A Randomized Trial of Laparoscopic Versus Laparoscopic-Assisted Minilaparotomy Myomectomy for Removal of Large Uterine Myoma: Short-Term Outcomes

Ji, Tan; Sun, Yangyan; Dai, Huihua; Zhong, Bao‐Liang; Wang, Daoyuan

doi:10.1016/j.jmig.2008.03.010

Cited by 22 publications

(40 citation statements)

References 25 publications

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“…To our knowledge, the literature contains few studies that compared LPS and MLPT myomectomy, and the results are conflicting [5,15,26,27]. Whereas Fanfani et al [24] concluded that there is no difference between the 2 techniques, both Alessandri et al [6] and Palomba et al [7] reported that LPS myomectomy is characterized by less blood loss and shorter hospital stay but also by longer operative time.…”

mentioning

confidence: 99%

Laparoscopy vs Minilaparotomy in Women with Symptomatic Uterine Myomas: A Prospective Randomized Study

Cicinelli

Tinelli

Colafiglio

et al. 2009

Journal of Minimally Invasive Gynecology

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mentioning

confidence: 99%

Laparoscopy vs Minilaparotomy in Women with Symptomatic Uterine Myomas: A Prospective Randomized Study

Cicinelli

Tinelli

Colafiglio

et al. 2009

Journal of Minimally Invasive Gynecology

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“…Así también, aunque observamos un menor requerimiento de analgesia con opiáceos y una menor estadía hospitalaria en pacientes operadas por laparoscopia, las diferencias se minimizan o desaparecen cuando se comparan miomas que miden menos de 5 cm. Estos resultados contrastan con los resultados de algunas series internacionales en donde se demuestra los beneficios de la laparoscopia en términos de dolor postoperatorio, pérdidas hemáticas, estadía hospitalaria y tiempo de recupe-ración (4,7,8,(11)(12)(13)(14)(15).…”

Section: Discussionunclassified

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

Sigüenza²,

et al. 2009

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: Múltiples pacientes requieren un manejo conservador del mioma uterino. Muchas de ellas no han completado su paridad, y otras no desean la remoción del útero preocupadas del impacto que esa alternativa tenga en su vida sexual. Objetivos: Evaluar nuestra experiencia en pacientes miomectomizadas mediante laparoscopia o laparotomía y revisar la literatura para definir las ventajas de cada técnica y recomendaciones para su indicación. Método: Estudio prospectivo, no randomizado, de pacientes miomectomizadas en el Servicio de Ginecología del Hospital Clínico de la Universidad Católica de Chile, durante el período noviembre de 2007 y mayo de 2008. Resultados: La población incluida fue de 43 casos; 16 casos correspondieron a miomectomía laparoscópica (37,2%) y 27 a miomectomía por laparotomía (67,8%). La miomectomía por laparotomía se realizó en 40% de los casos utilizando una incisión transversa mínima. Esta vía de abordaje fue más frecuentemente utilizada cuando se trataba de miomas de gran tamaño o de múltiples miomas. En nuestra serie, la miomectomía laparoscópica se asociaría a un menor requerimiento de analgesia. No hay diferencias en la frecuencia de complicaciones, tiempo operatorio y estadía hospitalaria entre ambas técnicas, cuando se trata de miomas operados menores de 5 cm. Conclusión: Nuestros resultados sugieren que la miomectomía por laparotomía es una técnica segura que debiese privilegiarse cuando se trata de miomas grandes y múltiples. La laparoscopia es igualmente segura reservada para casos bien seleccionados y cirujanos experimentados en el procedimiento.PALABRAS CLAVE: Mioma, miomectomía, cirugía, laparoscopia, complicaciones SUMMARY Background: Multiple patients ask for a conservative management of uterine fibroids. Some of the patients have not completed their parity at the time of surgery, and others do not want an hysterectomy worried about de impact of this procedure in their sexual life. Objectives: The objective of this study was to evaluate our experience in the short term surgical results of patients undergoing a laparoscopic or abdominal myomectomy. We also did a literature review to define the advantages for each technique and their indications. Methods: A prospective, non-randomized study comparing short term surgical outcomes in patients undergoing laparoscopic versus abdominal myomectomy in the Gynecology Service of the Clinical Hospital of the Pontificia Universidad Católica de Chile, between November 2007 and May 2008. Results: Forty-three patients undergoing myomectomy in our centre were analyzed. 16 of them were approached by laparoscopy (37.2%)

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“…Fourteen studies were included in the final analysis (Alessandri et al, 2006;Benassi et al, 2005;Cagnacci et al, 2003;Ciavattini et al, 2010;Cicinelli et al, 2009;Fanfani et al, 2005;Kalogiannidis et al, 2010;Malzoni et al, 2010;Palomba et al, 2007aPalomba et al, , 2007bPrapas et al, 2009;Sesti et al, 2008;Tan et al, 2008;Wen et al, 2008Wen et al, , 2010 for an overall population of 2151 patients. Seven studies (Alessandri et al, 2006;Benassi et al, 2005;Cagnacci et al, 2003;Cicinelli et al, 2009;Palomba et al, 2007aPalomba et al, , 2007bSesti et al, 2008;Tan et al, 2008) were RCTs, whereas other five were prospective non-randomized (Fanfani et al, 2005;Kalogiannidis et al, 2010;Prapas et al, 2009;Wen et al, 2008Wen et al, , 2010 and two retrospective (Ciavattini et al, 2010;Malzoni et al, 2010).…”

