Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis
Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Sea...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Goyal, Manu [verfasserIn] Dawood, Ayman Shehata [verfasserIn] Elbohoty, Shereen B. [verfasserIn] Abbas, Ahmed M. [verfasserIn] Singh, Pratibha [verfasserIn] Melana, Nitesh [verfasserIn] Singh, Surjit [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: European journal of obstetrics & gynecology and reproductive biology - Amsterdam [u.a.] : Elsevier Science, 1971, 256, Seite 145-157 |
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| Übergeordnetes Werk: |
volume:256 ; pages:145-157 |
| DOI / URN: |
10.1016/j.ejogrb.2020.11.008 |
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| Katalog-ID: |
ELV005294150 |
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| 520 | |a Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. | ||
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| 700 | 1 | |a Abbas, Ahmed M. |e verfasserin |0 (orcid)0000-0002-2359-2729 |4 aut | |
| 700 | 1 | |a Singh, Pratibha |e verfasserin |4 aut | |
| 700 | 1 | |a Melana, Nitesh |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Surjit |e verfasserin |4 aut | |
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10.1016/j.ejogrb.2020.11.008 doi (DE-627)ELV005294150 (ELSEVIER)S0301-2115(20)30719-3 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Goyal, Manu verfasserin (orcid)0000-0002-8691-1790 aut Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. Cesarean section Myomectomy Leiomyoma Feasibility Dawood, Ayman Shehata verfasserin (orcid)0000-0002-6607-5828 aut Elbohoty, Shereen B. verfasserin aut Abbas, Ahmed M. verfasserin (orcid)0000-0002-2359-2729 aut Singh, Pratibha verfasserin aut Melana, Nitesh verfasserin aut Singh, Surjit verfasserin aut Enthalten in European journal of obstetrics & gynecology and reproductive biology Amsterdam [u.a.] : Elsevier Science, 1971 256, Seite 145-157 Online-Ressource (DE-627)320443469 (DE-600)2005196-7 (DE-576)094142106 1872-7654 nnns volume:256 pages:145-157 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 256 145-157 |
| spelling |
10.1016/j.ejogrb.2020.11.008 doi (DE-627)ELV005294150 (ELSEVIER)S0301-2115(20)30719-3 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Goyal, Manu verfasserin (orcid)0000-0002-8691-1790 aut Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. Cesarean section Myomectomy Leiomyoma Feasibility Dawood, Ayman Shehata verfasserin (orcid)0000-0002-6607-5828 aut Elbohoty, Shereen B. verfasserin aut Abbas, Ahmed M. verfasserin (orcid)0000-0002-2359-2729 aut Singh, Pratibha verfasserin aut Melana, Nitesh verfasserin aut Singh, Surjit verfasserin aut Enthalten in European journal of obstetrics & gynecology and reproductive biology Amsterdam [u.a.] : Elsevier Science, 1971 256, Seite 145-157 Online-Ressource (DE-627)320443469 (DE-600)2005196-7 (DE-576)094142106 1872-7654 nnns volume:256 pages:145-157 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 256 145-157 |
| allfields_unstemmed |
10.1016/j.ejogrb.2020.11.008 doi (DE-627)ELV005294150 (ELSEVIER)S0301-2115(20)30719-3 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Goyal, Manu verfasserin (orcid)0000-0002-8691-1790 aut Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. Cesarean section Myomectomy Leiomyoma Feasibility Dawood, Ayman Shehata verfasserin (orcid)0000-0002-6607-5828 aut Elbohoty, Shereen B. verfasserin aut Abbas, Ahmed M. verfasserin (orcid)0000-0002-2359-2729 aut Singh, Pratibha verfasserin aut Melana, Nitesh verfasserin aut Singh, Surjit verfasserin aut Enthalten in European journal of obstetrics & gynecology and reproductive biology Amsterdam [u.a.] : Elsevier Science, 1971 256, Seite 145-157 Online-Ressource (DE-627)320443469 (DE-600)2005196-7 (DE-576)094142106 1872-7654 nnns volume:256 pages:145-157 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 256 145-157 |
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10.1016/j.ejogrb.2020.11.008 doi (DE-627)ELV005294150 (ELSEVIER)S0301-2115(20)30719-3 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Goyal, Manu verfasserin (orcid)0000-0002-8691-1790 aut Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. Cesarean section Myomectomy Leiomyoma Feasibility Dawood, Ayman Shehata verfasserin (orcid)0000-0002-6607-5828 aut Elbohoty, Shereen B. verfasserin aut Abbas, Ahmed M. verfasserin (orcid)0000-0002-2359-2729 aut Singh, Pratibha verfasserin aut Melana, Nitesh verfasserin aut Singh, Surjit verfasserin aut Enthalten in European journal of obstetrics & gynecology and reproductive biology Amsterdam [u.a.] : Elsevier Science, 1971 256, Seite 145-157 Online-Ressource (DE-627)320443469 (DE-600)2005196-7 (DE-576)094142106 1872-7654 nnns volume:256 pages:145-157 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 256 145-157 |
