Evaluation of Abdominal and Laparoscopic Myomectomies with Respect to Postoperative Complications and Fertility

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Objective: The aim of this study is to compare the postoperative complications of laparoscopic and abdominal myomectomy procedures for the myoma of uterus and their effects on postoperative fertility. Material and Methods: In this study, we retrospectively evaluated 221 cases who were performed myomectomy operation at Suleymaniye Obstetrics and Gynecology Hospital between 2003-2007. All cases were divided into two groups with respect to the surgical procedure performed. 136 patients were in the abdominal myomectomy (AM) group, 85 patients were in the laparoscopic myomectomy group and the groups were compared. Results: There is no significant difference in age, smoking, history of abdominal surgery, pelvic infection, postoperative need for transfusion, and ileus between the groups. The mean number of parity was higher in the laparoscopic myomectomy group. In abdominal myomectomy group, number of cases in which more than 4 myomas were removed (p 0.01) and number of cases in which myoma was greater than 6 cm in diameter (p 0.001) were higher than laparoscopic myomectomy group. The operation time and duration of hospital stay was longer (p 0.001), while postoperative hemotocrit levels were lower in abdominal myomectomy group when compared with laparoscopic myomectomy group (p 0.017). Postoperative cumulative pregnancy rate and pregnancy by assisted reproductive technology is higher in laparoscopic myomectomy group than abdominal myomectomy group ( p 0,001). Conclusion: There was no difference between the groups in complications during and after the operations, while laparoscopy was more advantageous than abdominal surgery with shorter time of surgery and hospital stay, less bleeding during the procedure and higher rates of pregnancy postoperatively.

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Laparoscopic myomectomy , abdominal myomectomy , complication , fertility

Kocatepe Medical Journal

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Kocatepe Medical Journal