Consequences of Concurrent Myomectomy and Cesarean Section Versus Cesarean Section Alone: Systematic Review and Meta- Analysis

Abstract

Myomas are the most common benign tumors in the reproductive organs of women. Myomectomy surgery and cesarean section are the most common surgeries in the fields of gynecology and obstetrics. Performing myomectomy during caesarean section and the safety of this surgery is a matter of discussion. Considering that there is a possibility of bleeding and a possibility of morbidity in cesarean myomectomy, and on the opposite point, additional surgery and complications and morbidity of the second surgery are discussed. Correct identification, review and planning based on available statistics and information are needed for cesarean myomectomy. The purpose of this study is to systematically review meta-analysis methods, complications and benefits of cesarean myomectomy in comparison with cesarean section alone. Methods In this systematic review we have followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Electronic resources such as MEDLINE, Cochrane, EMBASE, Scopus, and PubMed were searched. A total of 3057 articles were reviewed. In the systematic search, 3057 articles were identified. The number of 1167 studies were excluded from the study due to duplication, and the number of 1890 articles was reduced to 130 articles. After reviewing the full text of the articles and reviewing the titles of the articles based on the objectives of the study, 44 articles were selected based on the inclusion and exclusion criteria, of these, 33 met the inclusion criteria and were included in the final analysis. The reviewed outcomes were hemoglobin (Hb) before and after operation, blood transfusion rate, hemorrhage, operation time, duration of hospitalization and complication such as fever. Results: A meta-analysis on 33 articles with 5586 participants in CM group and 2935 participants in CS group. The results of the meta-analysis showed a statistically significant difference in hemoglobin before and after surgery in the cesarean myomectomy group. The transfusion rate was higher in the CM group and intraoperative hemorrhage was higher in CM group. The mean operation time and hospitalization time were significantly higher in the CM group. There was no significant difference in the incidence of the postoperative fever between the two groups.