Laparoscopic intracapsular myomectomy: comparison of single versus multiple fibroids removal. An institutional experience.
OBJECTIVE
The aim of this study was to compare single versus multiple laparoscopic myomectomy with an intracapsular method.


METHODS
A total of 335 laparoscopic intracapsular myomectomies were compared. They were subdivided into two groups. Group I included 195 patients with myoma; group II, 140 patients with multiple myomas, 4-9 cm in diameter. Laparoscopic procedures were compared with respect to intraoperative complications, postoperative compliance, and general surgical feedback. Results were analyzed using SAS software (version 8), considering a P-value of <0.05 as significant.


RESULTS
No differences (P>0.05) between groups were observed with respect to the following: intraoperative blood loss (98 ± 4.7 mL of group I versus 106 ± 6.8 mL of group II), catheter inside pelvis for postsurgical drainage (40% versus 36.4% women), analgesic administration for the first 24 hours (41.5% versus 40% patients), postoperative fever after 24 hours (11.2% versus 9.2% women), postoperative therapeutic antibiotics administration (8.2% versus 6.4% patients), and hospitalization and postoperative ultrasound (US) intramyometrial hematoma detection (6.6% versus 5.7% of group II). The only surgical statistical difference (P<0.05) was in the mean total laparoscopic time (60 ± 7.2 minutes for group I versus 97 ± 8.9 minutes for group II).


CONCLUSIONS
Intracapsular laparoscopic myomectomies, performed in the same session on a single or on multiple fibroids, seem to preserve myometrial integrity and allow the restoration of uterine scar, with few early and late surgical complications.
Tinelli
Andrea
A
Division of Experimental Endoscopic Surgery, Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
Malvasi
Antonio
A
Hudelist
Gernot
G
Cavallotti
Carlo
C
Tsin
Daniel Alberto
DA
Schollmeyer
Thoralf
T
Bojahr
Bernd
B
Mettler
Liselotte
L
D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult