Comparison of Laparoscopic Versus Abdominal Myomectomy in BMA Medical College and Vajira Hospital

Abstract

Comparison of Laparoscopic Versus Abdominal Myomectomy in BMA Medical College and Vajira Hospital

Sarwinee Ratchanon MD, MSc (Reproductive Biology)

Budsaba Wiriyasirivaj MD, MSc (Epidemiology), MSc (Clinical Embryology)

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To compare operative time, operative blood loss, complications and duration of postoperative hospital stay in patients undergoing laparoscopic versus abdominal myomectomy.

Study design: Descriptive study.

Subjects: A total of 44 patients who underwent laparoscopic myomectomy and 19 patients who underwent abdominal myomectomy from January 2003 to December 2006 in Bangkok Metropolitan Administration Medical College and Vajira Hospital were enrolled.

Methods: Patients' characteristics, intra-operative data, complications and hospital stay were collected from hospital records.

Main outcome measures: Operative time, operative blood loss, complications and duration of postoperative hospital stay.

Results: Both groups had similar characteristics. The mean operative time in laparoscopic myomectomy (232.6 ± 71.4 minutes) was significantly longer than that in abdominal myomectomy (94.7 ± 29.3 minutes; p-value < 0.01). The operative blood loss in each group was not significantly different, 358.2 ± 51.3 ml and 302.6 ± 62.7 ml, respectively. The use of meperidine was 76.1 ± 60.6 mg. in laparoscopic group which was significantly less than 126.9 ± 12.2 mg in abdominal group (p-value < 0.01). The duration of postoperative hospital stay were also less in laparoscopic group compared to those in abdominal group (2.4 ± 0.2 days vs 3.9 ± 0.4 days, p-value < 0.01). The major complications, profuse bleeding from myomectomy site during operation (leading to conversion), were found only in 2 cases (4.5%); both in laparoscopic group. There was no injury to urinary bladder, ureter or bowel. Minor complications were not significantly different in both groups.

Conclusion: Although the operative time in laparoscopic myomectomy was longer than transabdominal approach, the patients who underwent laparoscopic myomectomy had lower postoperative pain and shorter postoperative hospital stay than transabdominal approach. Major complications were low. Blood loss and minor complications were not different from abdominal myomectomy.

Vajira Med J 2008 ; 52 : 101 - 109