MOLECULAR ESTIMATION OF MYOGENESIS AND STATE OF UTERINE SCAR AFTER MYOMECTOMY IN DIFFERENT SURGICAL APPROACHES

A.K. Dolinskiy, G.Kh. Tolibova, T.G. Tral', V.F. Bezhenar' D.O. Ott Research Institute of Obstetrics and Gynecology, Russian Federation, 199034, Saint Petersburg, Mendeleevskaya line, 3

Introduction. Due to the impetuous development of endovideosurgery in gynecology, laparoscopic access technique is increasingly frequently used to perform myomectomy. However in the available literature until now there is no decisive opinion on the feasibility of using laparoscopy for removal of uterine fibroids in females with infertility or in cases of planning pregnancy. The aim of the study. The aim of the study was to compare the histological and immunohistochemical parameters of the uterine scar after myomectomy performed by laparoscopic or laparotomic access. Methods. The study included 9 myometrial biopsies from the area of the uterine scar after laparoscopic myomectomy (LS), 9 myometrial biopsies after laparotomic myomectomy (LT) and 10 biopsies of normal myometrium (control group, K). Results. The results of histological studies have shown that in cases of the application of a standardized laparoscopic technique of myomectomy in biopsy scar on the uterus mild fibroblastic changes were observed with prevalently high degree of ingrowth of muscle fibers and vascularization in the zone of connective tissue scar, if compared with histological changes in bioptates in groups with laparotomyc access. Conclusions. The obtained data correlated with immunohistochemical characteristics, according to which the expression of myosin and desmin, as an indices of muscle tissue, and type IV collagen as a measure of vascularization of the scar in the LS group was significantly higher in comparison with LT group.
Keywords: 
uterine scar, myomectomy, laparoscopy, immunohistochemical study