Laparoscopically assisted myomectomy versus abdominal myomectomy in short-term outcomes: a prospective study

Abstract

Purpose: Comparison between laparoscopically assisted myomectomy (LAM) and abdominal myomectomy (laparotomy), used in the management of women with intramural or subserous uterine fibroids up to 90 mm of maximum diameter.

Methods: Seventy-five premenopausal women were prospectively enrolled in the study, managed by LAM (n=48) or by laparotomy (n=27) approach. The short-term outcomes were compared between the two groups. The patient characteristics were also analyzed.

Results: The mean (+/-SD) estimated blood loss was significantly less in the LAM procedure compared with laparotomy (246+/-161 vs. 351+/-219 ml, respectively, P=0.03). Similarly, the operative time was shorter in the LAM modality compared with laparotomy (68+/-21 vs. 83+/-24 min, respectively, P=0.01). Intraoperative and postoperative complications were not different between the two groups. The mean days of the bowel reactivity (1.04+/-0.2) was faster (P<0.0001), while the duration of hospitalization (1.2+/-0.6) was shorter (P<0.0001) in the LAM technique, when compared with abdominal myomectomy (1.8+/-0.5 and 4.2+/-0.8, respectively).

Conclusions: In selected group of patients, LAM as minimally invasive approach is an attractive alternative to conventional laparotomic myomectomy, offering significant advantages.