Section: Search Datamentioning

confidence: 99%

“…A total of 1139 patients were treated with minilaparotomy (Alessandri et al, 2006;Benassi et al, 2005;Cagnacci et al, 2003;Ciavattini et al, 2010;Cicinelli et al, 2009;Fanfani et al, 2005;Kalogiannidis et al, 2010;Malzoni et al, 2010;Palomba et al, 2007aPalomba et al, , 2007bPrapas et al, 2009;Sesti et al, 2008;Tan et al, 2008;Wen et al, 2008Wen et al, , 2010, whereas 239 and 773 patients received, respectively, a laparotomy (Benassi et al, 2005;Cagnacci et al, 2003;Kalogiannidis et al, 2010;Wen et al, 2008Wen et al, , 2010 or other minimally invasive surgical techniques (Alessandri et al, 2006;Ciavattini et al, 2010;Cicinelli et al, 2009;Fanfani et al, 2005;Malzoni et al, 2010;Palomba et al, 2007aPalomba et al, , 2007bPrapas et al, 2009;Sesti et al, 2008;Tan et al, 2008). Specifically, the minimally invasive surgeries used as comparative procedures consisted of either traditional gas laparoscopy (Alessandri et al, 2006;Ciavattini et al, 2010;Cicinelli et al, 2009;Fanfani et al, 2005;Malzoni et al, 2010;Palomba et al, 2007aPalomba et al, , 2007bPrapas et al, 2009) or isobaric gasless laparoscopy…”

Section: Search Datamentioning

confidence: 99%

“…In one study (Ciavattini et al, 2010) also patients with intramural-submucosal leyomyomas were included. Submucosal leiomyomas were formally excluded in six studies (Alessandri et al, 2006;Fanfani et al, 2005;Malzoni et al, 2010;Palomba et al, 2007aPalomba et al, , 2007bPrapas et al, 2009;Tan et al, 2008). The presumed presence of peduncolated leiomyomas was a further exclusion criterion in eight studies (Cagnacci et al, 2003;Ciavattini et al, 2010;Fanfani et al, 2005;Prapas et al, 2009;Sesti et al, 2008;Tan et al, 2008;Wen et al, 2008Wen et al, , 2010.…”

Section: Qualitative Data Analysismentioning

confidence: 99%

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Safety and efficacy of the minilaparotomy for myomectomy: a systematic review and meta-analysis of randomized and non-randomized controlled trials

Palomba

Fornaciari

Falbo

et al. 2015

Reproductive BioMedicine Online

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Myomectomy is the most frequent reproductive surgery to preserve, improve fertility, or both. The present study was designed to assess the safety and efficacy of minilaparotomy for myomectomy through a systematic review of randomized and non-randomized controlled trials with a meta-analysis. All available studies comparing minilaparotomy myomectomy with laparotomy, other minimally invasive surgeries, or both, were included. Available surgical and reproductive data were extrapolated, and a qualitative and quantitative analysis was carried out. Fourteen studies were included in the final analysis for an overall sample of 2151 patients. A total of 1139 patients were treated with minilaparotomy, whereas 239 and 773 patients were treated, respectively, with the laparotomy or laparoscopy. Only two studies comparing minilaparotomy with laparoscopy assessed the reproductive outcomes, and their data synthesis did not demonstrate significant difference between the two surgical techniques. Specific surgical end-points differed significantly between minilaparotomy and laparotomy or laparoscopy, even if those differences were not clinically relevant. In conclusion, current data do not permit a definite conclusion to be drawn. Further studies are needed to clarify the risk-benefit ratio of the minilaparotomy compared with the other minimally invasive surgical procedures for myomectomy to provide clinical recommendations with strong scientific evidence.

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A Randomized Trial of Laparoscopic Versus Laparoscopic-Assisted Minilaparotomy Myomectomy for Removal of Large Uterine Myoma: Short-Term Outcomes

Cited by 22 publications

References 25 publications

Laparoscopy vs Minilaparotomy in Women with Symptomatic Uterine Myomas: A Prospective Randomized Study

Laparoscopy vs Minilaparotomy in Women with Symptomatic Uterine Myomas: A Prospective Randomized Study

Miomectomía Abdominal Versus Miomectomía Laparoscópica: Experiencia Preliminar Del Hospital Clínico De La Pontificia Universidad Católica De Chile

Safety and efficacy of the minilaparotomy for myomectomy: a systematic review and meta-analysis of randomized and non-randomized controlled trials

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