Comparative study of transabdominal and laparoscopic myomectomy

doi:10.3877/cma.j.issn.1673-5250.2017.01.011

Objective

To explore the residual, recurrence and pregnancy outcomes of uterus myoma (UM) patients with transabdominal and laparoscopic myomectomy.

Methods

From January 2009 to December 2015, a total of 116 cases of UM patients in Department of Obstetrics and Gynecology, Zhongshan Dongsheng Hospital of Guangdong Province were selected as research objects. According to the random number table method, they were divided into the observation group (n=58) and control group (n=58). The patients in observation group were treated with laparoscopic myomectomy, and the patients in control group underwent routine laparotomy myomectomy. The transoperative bleeding volume, operation duration, length of hospitalization, removal number of UM, removal weight of UM, postoperative complications, and postoperative pregnancy outcomes, UM recurrence and residual between two groups were analyzed by statistical methods. There were no significant differences between two groups in the age, diameter and number of UM and constituent ratio of solitary and multiple UM (P>0.05). All the UM patients who agreed to accept this study signed the informed consent.

Results

①Compared with control group, both the transoperative bleeding volume and removal number of UM in the observation group were significantly reduced, and both the operation duration and length of hospitalization were significantly shortened, and removal weight of UM decreased significantly, and all the differences were statistically significant (t=7.136, P=0.029; t=4.913, P=0.041; t=9.259, P=0.017; t=5.715, P=0.035; t=8.149, P=0.023). ②The incidence of postoperative complication in observation group was 15.5% (9/58), which was significantly lower than 27.7% (16/58) in control group, and the difference was statistically significant (χ²=4.132, P=0.045). ③There were no significant differences between two groups in the rates of UM residual, UM recurrence and pregnancy (χ²=0.892, P=0.345; χ²=1.335, P=0.248; χ²=0.637, P=0.425).

Conclusions

Postoperative UM residual, recurrence and pregnancy outcomes of transabdominal and laparoscopic myomectomy are similar. But the operation duration, length of hospitalization and transoperative bleeding volume of laparoscopic myomectomy are superior to transabdominal myomectomy, and leads to less postoperative complications with high safety.

Key words: Leiomyoma, Neoplasm, residual, Neoplasm recurrence, local, Pregnancy outcome, Transabdominal myomectomy, Laparoscopic myomectomy, Women

表1 2组子宫肌瘤患者手术情况比较(±s)

组别	例数	术中出血量(mL)	手术时间(min)	住院时间(d)	剔除的UM个数(个)	剔除的UM重量(g)
观察组	58	163.6±36.4	74.7±9.0	4.9±1.1	3.2±0.9	137.5±72.2
对照组	58	254.9±55.3	97.1±11.2	6.8±1.4	6.8±1.3	314.5±152.1
t值	?	7.136	9.259	5.715	4.913	8.149
P值	?	0.029	0.017	0.035	0.041	0.023

表1 2组子宫肌瘤患者手术情况比较(±s)

组别	例数	术中出血量(mL)	手术时间(min)	住院时间(d)	剔除的UM个数(个)	剔除的UM重量(g)
观察组	58	163.6±36.4	74.7±9.0	4.9±1.1	3.2±0.9	137.5±72.2
对照组	58	254.9±55.3	97.1±11.2	6.8±1.4	6.8±1.3	314.5±152.1
t值	?	7.136	9.259	5.715	4.913	8.149
P值	?	0.029	0.017	0.035	0.041	0.023

表2 2组子宫肌瘤患者术后并发症发生情况比较[例数(%)]

组别	例数	术后出血	切口愈合不良	发热	尿潴留	合计
观察组	58	3(5.2)	0(0)	5(8.6)	1(1.7)	9(15.5)
对照组	58	6(10.3)	3(5.2)	5(8.6)	2(3.4)	16(27.6)
χ²值	?	－	－	－	－	4.132
P值	?	－	－	－	－	0.045

表2 2组子宫肌瘤患者术后并发症发生情况比较[例数(%)]

组别	例数	术后出血	切口愈合不良	发热	尿潴留	合计
观察组	58	3(5.2)	0(0)	5(8.6)	1(1.7)	9(15.5)
对照组	58	6(10.3)	3(5.2)	5(8.6)	2(3.4)	16(27.6)
χ²值	?	－	－	－	－	4.132
P值	?	－	－	－	－	0.045

表3 2组子宫肌瘤患者术后肌瘤残留、复发及妊娠结局比较[例数(%)]

组别	例数	UM残留	UM复发	妊娠
观察组	58	3(5.2)	6(10.3)	36(62.1)
对照组	58	2(3.4)	3(5.2)	33(56.9)
χ²值	?	0.892	1.335	0.637
P值	?	0.345	0.248	0.425

表3 2组子宫肌瘤患者术后肌瘤残留、复发及妊娠结局比较[例数(%)]

组别	例数	UM残留	UM复发	妊娠
观察组	58	3(5.2)	6(10.3)	36(62.1)
对照组	58	2(3.4)	3(5.2)	33(56.9)
χ²值	?	0.892	1.335	0.637
P值	?	0.345	0.248	0.425

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