Submited on: 20 Feb 2018 08:49:07 AM GMT
Published on: 23 Feb 2018 05:15:05 AM GMT
 
Uterine giant myomectomy: A case report
Posted by Prof. Kulvinder K Kaur on 13 Mar 2018 09:14:48 AM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The authors present a case report in a 39 yr old nulliparous single woman presenting with a 3.6kg giant myoma of 3.9kg desiring fertility.Myomectomy was done  diagnosinf ut leiomyoma with degeneration.Thus they concluded myomectomy can be done safely in pts with large myomas.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    NO.Larger GIANT UT Leiomyomas have been reported

    1)Savulescu F,Lordache I.Albita O,Hrisrea R,Duitru C,Lordache A,Balasa G,etal(2011)Giant uterine leiomyoma.Chirurgia(Buccr)1;106(5):665-8.

    2)Moris DMVernandakis S(2014).Giant uterine leromyoma mimicking pregnancy.Mayo Clin Proc;89(6):e53-4

    3)Mate S,Szatmari E,Sipos S,Szell Z.Szanthao A.Rigo J Jr(2013).Giant ut leiomyoma causing acute symptoms.City Hetil;154(10):387-90.

    4)Aydin C,Erin S,Yalcin Y,Sen Selim H(2013). A giant cystic eiomyoma minmicking an ovarian malignancy.Int J Surg Case Rp;4(11):1010-2.

    5)Nayki U,Nayki C,Ulug P,Yilma I,Cetin Z.Yildirim Y(2014).A rare case of giant leiomyoma presenting as a retroperitoneal mass.Iran J Repr Me;12(12):831-4.


  • Are the claims properly placed in the context of the previous literature?

    Most earlier reported cases have been in an older group and TAH with BSO had been the treatment of option.Here in view of infertility myomectomy was done in a so called giant myoma which was muh smaller than earlier reported cases


  • Do the results support the claims? If not, what other evidence is required?

    Differences from earlier cases highlighted in previous columns.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    is a case report only


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    .


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    It is a case report.use of funny abbreviations like  Apound abbreviation should be avoided,similarly in case report mass measuring 14A-12cm with hyphen n  should be avoided-use English data for size demonstrtion


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No


  • Other Comments:

    This case is a smaller version of so called giant leiomyoma-3.6kg and not special as compared to other reported cases.

  • Competing interests:

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    If ‘yes’ please specify your Experience/ If ‘No’ (Please note that even though your review will be freely available on our portal, it will not count towards the final reviewer score for the article and towards inclusion of article into WebmedCentral Peer Reviewed category.)Working as a gynaecologist for over 35yrs and have dealt with umpteen fibroids and myomectomies.

  • How to cite:  Kaur K K.Uterine giant myomectomy: A case report[Review of the article 'Uterine giant myomectomy: A case report ' by Kim T].WebmedCentral 2018;9(3):WMCRW003400
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Review on: Uterine giant myomectomy: A case report
Posted by Dr. Hans-Christian Kolberg on 25 Feb 2018 04:01:32 PM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The main claim of the manuscript is that abdominal myomectomy is a good treatment option even for huge fibroids or leiomyoma if patients wish to preserver their fertility. This is not actually new but since there are still way too many hysterectomies all over the world it cannot be repeated often enough.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No, this claim is not new and the authors themselves are citing other case reports with reports about fibroids much bigger than the one they are reporting. These citations can be found in the reference section of the manuscript.


  • Are the claims properly placed in the context of the previous literature?

    As far as surgical approaches are concerned the authors are citing the previous literature. Literature about non-surgical approaches (see below) is missing.


  • Do the results support the claims? If not, what other evidence is required?

    As far as a case report can support a claim, it dos in this case.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    n/a


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    n/a


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    n/a


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    This is an encouraging case report and may support surgeons in decision making for versus against uterus-conserving surgery for large fibroids. I woud be a little cautious calling this outstanding.


  • Other Comments:

    I would recommend the following changes to the manuscript:

     

    1. The authors should consider English language editing.

    2. The authors are only mentioning the differential diagnoses of large fibroids in the last sentence of their discussion. This subject needs a lot more room in the discussion. The authors should provide criteria helping the reader decide if a large and fast-growing fibroid requires histological verification or if watchful waiting is sufficient. This question has to be a central point in this case report.

    3. The authors are not mentioning non-surgical approaches in the therapy of symptomatic fibroids at all. They should add information regarding the options of uterine artery embolization and MR guided high focussed ultrasound and also discuss drug therapy such as ulipristal.

    4. The authors should be careful with the wording "minimally invasive". By all standards a laparotomy and myomectomy is not minmally invasive. It is uterus-conserving, but still invasive surgery.

  • Competing interests:

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Kröncke T, David M für die Teilnehmer des Konsensustreffens ( Beck A, David M, Debus G, Düx M, Ebert A, Hadji P, Hess T, Hoellen F, Hunold P, Kolberg HC, Kröncke T, Matzko M, Rimbach S, Trumm C (2015) Magnetic Resonance Guided Focused Ultrasound for Fibroid Treatment – Results of the Second Radiological Gynecological Expert Meeting. Fortschr Röntgenstr 187(06): 480-482

  • Experience and credentials in the specific area of science:

    I have a special fibroid clinic twice a week. We are doing all kinds of open and endoscopic surgery for fibroids as well as also UAE and MRgFUS.

  • How to cite:  Kolberg H .Review on: Uterine giant myomectomy: A case report[Review of the article 'Uterine giant myomectomy: A case report ' by Kim T].WebmedCentral 2018;9(2):WMCRW003399
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review of the case report
Posted by Dr. Mohammad Othman on 24 Feb 2018 01:11:51 PM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    the ussual claims of rarity of the giant fibroids but we realy see them more and more.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    no it is not novel but there is no sensus of the previlance of giant fibroids.


  • Are the claims properly placed in the context of the previous literature?

    yes they are.


  • Do the results support the claims? If not, what other evidence is required?

    yes it does.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    not aplicable.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    not apllicable.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    no


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    no, it is a regular paper.


  • Other Comments:

    no

  • Competing interests:

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I am an assistant professor and consultant of Obstetrics and Gynecology and author of many articles and books

  • How to cite:  Othman M .review of the case report[Review of the article 'Uterine giant myomectomy: A case report ' by Kim T].WebmedCentral 2018;9(2):WMCRW003398
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