1685 Fibroid Size and Complexity do not Impact on Clinical Outcomes: A Twelve Year Single-Centre Single-Surgeon Observational Study

Abstract

Study Objective To review clinical and surgical outcomes for laparoscopic removal of fibroids measuring ≥6cm and to assess how increasing fibroid size and complexity impact on reported outcomes. Design Retrospective observational study of consecutive cases of laparoscopic myomectomy (LM) performed by a single surgeon between September 2004 and December 2017. Setting Tertiary referral centre for gynaecological laparoscopic surgery. Patients or Participants Women with symptomatic large (≥6cm) uterine fibroids. Interventions Laparoscopic myomectomy. Measurements and Main Results This study examined data from 305 women undergoing LM. Comparisons were made between those with single fibroids measuring 6-8cm (Group A) and those with either single fibroids >8cm or multiple fibroids ≥6cm (Group B). Main outcome measures were operative time, blood loss and complication rates (including blood transfusion and conversion to laparotomy). Sixty-two women had multiple large fibroids resected, 117 had one fibroid measuring 6-8cm resected and 126 had a single myoma >8cm removed. A total of 387 large fibroids were removed with a median size of 8cm (range, 6-20cm), median operative time of 110minutes (range, 40-320 minutes) and median blood loss of 100mls (range, 20-2000mls). There was a significant correlation between fibroid size and operative time (Pearson's R: 0.313 p Conclusion Whilst blood loss and operative time increase with increasing fibroid size and complexity, clinical outcomes (blood transfusion, conversion to laparotomy, complications and hospital stay) remain comparable suggesting that large and multiple fibroids may be safely removed laparoscopically