A prospective short-term evaluation of uterine leiomyomas treated by myomectomy through conventional laparotomy or ultraminilaparotomy

Objective: To evaluate the short-term therapeutic outcome of myomectomy through conventional laparotomy in the treatment of uncomplicated uterine myomas compared with myomectomy through ultraminilaparotomy. Design: Controlled, nonrandomized clinical study. Setting: University-affiliated tertiary care referral center. Patient(s): One hundred thirteen patients with symptomatic and uncomplicated uterine myomas warranting surgical treatment, who expressed a strong desire to retain their uterus, Seventy-two patients underwent myomectomy by laparotomy and 41 by ultraminilaparotomy. Intervention(s): Myomectomy through laparotomy or ultraminilaparotomy access. Main Outcome Measure(s): The outcome was measured by comparing blood loss, need for blood transfusion, operative time, postoperative febrile morbidity, time of flatus passage after operation, and postoperative pain (visual analogue scale score and anesthesia use) in both groups. Result(s): General characteristics of the patients were similar in both groups. There were no statistical differences in mean operative time, blood loss, febrile morbidity, insurance pay, and therapeutic efficacy (symptom relief) between the two groups. However, postoperative recovery seemed to be better and more rapid in the ultraminilaparotomy group compared with that in the laparotomy group, including rapid and early bowel movement, lower scores on the visual analogue scale, and shortened postoperative hospital stay. Conclusion(s): This study demonstrates the superiority of ultraminilaparotomy in treating uncomplicated uterine myomas, compared with laparotomy, during this 1-year short-term follow-up. (Fertil Steril (R) 2008;90:2361-6. (C) 2008 by American Society for Reproductive Medicine.)