A randomized, controlled study comparing minilaparotomy versus isobaric gasless laparoscopic assisted minilaparotomy myomectomy for removal of large uterine myomas: short-term outcomes.
OBJECTIVE
To compare the operative data and early postoperative outcomes for myomectomy performed by minilaparotomy (MLT) with isobaric laparoscopic assisted minilaparotomy myomectomy (LM) in a series of patients with large uterine myomas (>or=5 cm) randomly assigned to each surgical technique.


METHODS
80 patients were randomized blindly using a computer randomization list to MLT (n=40) or LM (n=40).


RESULTS
The mean (+/-SD) operating time was significantly shorter after LM than after MLT (75.50+/-25.70 vs 96.00+/-26.20 min; p<0.01). Intraoperative blood loss was less with LM (72.15+/-44.00 vs 96.21+/-38.50 ml; p<0.05), and DeltaHb was less with LM (1.21+/-0.55 vs 1.64+/-0.57; p<0.05). No intraoperative complications occurred, and no case was returned to the theater in either group. No conversion to standard laparotomy was necessary. Hospitalization was shorter after LM than after MLT (4.30+/-1.20 vs 6.90+/-2.70 days; p<0.01). Postoperative ileus was shorter after LM than after MLT (26.20+/-4.20 vs 40.50+/-4.90h; p<0.01). The mean VAS score at 12h for abdominal pain was 5.5+/-0.7 in the LM group and 5.2+/-0.8 in MLT group (p<0.05), whereas it was analogous in the two groups at 24h, and at 48h was 3.4+/-1.1 in the LM group and 4.2+/-1.1 in the MLT group (p<0.05), and no difference between two groups was detected in the overall mean (at 12, 24 and 48h).


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