Ultra-minilaparotomy myomectomy: a minimally invasive surgical approach for the treatment of large uterine myomas.
BACKGROUND
In recent years, a growing number of more conservative methods for the treatment of uterine myomas has been reported. However, only a small number of techniques is used for the treatment of large myomas.


OBJECTIVE
In the present retrospective study, we report our experience with a group of patients who consecutively underwent ultra-minilaparotomy myomectomy for single or multiple large myomas, with diameter greater than 5 cm, with emphasis on the safety and efficacy of this procedure.


METHODS
Forty-one women underwent an ultra-minilaparotomy myomectomy that involved a <4 cm transverse skin incision, with or without laparoscopic assistance.


RESULTS
Mean operating time was 92.4 min, the mean hemoglobin decline was 2.0 g/dl and the mean hematocrit decline was 5.7%. The mean time to discharge was 84.3 h. No patient underwent a second surgery for early postoperative complications. Postoperative fever occurred in 4 patients, especially in patients who underwent ultra-minilaparotomy without assisted laparoscopy. There were two cases of severe anemia with recourse to blood transfusion.


CONCLUSIONS
The results of this study suggest that ultra-minilaparotomy myomectomy with or without laparoscopic assistance might represent a safe and effective minimally invasive alternative to standard open myomectomy in the treatment of large myomas.
Ciavattini
Andrea
A
Department of Obstetrics and Gynecology, Università Politecnica delle Marche, IT-60123 Ancona, Italy. andreac@univpm.it
Tsiroglou
Dimitrios
D
Litta
Pietro
P
Frizzo
Helga
H
Tranquilli
Andrea Luigi
AL
D000328:Adult; D000740:Anemia / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000295:instrumentation / Q000379:methods; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012189:Retrospective Studies; D012449:Safety; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*