Obstet Gynecol Sci.  2017 Mar;60(2):193-199. 10.5468/ogs.2017.60.2.193.

Recurrence factors and reproductive outcomes of laparoscopic myomectomy and minilaparotomic myomectomy for uterine leiomyomas

• Shin DG
• Yoo HJ
• Lee YA
• Kwon IS
• Lee KH

• KMID: 2372804
• DOI: http://doi.org/10.5468/ogs.2017.60.2.193

Abstract

OBJECTIVE
The aim of this study was to determine recurrence factors and reproductive outcomes of laparoscopic myomectomy (LM) and minilaparotomic myomectomy (MM) for treating uterine leiomyomas.
METHODS
Between 2007 and 2013, 160 patients underwent myomectomy, including 122 who underwent LM and 38 who underwent MM. Patients were followed up for recurrence based on pelvic ultrasound exams. Only patients who were followed up for a minimum of two years were selected for this retrospective study. Pregnancy rate, delivery, and delivery methods were compared between the two groups to evaluate reproductive outcomes. Furthermore, mean age, body mass index, preoperative administration of gonadotropin-releasing hormone agonist (GnRHa), and characteristics of leiomyomas were investigated to determine recurrence factors.
RESULTS
The mean body mass index in the MM group was significantly (P=0.048) higher than that in the LM group. The number and the largest diameter of removed leiomyoma were also significantly higher in the MM group (both P=0.001). Logistic regression after adjusting significantly different characteristics showed that the LM group had shorter (P=0.020) postoperative hospitalization days compared to the MM group. Other outcome variables including recurrence rate were not significantly different between the two groups. Reproductive outcomes such as pregnancy rate, delivery, and delivery methods were not significantly different between the two groups. Preoperative GnRHa therapy was the only significant (P=0.039) recurrence factor after myomectomy.
CONCLUSION
This study showed that LM and MM had similar recurrence rates and reproductive outcomes. The only recurrence factor of significance was preoperative administration of GnRHa.

Keyword

Laparoscopy; Laparotomy; Leiomyoma; Recurrence; Uterine myomectomy

MeSH Terms

Body Mass Index
Gonadotropin-Releasing Hormone
Hospitalization
Humans
Laparoscopy
Laparotomy
Leiomyoma*
Logistic Models
Pregnancy Rate
Recurrence*
Retrospective Studies
Ultrasonography
Uterine Myomectomy
Gonadotropin-Releasing Hormone

Figure

• 

  Fig. 1 Cumulative recurrence of leiomyomas with and without preoperative administration of gonadotropin-releasing hormone (GnRH) agonist with Kaplan-Meier curve.

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