title: Efficacy of combined laparoscopic uterine artery occlusion and myomectomy via minilaparotomy in the treatment of recurrent uterine myomas.
abstract: OBJECTIVE
  To evaluate the therapeutic efficacy of laparoscopic uterine artery occlusion combined with myomectomy through a minilaparotomy in the treatment of recurrent uterine myomas, compared with myomectomy alone.
  
  
  METHODS
  Controlled, nonrandomized clinical study.
  
  
  METHODS
  University-affiliated tertiary care referral center.
  
  
  METHODS
  Eighty-two women with symptomatic, recurrent myomas warranting surgical treatment, who expressed a strong desire to retain their uterus. Fifty-two patients (63.4%) underwent laparoscopic uterine artery occlusion and subsequent minilaparotomy and myomectomy (group I) and 30 patients (36.6%) underwent myomectomy alone (group II).
  
  
  METHODS
  Occlusion of the uterine arteries was performed with a laparoscopic approach before minilaparotomy and myomectomy.
  
  
  METHODS
  The efficacy of combined laparoscopic uterine artery occlusion and myomectomy via minilaparotomy in the treatment of recurrent uterine myomas was measured by comparing blood loss, need for blood transfusion, postoperative febrile morbidity, recurrence rate of the uterine myomas, and fertility rate in the treatment (group I) and control (group II) groups.
  
  
  RESULTS
  The average blood loss was 125 +/- 72.6 and 550 +/- 394.8 mL in groups I and II, respectively. The recurrence rate of uterine myomas was 5.8% (3 of 52) in group I and 36.7% (11 of 30) in group II during an average follow-up period of 42.5 months. Of the sexually active patients who did not use contraception, 19.2% (5 of 26) and 22.4% (4 of 18) became pregnant in groups I and II, respectively (no statistical significance).
  
  
  CONCLUSIONS
  This study has demonstrated the superiority of laparoscopic uterine artery occlusion when combined with repeat myomectomy in treating recurrent symptomatic myomas.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Medical University Hospital, and Taipei Medical University, Taipei, Taiwan. weiminliu50@hotmail.com <weiminliu50@hotmail.com>
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Liu
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Chun-Shan
authors.initials: CS
authors.lastname: Chou
authors.forename: Wun-Long
authors.initials: WL
authors.lastname: Tang
authors.forename: I-Te
authors.initials: IT
authors.lastname: Wang
authors.forename: Chii-Ruey
authors.initials: CR
authors.lastname: Tzeng
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000098:blood supply* / Q000601:surgery*