Predictors of postoperative hemoglobin drop after laparoscopic myomectomy

INTRODUCTION Laparoscopic myomectomy (LM) can be associated with significant bleeding. AIM To identify factors influencing the postoperative hemoglobin (Hb) drop after LM. MATERIAL AND METHODS This is a retrospective, single-center study. We evaluated data of 150 consecutive patients undergoing LM due to intramural myomas between 2010 and 2015. RESULTS The median age of the patients was 37 (23-53) years. The mean diameter of the largest myoma was 5.7 ±2.3 (1.5-12) cm. The mean surgical time was 83 ±38 (35-299) min. The median number of sutures was 3 (1-11). The mean postoperative Hb drop was 1.6 ±1.2 (0-6) g/dl, and the mean estimated blood loss was 261 ±159 (50-1700) ml. In the univariate analysis, the postoperative Hb drop correlated with the duration of surgery (p < 0.001), diameter of the largest myoma (p < 0.001), cumulative myoma weight (p < 0.001), and number of sutures (p < 0.001), but not with patients' age or number of intramural myomas. In the multivariable analysis, the surgical time (β = 0.395, p < 0.001), diameter of the largest myoma (β = 0.292, p = 0.03) and preoperative Hb concentration (β = 0.299, p < 0.001) predicted the postoperative Hb change. CONCLUSIONS Surgical time and dominant myoma diameter are independent predictors of the postoperative Hb drop after LM.