Cherney versus midline vertical incision for myomectomy or hysterectomy of a significantly enlarged uterus

OBJECTIVE: Our purpose was to determine whether a different in clinical outcome could be demonstrated with the choice of Cherney versus vertical incision in patients undergoing surgical treatment of large benign uterine myomas. STUDY DESIGN: Twenty consecutive patients underwent hysterectomy or myomectomy for a large (five or more times normal size) myomatous uterus through a Cherney incision. A pathologist blinded for clinical outcome matched the specimens removed from the Cherney group with 20 others removed through vertical incisions during the corresponding period on the basis of specimen weight alone. A chart review was undertaken to determine significant demographic and outcome variables, with particular attention to clinical course and operative complications. RESULTS: The groups were similar in age, race, parity, body mass index, preoperative hematocrit, associated illnesses, type of anesthesia and anesthetic agents, associated surgical fiindings, and associated surgical procedures. No significant differences were detected in the duration of anesthesia, surgical procedure or hospital stay, volume of perioperative blood loss, narcotic analgesic usage, or the number of minor or major complications. Trends toward greater blood loss, transfusion, and complications in the vertical group may have been related to exposure, whereas longer duration of surgery and greater postoperative analgesic use were seen with Cherney incisions. CONCLUSION: No clinical difference could be demonstrated with incision choice in a group of 40 patients having surgical treatment of large uterine myomas.