Comparing uterine fibroids treated by myomectomy through traditional laparotomy and 2 modified approaches: ultraminilaparotomy and laparoscopically assisted ultraminilaparotomy

Received 1 May 2009; received in revised form 15 August 2009; accepted 27 October 2009. published online 25 December 2009.

Objective

We sought to compare myomectomy performed by laparotomy (LT), and 2 other modified approaches: ultraminilaparotomy (UMLT) and laparoscopically assisted UMLT for uterine fibroids with a size <8 cm and the number <5.

Study Design

A cohort study, including 79 (35.3%) women in the LT group, 71 (31.7%) in the UMLT group, and 74 (33.0%) in the laparoscopically assisted UMLT group, was conducted. The outcome was measured by comparing surgical parameters, immediate postoperative recovery, and therapeutic outcomes.

Results

The median follow-up was 52 months with similar recurrence rates in the 3 groups. The modified approaches had advantages not only in the surgical parameters, but also in postoperative recovery, compared to LT (all P < .05).

Conclusion

UMLT and laparoscopically assisted UMLT can be used successfully in place of LT in the management of uterine fibroids.

Key words: fibroids, laparoscopically assisted ultraminilaparotomy, laparotomy, leiomyoma, myomectomy, ultraminilaparotomy

a Department of Obstetrics and Gynecology, Institute of Clinical Medicine, National Yang-Ming University School of Medicine, National Yang-Ming University Hospital, Ilan, and Taipei Veterans General Hospital, Taiwan

b Department of Obstetrics and Gynecology, Chutung Veterans General Hospital, Hsin-Chu, Taiwan

c Department of Obstetrics and Gynecology, Chia-Yi Veterans General Hospital, Chia-Yi, Taiwan

Reprints: Peng-Hui Wang, MD, PhD, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University School of Medicine, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan

The first 3 authors contributed equally to this article.

This work was supported in part by Grants from Taipei Veterans General Hospital (V97ED1-008, V98F-009, V98C1-044) and the National Science Council (NSC 96-2314-B-010-018-MY3), Taipei, Taiwan.

Cite this article as: Wen K-C, Chen Y-J, Sung P-L, et al. Comparing uterine fibroids treated by myomectomy through traditional laparotomy and 2 modified approaches: ultraminilaparotomy and laparoscopically assisted ultraminilaparotomy. Am J Obstet Gynecol 2010;202:144.e1-8.

PII: S0002-9378(09)02088-2

doi:10.1016/j.ajog.2009.10.872

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