Long-Term Follow-up of Laparoscopic Myomectomy
One hundred fourteen women (average age 37.1 yrs) underwent laparoscopic myomectomy for pain (77.8%), abnormal bleeding (53.1%), and infertility (20.8%). The location and depth of penetration of the myoma(s) were determined by ultrasonography and laparoscopic assessment. Follow-up data were obtained either by review of patient charts or returned questionnaires. Relevant risk factors for recurrence were isolated by discriminant analysis. The cumulative risk of recurrence was 10.6% after 1 year, 31.7% after 3 years, and 51.4% after 5 years. Associated risk factors were the number of myomas and the depth of infiltration. Patients without recurrence had an average of 2.5 &plusmn; 2.3 fibroids and those with recurrences had 4.1 &plusmn; 2.9 myomas (p <0.01). The recurrence rates for pedunculated, subserosal, and intramural myomas were 0.0%, 11.8%, and 44.9%, respectively (p <0.01). Myoma size, patient age, parity, and postoperative pregnancies had no influence on the recurrence rate. The cumulative risk of recurrence after laparoscopic myomectomy seems to be higher than that reported after laparotomy.
Nezhat
FR
Center for Special Pelvic Surgery, 5555 Peachtree-Dunwoody Road, Suite 276, Atlanta, GA 30342.
Roemisch
M
Nezhat
CH