Obstet Gynecol Sci.  2013 Nov;56(6):375-381. 10.5468/ogs.2013.56.6.375.

Obstetric outcomes after uterine myomectomy: Laparoscopic versus laparotomic approach

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. blasto@snubh.org
  • 3Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVE
To compare the pregnancy-related complications after laparoscopic and laparotomic uterine myomectomy.
METHODS
A retrospective study of 415 women who received laparoscopic (n = 340) or laparotomic (n = 75) resection of uterine leiomyomas in one center. The mean follow-up period was 26.5 months in laparoscopic group and 23.9 months in laparotomic group.
RESULTS
Fifty-four and 12 pregnancies occurred in laparoscopic and laparotomic myomectomy group, respectively. The major obstetric outcomes were similar between two groups. There was no ectopic pregnancy or preterm birth. There were two cases of obstetric complication in laparoscopic group only; one experienced neonatal death and postpartum hemorrhage due to placental abruption and the other underwent subtotal hysterectomy due to uterine dehiscence identified during Cesarean section.
CONCLUSION
Uterine rupture or dehiscence after laparoscopic myomectomy occurred in 3.7% (2/54) which lead to unfavorable outcome. Appropriate selection of patients and secure suture techniques appears to be important for laparotomic myomectomy in reproductive-aged women.

Keyword

Laparoscopic myomectomy; Laparotomic myomectomy; Myomectomy; Obstetric outcome
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