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10.1016/j.ejogrb.2020.11.008 doi (DE-627)ELV005294150 (ELSEVIER)S0301-2115(20)30719-3 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Goyal, Manu verfasserin (orcid)0000-0002-8691-1790 aut Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. Cesarean section Myomectomy Leiomyoma Feasibility Dawood, Ayman Shehata verfasserin (orcid)0000-0002-6607-5828 aut Elbohoty, Shereen B. verfasserin aut Abbas, Ahmed M. verfasserin (orcid)0000-0002-2359-2729 aut Singh, Pratibha verfasserin aut Melana, Nitesh verfasserin aut Singh, Surjit verfasserin aut Enthalten in European journal of obstetrics & gynecology and reproductive biology Amsterdam [u.a.] : Elsevier Science, 1971 256, Seite 145-157 Online-Ressource (DE-627)320443469 (DE-600)2005196-7 (DE-576)094142106 1872-7654 nnns volume:256 pages:145-157 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 256 145-157 |
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Goyal, Manu @@aut@@ Dawood, Ayman Shehata @@aut@@ Elbohoty, Shereen B. @@aut@@ Abbas, Ahmed M. @@aut@@ Singh, Pratibha @@aut@@ Melana, Nitesh @@aut@@ Singh, Surjit @@aut@@ |
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Goyal, Manu |
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Goyal, Manu ddc 610 bkl 44.92 misc Cesarean section misc Myomectomy misc Leiomyoma misc Feasibility Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis |
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610 DE-600 44.92 bkl Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis Cesarean section Myomectomy Leiomyoma Feasibility |
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Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis |
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Goyal, Manu Dawood, Ayman Shehata Elbohoty, Shereen B. Abbas, Ahmed M. Singh, Pratibha Melana, Nitesh Singh, Surjit |
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cesarean myomectomy in the last ten years; a true shift from contraindication to indication: a systematic review and meta-analysis |
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Cesarean myomectomy in the last ten years; A true shift from contraindication to indication: A systematic review and meta-analysis |
| abstract |
Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. |
| abstractGer |
Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. |
| abstract_unstemmed |
Background: A lot of debate is present about Cesarean myomectomy (CM) in women with uterine myoma whether to consider it a feasible and safe procedure or an absolute contraindication.Objective: To assess the safety and feasibility of myomectomy during cesarean section in women with uterine myoma.Search strategy: Electronic search was made on MEDLINE, EMBASE, Cochrane Library, ISI web of knowledge and Scopus from January 1, 2008 to December 31, 2019 using terms “Caesarean section”, “Myomectomy”, “Fibroid”, “Caesarean myomectomy”.Selection criteria: All full length studies either prospective or retrospective that address caesarean myomectomy were included.Data collection and analysis: The outcomes studied were haemorrhage, mean change in haemoglobin, operative time, need for blood transfusion, febrile morbidity and duration of hospital stay.Results: Total 249 studies were assessed for eligibility and 17 studies included in analysis with 6545 women. There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres. |
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There were 4702 (71.85 %) women in caesarean myomectomy (CM) group and 1843 (28.15 %) women in cesarean section (CS) group. There was statistically significant but clinically insignificant decrease in hemoglobin [MD = 0.27, 95 %CI = 0.08−0.45, p = 0.005; very low quality], significant higher need for blood transfusion [RR = 1.45, 95 %CI = 1.05–1.99, p = 0.02; high quality] in CM group versus CS alone. The mean operative time (minutes) [MD = 14.77, 95 %CI = 6.91–22.64, p = 0.0002; moderate quality] and mean hospital stay (days) [MD = 0.36, 95 %CI = 0.19−0.53, p < 0.00001; high quality] was significantly less in CM group, though of not any clinical significance. No difference in incidence of haemorrhage [RR = 1.16, 95 %CI = 0.86–1.56, p = 0.32; moderate quality evidence] and fever [RR = 1.17, 95 %CI = 0.83–1.65), p = 0.36; moderate quality] in two groups.Conclusions: The meta-analysis suggests CM is associated with clinical insignificant increase in operative time, blood loss and hospital stay, especially with multiple and large size myomas. CM should be preferred over CS alone especially by experienced surgeons with appropriate haemostatic techniques and tertiary care centres.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Cesarean section</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Myomectomy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Leiomyoma</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Feasibility</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Dawood, Ayman Shehata</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0002-6607-5828</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Elbohoty, Shereen B.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield 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