munro MG, Critchley HO, Broder MS. et al. FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011; 113: 3-13
• 5 Fedele L, Parazzini F, Luchini L. et al. Recurrence of fibroids after myomectomy: a transvaginal ultrasonographic study. Hum Reprod 1995; 10: 1795-1796
• 6 Yoo EH, Lee PI, Huh CY. et al. Predictors of leiomyoma recurrence after laparoscopic myomectomy. J Minim Invasive Gynecol 2007; 14: 690-697
• 7 Buchholz S, Ortmann O. Operative Strategien bei Myomen. Frauenheilkunde up2date 2013; 7: 55-65
• 8 Malzoni M, Tinelli R, Cosentino F. et al. Laparoscopy versus minilaparotomy in women with symptomatic uterine myomas: short-term and fertility results. Fertil Steril 2010; 93: 2368-2373
• 9 Jin C, Hu Y, Chen XC. et al. Laparoscopic versus open myomectomy – a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2009; 145: 14-21
• 10 Sizzi O, Rossetti A, Malzoni M. et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 2007; 14: 453-462
• 11 Discepola F, Valenti DA, Reinhold C. et al. Analysis of arterial blood vessels surrounding the myoma: relevance to myomectomy. Obstet Gynecol 2007; 110: 1301-1303
• 12 Mara M, Maskova J, Fucikova Z. et al. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol 2008; 31: 73-85
• 13 Barakat EE, Bedaiwy MA, Zimberg S. et al. Robotic-assisted, laparoscopic, and abdominal myomectomy: a comparison of surgical outcomes. Obstet Gynecol 2011; 117: 256-265
• 14 Toub DB. A New Paradigm for Uterine Fibroid Treatment: Transcervical, Intrauterine Sonography-Guided Radiofrequency Ablation of Uterine Fibroids with the Sonata System. Curr Obstet Gynecol Rep 2017; 6: 67-73
• 15 Sinha R, Hegde A, Mahajan C. et al. Laparoscopic myomectomy: do size, number, and location of the myomas form limiting factors for laparoscopic myomectomy?. J Minim Invasive Gynecol 2008; 15: 292-300
• 16 West S, Ruiz R, Parker WH. Abdominal myomectomy in women with very large uterine size. Fertil Steril 2006; 85: 36-39
• 17 Dubuisson JB, Fauconnier A, Chapron C. et al. Second look after laparoscopic myomectomy. Hum Reprod 1998; 13: 2102-2106
• 18 Tsuji S, Takahashi K, Imaoka I. et al. MRI evaluation of the uterine structure after myomectomy. Gynecol Obstet Invest 2006; 61: 106-110
• 19 Landi S, Zaccoletti R, Ferrari L. et al. Laparoscopic myomectomy: technique, complications, and ultrasound scan evaluations. J Am Assoc Gynecol Laparosc 2001; 8: 231-240