Laparoscopic treatment of uterine fibroids: a comparison of peri-operative outcomes in laparoscopic hysterectomy and myomectomy.

Abstract:

PURPOSE:To compare peri-operative outcomes between laparoscopic myomectomy (LM) and laparoscopic hysterectomy (LH) for the treatment of uterine fibroids. METHODS:Retrospective cohort study including 400 women who underwent LH or LM for the management of uterine fibroids. RESULTS:LH patients were older, with higher BMI and larger uterine size but LH was associated with shorter operative duration (80.2 vs. 115.7 min, p < 0.0001), lower blood loss (215 vs. 316 ml, p < 0.0001), and shorter hospital stay (1.81 vs. 2.12 days, p = 0.0003). Seven LM patients (3.2%) had blood loss >1000 ml compared with no LH patients and five LM patients (2.3%) required blood transfusion compared to 1 (0.5%) LH patient. Three LM patients (1.9%) and no LH patients required conversion to laparotomy. Bladder injury occurred in three LH cases (1.6%) and no LM cases. When the data was restricted only to women aged 44 years or over, LH was again associated with significantly lower operative duration and estimated blood loss. CONCLUSIONS:Particularly in perimenopausal women, the decision to perform myomectomy can be controversial. These data suggest that there are potential advantages to LH over LM, including reduced operation length, blood loss and hospital stay but increased risk of urinary tract injury.

journal_name

Arch Gynecol Obstet

authors

Odejinmi F,Maclaran K,Agarwal N

doi

10.1007/s00404-014-3434-y

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

579-84

issue

3

eissn

0932-0067

issn

1432-0711

journal_volume

291

pub_type

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