Laparoscopy vs minilaparotomy in women with symptomatic uterine myomas: a prospective randomized study.

OBJECTIVE

To compare outcomes in patients with symptomatic uterine myomas who underwent laparoscopic (LPS) or minilaparotomic (MLPT) myomectomy.

DESIGN

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

SETTING

University hospital.

PATIENTS

Eighty patients with no more than 3 uterine myomas of maximal diameter of 7 cm.

INTERVENTION

Either LPS or MLPT myomectomy.

MEASUREMENTS AND MAIN RESULTS

Mean blood loss, mean duration of postoperative ileus, and mean decrease in hemoglobin were significantly lower in the LPS compared with the MLPT group (p < .001). Mean operative time was not significantly longer in the LPS group compared with the MLPT group. Duration of hospitalization was significantly shorter in the LPS compared with the MLPT group (p < .001). No intraoperative complications were observed during MLPT. In 1 patient, conversion from LPS to MLPT was necessary because of difficulty in reconstructing the uterine wall.

CONCLUSION

Laparoscopic myomectomy is a suitable alternative to MLPT in women with 1 to 3 myomas. However, preoperative careful evaluation of the size and sites of the myomas is necessary to avert conversion and prevent complications.