A Comparison Of Surgical Outcomes Between Laparoscopic And Laparotomy Myomectomy

Myoma is the most common benign neoplasm that can occur in the femalereproductive system, most frequently seen in women in their30s-50s.. The incidence ofmyoma is20％～25％. The typical clinical presentations of uterine myoma aremenorrhagia、compression symptoms、subfertility status and abortion, eg. As our livingcondition is better, female think highly of the cosmetic problems and their organs. Sominimally invasive surgery is praised more highly. Laparoscopic myomectomy now iswidely used in myomectomy. To compare operative data and operative and clinicaloutcomes of laparoscopic myomectomy (LM)with those of laparotomy myomectomy. Sowe can know the advantage and disadvantage of LM.A comparison of surgical outcomes between laparoscopic andlaparotomy myomectomyObjective: As our living condition is better, female think highly of the cosmeticproblems and their organs. So minimally invasive surgery is praised more highly.Laparoscopic myomectomy now is widely used in myomectomy. But there are differentsbetween laparoscopic myomectomy (LM) and laparotomy myomectomy. So this researchis to sum up the advantage and disadvantage of LM, by comparing operative data andoperative and clinical outcomes of laparoscopic myomectomy (LM)with those oflaparotomy myomectomy.Study design: In a prospective comparative study, we enrolled160patients, LM wasperformed on80patients, and laparotomy myomectomy was performed on80the otherpatients. And to compare the operation time, blood loss, hospital stay after operation、anal exhaust time，and recurrences in2years followed-up time. And we also analy thereproductive condition in the female who have fertility requirements with myoma.Results: In the laparotomy mymectomy part, the myomectomy rate is156.76%. Inthe LM part, the myomectomy rate is144.76%.The second one is lower than the first one.The mean blood loss in operation of laparotomy mymectomy part is102.3ml, this numberis higher than the LM part which is53.1ml, and the P＜0.05, have statistical significance.The operation time of the laparotomy mymectomy part is82.6min, this time lower than theLM part which is97.2min, and the P＜0.05, have statistical significance. The anal exhausttime of the laparotomy mymectomy part is2.6d, this number is higher than the LM partwhich is1.2d. The hospital stay after operation of laparotomy mymectomy part is4.2d,this number is higher than the LM part which is3.7d. The P of this tow parts betweenthe two teams all smaller than0.05, have statistical significance. In2years followed-uptime, the recurrence patients’ number of laparotomy mymectomy part is20,and this rate is25.00%; the recurrence patients’ number of LM part is18,and this rate is22.50%,the P is0.710, have no statistical significance. The recurrence patients’ number of laparotomymymectomy part whose myoma number in operation is smaller than3, is14,and the rate is70.00%; the recurrence patients’ number of LM part whose myoma number in operation issmaller than3, is13,and the rate is72.22%. The rates are all higher than rate which themyoma number in operation higher than3. The pregnancy rate after operation oflaparotomy mymectomy is57.14%, the rate of LM is66.67%, the P is0.850which ishigher than0.05, have no statistical significance.In the patients who have fertility requirements with myoma,only one is primaryinfertility, who delivery a boy by cesarean. Others haven’t been accepted examination ofinfertility,so this research can’t explain the relationship between myoma and infertility.In the160patients, there is no one has hemorrhea and no one has been accepted bloodtransfusion. In the LM one patient has hemorrhea in operation,the blood loss is about500ml, and accepted400ml MAP transfusion, in the hospital stay after operation has nohemorrhea. In the operation, we digged out four myomas, the diameter of the myomas are 9cm4cm4cm1.5cm. In the LM,one patient turned to laparotomy mymectomy, becausethis patient have abdominal operation history,and the adhension is very serious,we can’tseparate the adhension and can’t explore the operation area. And there is a myoma whichdiameter is6cm between uterine body and cervical.Conclusion:1. The laparotomy mymectomy is more thoroughly dig out myoma thanthe LM.2. In the blood loss in the operation,the LM is smaller than thelaparotomy mymectomy.3. In the operation time,the LM is longer than the laparotomymymectomy.4. In the hospital stay after operation and anal exhaust time,the LM isall shorter than the laparotomy mymectomy.5.There is no differences between the LM and the laparotomymymectomy, at the recurrence rate.