title: Comparability of perioperative morbidity between abdominal myomectomy and hysterectomy for women with uterine leiomyomas.
abstract: OBJECTIVE
  The aim of this study was to compare the perioperative morbidity associated with abdominal myomectomy with that of hysterectomy.
  
  
  METHODS
  This was a retrospective cohort study of 394 women at an academic medical center. Main outcome measured was perioperative morbidity, with the following secondary outcomes: febrile morbidity, hemorrhage, unintended major surgical procedures, life-threatening events, and rehospitalization.
  
  
  RESULTS
  Morbidity was associated with myomectomy and hysterectomy in 39% and 40% of cases, respectively. The crude odds ratio for morbidity of myomectomy with respect to hysterectomy was 0.93 (95% confidence interval, 0.63-1.40). Women who underwent myomectomy were significantly younger, weighed less, and had a smaller preoperative uterine size. In a multivariable analysis that accounted for these differences the odds ratio increased to 1.46 (95% confidence interval, 0.77-2.77) but still was not statistically elevated. The study had >90% power to detect a clinically relevant 15% absolute difference in overall morbidity between the 2 groups.
  
  
  CONCLUSIONS
  No clinically significant difference in perioperative morbidity between myomectomy and hysterectomy was detected. Myomectomy should be considered a safe alternative to hysterectomy.
authors: Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
authors: S W
authors: SW
authors: Sawin
authors: N D
authors: ND
authors: Pilevsky
authors: J A
authors: JA
authors: Berlin
authors: K T
authors: KT
authors: Barnhart
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D009214:Myoma / Q000601:surgery*; D016017:Odds Ratio; D010414:Pennsylvania; D011183:Postoperative Complications / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000601:surgery*