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.