Laparoscopic ultrasound procedure can reduce residual myomas in laparoscopic myomectomy for multiple myomas.

Abstract

To clarify whether the use of laparoscopic ultrasound (LUS) during laparoscopic myomectomy could reduce the number of residual myomas after surgery. A cohort study was conducted. Subjects were women who underwent laparoscopic myomectomy for multiple uterine myomas for the first time. The subjects were assigned to one of two groups: LUS group or non-LUS group. All subjects underwent pelvic MRI 3months before and 6months after surgery, and the number of myomas on MRI was counted by radiodiagnosticians. The extraction rate and residual rate of uterine myomas were compared between the two groups. Fourteen cases with and 30 cases without LUS were analyzed. Median operation times were 171min (range 75-295) and 141min (range 50-260) in cases with and without LUS, respectively (p=0.077). Median extraction rates relative to the total number of myomas were 106% (range 75-147%) in subjects with LUS and 100% (range 71-233%) in subjects without LUS (p=0.480). Numbers of residual myomas were 1 (range 0-3) in subjects with LUS and 2 (range 0-9) in subjects without LUS (p=0.028). Median residual rates of myomas were 6.1% (range 0-20%) in subjects with LUS and 20.0% (range 0-69%) in subjects without LUS (p=0.048). Myomas greater than 3cm in diameter were not observed in either group. The number and residual rate of myomas were significantly less in subjects with LUS as compared with those without LUS.