Laparoscopic Myomectomy Outcomes: an Experience in Srinagarind Hospital

Main Article Content

Amornrat Temtanakitpaisan Teerayut Temtanakitpaisan

Abstract

Objective: To evaluate the intraoperative and postoperative outcomes of laparoscopic myomectomy in Srinagarind Hospital.


Methods: Retrospective data regarding laparoscopic myomectomy were collected between July 2018 and June 2019 from the hospital operating room records and the histopathology database. We found records of 11 women who had undergone laparoscopic myomectomy using a similar technique and examined their demographic data (age, body weight, height, parity), presenting symptoms, preoperative GnRH agonist used, and operative details such as type and number of myomas, size of the largest myoma, and perioperative and postoperative outcomes.


Results: The mean age + SD and mean BMI + SD were 35.5 + 5.1 years and 22.7 + 3.7 kg/m2, respectively. The most common indications were hypermenorrhea and dysmenorrhea/pelvic pain. The procedure was completed laparoscopically in 10 of the 11 women (90.9%). The mean amount of intra-operative blood loss + SD and the mean operative time + SD were 320.0 + 249.8 ml. and 155.4 + 23.4 minutes, respectively. The median length of postoperative hospital stay was 3 days (IQ 3-4). No postoperative complications, such as surgical site infection, urinary tract infection, pulmonary complications, cardiac complications, or reoperation, were noted. One of the patients became pregnant after the procedure (9.1%)


Conclusions: Laparoscopic myomectomy is a minimally invasive procedure that requires advanced skills. Preoperative evaluation is important in deciding the type of procedure to be performed. In our experience, laparoscopic myomectomy is safe and is effective in preserving the uterus. 

Keywords

Article Details

Section
Original Articles

References

1. Liu L, Li Y, Xu H, Chen Y, Zhang G, Liang Z. Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma. Fertil Steril 2011; 95: 254–8.
2. Lagana AS, Vergara D, Favilli A, La Rosa VL, Tinelli A, Gerli S, et al. Epigenetic and genetic landscape of uterine leiomyomas: a current view over a common gynecological disease. Arch Gynecol Obstet 2017; 296: 855–67.
3. De La Cruz MSD, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. Am Fam Physician 2017; 95: 100–7.
4. Bean EMR, Cutner A, Holland T, Vashisht A, Jurkovic D, Saridogan E. Laparoscopic Myomectomy: A Single-center Retrospective Review of 514 Patients. J Minim Invasive Gynecol 2017; 24: 485–93.
5. Cohen SL, Senapati S, Gargiulo AR, Srouji SS, Tu FF, Solnik J, et al. Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial. BJOG Int J Obstet Gynaecol 2017; 124: 262–8.
6. Chen I, Motan T, Kiddoo D. Gonadotropin-releasing hormone agonist in laparoscopic myomectomy: systematic review and meta-analysis of randomized controlled trials. J Minim Invasive Gynecol 2011; 18: 303–9.
7. Glaser LM, Friedman J, Tsai S, Chaudhari A, Milad M. Laparoscopic myomectomy and morcellation: A review of techniques, outcomes, and practice guidelines. Best Pract Res Clin Obstet Gynaecol 2018; 46: 99–112.
8. Bhave Chittawar P, Franik S, Pouwer AW, Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev 2014; CD004638.
9. Sizzi O, Rossetti A, Malzoni M, Minelli L, La Grotta F, Soranna L, et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 2007; 14: 453–62.