Can Tercan, Emrah Dağdeviren, Ergün Tercan, Buğra Tunç, Osman Murat Güler, Gazi Güner
Journal of Academic Research in Medicine - 2025;15(3):112-121
Objective: To evaluate the association of pre-operative hematologic and inflammatory markers, fibroid burden, surgical factors, and surgeon experience with post-operative erythrocyte suspension (ES) transfusion risk in patients undergoing laparotomic (LM) and laparoscopic myomectomy (LSM). Methods: This retrospective case-control study included patients undergoing LM or LSM. Baseline demographics, clinical characteristics, pre- and post-operative hematologic and inflammatory parameters, and surgical data were analyzed. Multivariate logistic regression identified independent predictors of ES transfusion. Receiver operating characteristic curves established the pre-operative hemoglobin cut-off values that predict transfusion risk. Results: Transfusion groups had longer operation times, larger and heavier fibroids, and lower pre-operative hemoglobin in both LM and LSM cohorts. Myoma count and surgeon experience were independent predictors of transfusion only in the LM group, [odds ratio (OR) =1.128 and OR =0.916, respectively]. No inflammatory markers, including systemic immune-inflammation index, significantly predicted transfusion. Pre-operative hemoglobin cut-off of 11.75 g/dL predicted transfusion with moderate accuracy in both LM [area under the curve (AUC) =0.633] and LSM (AUC =0.639) groups. Surgeon experience reduced transfusion risk in LM, but not in LSM. Conclusion: Fibroid burden, operation time, and surgeon experience significantly influence transfusion risk in myomectomy, especially in open surgery. A pre-operative hemoglobin level of 11.75 g/dL serves as a useful threshold for anemia management to minimize transfusion needs. Incorporating these clinical factors into perioperative planning may improve patient safety and reduce transfusion-related complications. Further prospective studies are needed to refine prediction models.
