Comparative Study between Robotic Laparoscopic Myomectomy and Abdominal Myomectomy and Factors Affecting Short-Term Surgical Outcomes

Abstract

Study Objective: Compare short-term surgical outcomes of robotic and abdominal myomectomy and analyze the factors affecting those short-term outcomes. Design: A retrospective case-control study was performed on 122 patients with symptomatic leiomyomata: 77 cases of robotic assisted laparoscopic myomectomy (RALM) and 45 cases of abdominal myomectomy. Data includes: surgery type, age, BMI, gravity, parity, number and tumor size, operative time, blood loss and hospital stay. Setting: A retrospective case-control study. Patients: 122 patients with symptomatic Leiomyomata. Intervention: 77 cases underwent robotic assisted laparoscopic myomectomy. 45 cases underwent abdominal myomectomy. Measurements and Main Results: BMI was higher in AM compared to RALM (mean: 31.02 ± 7.15 in AM vs. 28.05 ± 5.98 kg/ m2 in RALM; p=0.0155). Number of leiomyomata was larger in AM compared to RALM (average: 4.22 ± 3.36 in AM vs. 3.06 ± 1.44 in RALM; p=0.0094). Tumor size was larger in AM compared to RALM (mean: 53.11 ± 25.71 in AM vs. 42.93 ± 17.91 mm in RALM; p=0.0114). Operative time was longer in RALM compared to AM (mean: 205.43 ± 73.58 in RALM vs. 161.65 ± 49.99 min in AM; p=0.0006). Blood loss was lower in RALM compared to AM (mean: 110.19 ± 62.48 in RALM vs. 176.11 ± 82.22 ml in AM; p< 0.0001). Hospital stay was shorter in RALM compared to AM (mean: 1.08 ± 0.42 in RALM vs. 2.35 ± 1.24 days in AM; p< 0.0001) and the predicted odds of staying one day or less in the hospital for RALM group was 193.5 times the odds for AM when adjusted for the number and tumor size. Conclusion: Robotic assisted laparoscopic myomectomy has shorter hospital stay, less blood loss and increased operative time compared to abdominal myomectomy.