Morbidity associated with abdominal myomectomy

Objective: To review the recent experience at Yale-New Haven Hospital with abdominal myomectomy and to assess morbidity associated with the procedure. Methods: The hospital records of 128 women who underwent abdominal myomectomies during a 39-month period were reviewed retrospectively. Particular attention was given to blood transfusion requirement and the febrile morbidity rate. Results: The average (± standard error of the mean) intraoperative estimated blood loss was 342 ± 37 mL. Five cases (4%) had an estimated blood loss greater than 1000 mL. Intraoperative or postoperative transfusion occurred in 26 cases (20%); 70% of the transfused patients received autologous blood only. The operation was converted intraoperatively to a hysterectomy in one case. There were no other intraoperative complications. Febrile morbidity occurred in 15 patients (12%). Three women (2%) experienced postoperative complications including paralytic ileus, wound infection, and deep venous thrombosis. Conclusion: Febrile morbidity and blood transfusions associated with abdominal myomectomy appear to occur at an acceptably low rate, especially when unnecessary blood transfusions are excluded. These findings should modify the way patients are counseled before abdominal myomectomy.