Laparoscopy vs laparoscopically assisted myomectomy in the management of uterine myomas: a prospective study

Objective

This study was undertaken to compare the intraoperative and short-term outcomes between the 2 modalities of minimally invasive surgery for the management of uterine fibroids.

Study Design

A total of 116 patients with inclusion criteria were prospectively collected in a study period from March 1997 through 2007. Laparoscopic (n = 40) vs laparoscopically assisted myomectomy (n = 76) were compared for the management of no more than 3 intramural or subserous uterine myomas, of a maximum diameter of 90 mm.

Results

The patients' characteristics by age, parity, body mass index, number and location of myomas were well balanced between the 2 study groups. The mean diameter of the myomas was the only characteristic significantly higher in the laparoscopically assisted myomectomy group. The operative time in the laparoscopically assisted myomectomy was significantly shorter compared with the laparoscopic myomectomy (mean ± standard deviation: 66 ± 19 minutes vs 94 ± 18 minutes, P < .0001). A shorter uterine incision was found in the laparoscopically assisted myomectomy technique compared with the laparoscopic myomectomy (2.9 ± 0.6 vs 4.3 ± 1.2, P < .0001). Estimated blood loss was significantly higher in the laparoscopically assisted myomectomy group (P = .002). Intraoperative, early postoperative complications, hospitalization days, and fully returned activity were similar between the 2 study groups.

Conclusion

The present data suggest that the laparoscopically assisted myomectomy is a valid alternative to laparoscopy in a setting of minimally invasive surgery for the management of uterine fibroids

Key words: laparoscopic assisted myomectomy, laparoscopy, myomas, myomectomy