{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T16:40:05Z","timestamp":1765039205329},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,4]],"date-time":"2013-02-04T00:00:00Z","timestamp":1359936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2013,4]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>The purpose of this study was to compare the intraoperative and postoperative parameters among the three approaches used to treat large uterine myomas: laparoscopic assisted vaginal hysterectomy (LAVH<\/jats:styled-content>), total laparoscopic hysterectomy (TLH<\/jats:styled-content>) and abdominal hysterectomy, and to evaluate the selection criteria for laparoscopic hysterectomy as determined by magnetic resonance imaging.<\/jats:p><\/jats:sec>Material and Methods<\/jats:title>The medical records of 155 patients who underwent a hysterectomy between J<\/jats:styled-content>anuary 2007 and A<\/jats:styled-content>pril 2010 were examined. We also compared the indications and outcomes of LAVH<\/jats:styled-content> and TLH<\/jats:styled-content> for myomas larger than 7\u2009cm.<\/jats:p><\/jats:sec>Results<\/jats:title>Patients who underwent LAVH<\/jats:styled-content> or TLH<\/jats:styled-content> had a lower average intraoperative blood loss, less intense postoperative pain, and shorter hospital stays than patients in the TAH<\/jats:styled-content> group, although the length of the operations in the laparoscopic groups were significantly longer. To evaluate the selection criteria for the large sized myomas, we compared the LAVH<\/jats:styled-content> and TLH<\/jats:styled-content> groups for the myomas larger than 7\u2009cm. The greatest uterine transverse diameters and the weight of the uteri were not significantly different between the LAVH<\/jats:styled-content> and TLH<\/jats:styled-content> groups (94.7\u2009\u00b1\u200920.8 and 83.1\u2009\u00b1\u200917.6\u2009mm, 371.6\u2009\u00b1\u2009160.3 and 286.7\u2009\u00b1\u2009158.0\u2009g, respectively). The average intraoperative blood loss in the TLH<\/jats:styled-content> group was significantly lower than that in the LAVH<\/jats:styled-content> (121.3\u2009\u00b1\u2009111.2 vs 379.3\u2009\u00b1\u2009222.4\u2009g, P<\/jats:italic>\u2009<\u20090.001).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our data suggest that TLH<\/jats:styled-content> is a better procedure for treating a large uterus no larger than 10\u2009cm in its greatest transverse diameter. The preoperative total length of myoma nodules determined by MRI<\/jats:styled-content> is a useful preoperative indicator of the uterine weight.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1447-0756.2012.02065.x","type":"journal-article","created":{"date-parts":[[2013,2,5]],"date-time":"2013-02-05T04:44:54Z","timestamp":1360039494000},"page":"814-819","source":"Crossref","is-referenced-by-count":13,"title":["Preoperative assessment by magnetic resonance imaging is useful for planning the treatment of an enlarged uterus by total laparoscopic hysterectomy"],"prefix":"10.1111","volume":"39","author":[{"given":"Koji","family":"Hatta","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Osaka Medical College Takatsuki Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshito","family":"Terai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Osaka Medical College Takatsuki Osaka 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