Perioperative and reproductive outcomes' comparison of mini-laparotomy and laparoscopic myomectomy in the management of uterine leiomyomas: a systematic review

ObjectiveTo evaluate and compare mini-laparotomy (MLPT) with laparoscopic (LPS) myomectomy perioperative and reproductive outcomes.MethodsWe systematically searched for related articles in the MEDLINE, Embase, Web of Science and the Cochrane library databases. Nine studies (4 randomized, 3 retrospective, 1 prospective and 1 case-control study) which involved 1723 patients met the inclusion criteria and were considered eligible for inclusion.ResultsDemographic characteristics were similar between the two groups. LPS was associated with shorter hospital stay (p = 0.04), lower blood loss (p < 0.00001), shorter duration of median ileus (p < 0.00001) and fewer episodes of postoperative fever (p = 0.04). None of the reproductive factors examined (pregnancy rate, preterm delivery, vaginal delivery and delivery with caesarean section) in women diagnosed with unexplained infertility and/or symptomatic leiomyomas reached statistical significance although the results represent a small size effect.ConclusionOur analysis demonstrated that LPS seems to be an alternative, safe and reliable surgical procedure for uterine leiomyoma treatment and in everyday practice seems to offer improved outcomes-regarding at least the perioperative period-over MLPT.

Automated summary

This study evaluated and compared the perioperative and reproductive outcomes of mini-laparotomy (MLPT) and laparoscopic (LPS) myomectomy. A systematic search of relevant articles yielded nine studies involving 1723 patients. The results showed that LPS had shorter hospital stay, lower blood loss, shorter duration of ileus, and fewer episodes of postoperative fever compared to MLPT. However, there was no significant difference in reproductive outcomes. In conclusion, LPS seems to be a safe and reliable surgical procedure for uterine leiomyoma treatment and offers improved outcomes in the perioperative period.