A randomized, controlled study comparing minilaparotomy versus isobaric gasless laparoscopic assisted minilaparotomy myomectomy for removal of large uterine myomas: Short-term outcomes

Abstract

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 (≥5 cm) randomly assigned to each surgical technique. Study design 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 ΔHb 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 ± 4.90 h; p < 0.01). The mean VAS score at 12 h 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 24 h, and at 48 h 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 48 h). Conclusions Several surgical and immediate postoperative outcomes were significantly better in the LM group than in the MLT group.