Preoperative preparation of anemic patients before myomectomy and surgery for adenomyosis


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详细

Objective. To study the efficacy of esmya in eliminating anemia in the preoperative preparation of patients with uterine myoma and adenomyosis. Subject and methods. Forty-five reproductive-aged women with multiple uterine myoma and adenomyosis who needed organ-sparing surgery (myomectomy, Osada operations) participated in the investigation. All the patients took one esmya tablet daily for 60 or 90 days before surgical treatment. Preoperative preparation with the agent was performed to reduce blood supply and myoma nodular sizes and to eliminate anemia. Results. There was a change in the sizes of myoma nodules; the most significant effect was seen in solitary nodules. With the use of esmya, the mean nodular volume reduction was 32±8%, which was greater than that in multiple nodules. In isolated adenomyosis, there was a statistically significant change in the volume of the corpus uteri, which was 24 to 29% (p < 0.05); there was also a clear separation of a glandular invasion area from the intact endometrium. The concentration of hemoglobin was increased by almost 60% in all the patients. Conclusion. A 3-month esmya cycle would suffice to reduce the volume of the uterus and fibroma. Increasing the concentration of hemoglobin assists in avoiding the need for intraoperative blood transfusion. This treatment may be useful before Osada surgery or myomectomy especially in case of large fibromas and severe anemia in women.

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作者简介

Nikolay Rukhlyada

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care

Email: nickolasr@mail.ru
Doctor of Medicine, Professor, Head of gynecology clinic

Dzhamala Gasymova

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care

Email: jemaliya@mail.ru
postgraduate student of the Department of obstetrics, gynecology and reproduction SPBSU, obstetrician-gynecologist in the Department of gynaecology № 2

参考

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