A randomized trial of laparoscopic versus laparoscopic-assisted minilaparotomy myomectomy for removal of large uterine myoma: short-term outcomes.
OBJECTIVE
To compare operative data and early postoperative outcomes for myomectomy performed by isobaric gasless laparoscopic-assisted minilaparotomy (LA-MLT) compared with those by isobaric gasless laparoscopy (LA) in a series of patients with large uterine leiomyomas (> or =5 cm) randomly assigned to each surgical technique.


METHODS
Randomized trial (Canadian Task Force classification I).


METHODS
University departments of gynecology in Jiangyin and Nanjing, Jiangsu Province, Republic of China.


METHODS
Fifty-two patients were randomized blindly by use of a computer randomization list to either LA (n = 26) or LA-MLT (n = 26).


RESULTS
The mean operating time was significantly shorter after LA-MLT than after LA (75.50 +/- 25.70 vs 96.00 +/- 26.20 minutes); the 95% confidence interval (95% CI) was 20.5 (6.04-34.96; p =.006). The intraoperative blood loss was less with LA-MLT (71.92 +/- 18.98 vs 96.34 +/- 32.42 mL); the 95% CI was 24.42 (9.63-39.22; p =.002); and the hemoglobin level decrease was less with LA-MLT (1.22 +/- 0.61 vs 1.65 +/- 0.61); the 95% CI was 0.43 (0.09-0.76; p =.014). There was a difference of the visual analog scale score among the 3 time points (0, 12, and 24 hours) with the 2 groups combined (F = 844.15, p <.001); and no difference in the visual analog scale score between the treatment groups, with values at all time points averaged and over time (p >.05). With regard to the early postoperative outcome, no difference between the 2 groups was detected in hospitalization days (1.81 +/- 0.57 vs 2.04 +/- 0.66 days; 95% CI 20.23 [20.57-0.11, p =.183]); and postoperative ileus (23.20 +/- 4.37 vs 22.80 +/- 3.94; 95% CI 0.39 [21.93-2.70, p =.738]).


CONCLUSIONS
Several surgical and immediate postoperative outcomes were significantly better in the gasless LA-MLT group than in the LA group.
Tan
Ji
J
Department of Gynaecology, Jiangyin Hospital, Medical School of Southeast of China University, Jiangyin City.
Sun
Yangyan
Y
Dai
Huihua
H
Zhong
Baoliang
B
Wang
Daoyuan
D
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D010147:Pain Measurement; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*