A prospective study of laparoscopy versus minilaparotomy in the treatment of uterine myomas.

STUDY OBJECTIVE

Comparison between laparoscopy and minilaparotomy in the management of intramural and/or subserosal uterine myomas.

DESIGN

Prospective study (Canadian Task Force classification II-2).

SETTING

University hospital.

PATIENTS

Two hundred-thirteen women with at least one subserosal and/or intramural uterine myoma.

INTERVENTION

Laparoscopy and minilaparotomy myomectomy.

MEASUREMENTS AND MAIN RESULTS

We performed 213 myomectomies, 120 by minilaparotomy and 93 by laparoscopy. Median number of myomas removed per patient was 1.4 (range 1-3) and 2.9 (range 1-5) in the laparoscopy and minilaparotomy groups, respectively (p<.05). The estimated blood loss was not significant in either of the two groups, and no intraoperative or early postoperative complications were registered. The median operating time was 62.3 minutes (range 45-80 min) and 61.6 minutes (range 40-90 min) in the laparoscopy and minilaparotomy groups, respectively (p=NS). Median duration of ileus was 1.4 days (range 1-2) in the laparoscopy group and 1.3 days (range 1-2 days) in the minilaparotomy group (p=NS). Median length of hospital stay was 2.3 days (range 2-3 days) and 2.8 days (range 2-3 days) in the laparoscopy and minilaparotomy groups, respectively (p=NS.).

CONCLUSION

Myomectomy by minilaparotomy can be considered a minimally invasive alternative to laparoscopy in the surgical management of intramural and subserosal myomas.