title: Recurrence factors and reproductive outcomes of laparoscopic myomectomy and minilaparotomic myomectomy for uterine leiomyomas.
abstract: OBJECTIVE
  The aim of this study was to determine recurrence factors and reproductive outcomes of laparoscopic myomectomy (LM) and minilaparotomic myomectomy (MM) for treating uterine leiomyomas.
  
  
  METHODS
  Between 2007 and 2013, 160 patients underwent myomectomy, including 122 who underwent LM and 38 who underwent MM. Patients were followed up for recurrence based on pelvic ultrasound exams. Only patients who were followed up for a minimum of two years were selected for this retrospective study. Pregnancy rate, delivery, and delivery methods were compared between the two groups to evaluate reproductive outcomes. Furthermore, mean age, body mass index, preoperative administration of gonadotropin-releasing hormone agonist (GnRHa), and characteristics of leiomyomas were investigated to determine recurrence factors.
  
  
  RESULTS
  The mean body mass index in the MM group was significantly (P=0.048) higher than that in the LM group. The number and the largest diameter of removed leiomyoma were also significantly higher in the MM group (bothP=0.001). Logistic regression after adjusting significantly different characteristics showed that the LM group had shorter (P=0.020) postoperative hospitalization days compared to the MM group. Other outcome variables including recurrence rate were not significantly different between the two groups. Reproductive outcomes such as pregnancy rate, delivery, and delivery methods were not significantly different between the two groups. Preoperative GnRHa therapy was the only significant (P=0.039) recurrence factor after myomectomy.
  
  
  CONCLUSIONS
  This study showed that LM and MM had similar recurrence rates and reproductive outcomes. The only recurrence factor of significance was preoperative administration of GnRHa.
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Dong Gi
authors.initials: DG
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Heon Jong
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Yeon Ah
authors.initials: YA
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine and Research Institute for Medical Sciences, Daejeon, Korea.
authors.forename: In Sun
authors.initials: IS
authors.lastname: Kwon
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Ki Hwan
authors.identifier: 0000-0001-9888-8332
authors.initials: KH
authors.lastname: Lee
keywords: Laparoscopy; Laparotomy; Leiomyoma; Recurrence; Uterine myomectomy