Curative effect of laparoscopic hysterectomy for uterine fibroids and its impact on ovarian blood supply.

Abstract

This study evaluates the curative effects laparo-scopic hysterectomies performed to treat uterine fibroids and determined the impact of the procedures on ovarian blood supply. A total of 124 patients with uterine fibroids admitted and treated in our hospital from December 2014 to December 2015 participated in the study. Two groups of 62 patients each were formed according to different operating plans; one group of patients underwent abdominal (open) panhysterectomy and were set as the control group; with the other group of patients were treated with laparoscopic hysterectomy and were set as the observation group. Ovarian endocrine function tests and blood supply changes were measured in both groups before the operation and one month after it, and the clinical conditions of all the patients were followed up for 24 months after surgery. Our results showed the duration of operation, amount of bleeding and time to recovery after the procedure were significantly lower in the patients in the observation group (P<0.05). Also, compared with preoperative conditions, the levels of PRL, FSH, E2, LH and other ovarian function markers in both groups were significantly lower one month after the operation, but the levels of the patients in the observation group were still significantly higher than those of the patients in the control group (P<0.05). Likewise, the surgeries affected the ovarian blood supply in patients of both groups, as evidenced by the lower levels of PI, RI, Vmin, Vmax and other blood supply indexes observed by Doppler ultrasound a month after the operations. However, the impact of the surgery on the ovarian blood supply was less marked in the patients in the observation group as their levels remained higher than those of patients in the control group (P<0.05). The numbers of patients with completely healed abdominal muscular layers in the observation group were always significantly higher than those of patients in the control group, at every different time point examined (1, 4, 8 and 12 months after surgery) (P<0.01). At the end of the 24 months of the follow-up period, the recurrence rate of fibroids for patients in the observation group was 4.8%. In our hands, the laparoscopic hysterectomy procedure to treat uterine fibroids showed the usual advantages over the abdominal open hysterectomy, like small trauma, short surgical procedure and rapid postoperative recovery, but it also proved to cause a significantly smaller impact on ovarian blood supply and should be considered whenever uterus preservation is a priority.