nach oben

Archives of Gynecology and Obstetrics

Erschienen in:

11.08.2023 | Review

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

verfasst von: Eleni Tsiampa, Konstantinos Tsiampas, Filippos Kapogiannis

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2024

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate and compare mini-laparotomy (MLPT) with laparoscopic (LPS) myomectomy perioperative and reproductive outcomes.

Methods

We 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.

Results

Demographic 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.

Conclusion

Our 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.

Verkauf BS (1992) Myomectomy for fertility enhancement and preservation. Fertil Steril. 58(1):1–15. https://doi.org/10.1016/s0015-0282(16)55128-0CrossRefPubMed

Stewart EA (2001) Uterine fibroids. Lancet 357(9252):293–298. https://doi.org/10.1016/S0140-6736(00)03622-9CrossRefPubMed

Damiani G, Campo S, Dargenio R, Garcea N (2008) Laparoscopic vs laparotomic ovarian cystectomy in reproductive age women: an economic evaluation. Gynaecol Endosc 7(1):19–23. https://doi.org/10.1046/j.1365-2508.1998.00135.xCrossRef

Nezhat F, Nezhat C, Gordons S, Wilkins E (1992) Laparoscopic versus abdominal hysterectomy. J Reprod Med 37(3):247–250 (PMID: 1532990)PubMed

Hidlebaugh DA, Vulgaropulos S, Orr RK (1997) Treating adnexal masses. J Reprod Med 42(9):551–558 (PMID: 9336750)PubMed

Benedetti-Panici P, Maneschi F, Cutillo G, Scambia G, Congiu M, Mancuso S (1996) Surgery by minilaparotomy in benign gynecologic disease. Obstet Gynecol 87(3):456–459. https://doi.org/10.1016/0029-7844(95)00441-6CrossRefPubMed

Fagotti A, Ferrandina G, Longo R, Mancuso S, Scambia G (2002) Minilaparotomy in early stage endometrial cancer: an alternative to standard and laparoscopic treatment. Gynecol Oncol 86(2):177–186. https://doi.org/10.1006/gyno.2002.6721CrossRefPubMed

Fanfani F, Fagotti A, Ercoli A et al (2004) A prospective randomized study of laparoscopy and minilaparotomy in the management of benign adnexal masses. Hum Reprod 19(10):2367–2371. https://doi.org/10.1093/humrep/deh413CrossRefPubMed

Fanfani F, Fagotti A, Longo R, Marana E, Mancuso S, Scambia G (2005) Minilaparotomy in the management of benign gynecologic disease. Eur J Obstet Gynecol Rep Biol 119(2):232–236. https://doi.org/10.1016/j.ejogrb.2004.07.040CrossRef

10.

Seracchioli R, Rossi S, Govoni F et al (2000) Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy. Hum Reprod 15(12):2663–2668. https://doi.org/10.1093/humrep/15.12.2663CrossRefPubMed

11.

Mais V, Ajossa S, Guerriero S, MasciaM SE, Melis GB (1996) Laparoscopic versus abdominal myomectomy: a prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 174(2):654–658. https://doi.org/10.1016/S0002-9378(96)70445-3CrossRefPubMed

12.

Marret H, Chevillot M, Giraudeau B (2004) A retrospective multicentre study comparing myomectomy by laparoscopy and laparotomy in current surgical practice: what are the best patient selection criteria? Eur J Obstet Gynecol Reprod Biol 117(1):82–88. https://doi.org/10.1016/j.ejogrb.2004.04.015CrossRefPubMed

13.

Chang FH, Soong YK, Cheng PJ et al (1996) Laparoscopic myomectomy of large symptomatic leiomyoma using airlift gasless laparoscopy: a preliminary report. Hum Reprod 11(7):1427–1432. https://doi.org/10.1093/oxfordjournals.humrep.a019413CrossRefPubMed

14.

Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700. https://doi.org/10.1136/bmj.b2700CrossRefPubMedPubMedCentral

15.

Fanfani F, Fagotti A, Bifulco G, Ercoli A, Malzoni M, Scambia G (2005) A prospective study of laparoscopy versus minilaparotomy in the treatment of uterine myomas. J Minim Invasive Gynecol 12(6):470–474. https://doi.org/10.1016/j.jmig.2005.07.002CrossRefPubMed

16.

Alessandri F, Lijoi D, Mistrangelo E, Ferrero S, Ragni N (2006) Randomized study of laparoscopic versus minilaparotomic myomectomy for uterine myomas. J Minim Invasive Gynecol 13(2):92–97. https://doi.org/10.1016/j.jmig.2005.11.008CrossRefPubMed

17.

Sesti F, Capobianco F, Capozzolo T, Pietropolli A, Piccione E (2008) Isobaric gasless laparoscopy versus minilaparotomy in uterine myomectomy: a randomized trial. Surg Endosc 22(4):917–923. https://doi.org/10.1007/s00464-007-9516-1CrossRefPubMed

18.

Palomba S, Zupi E, Russo T et al (2007) A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: short-term outcomes. Fertil Steril 88(4):942–951. https://doi.org/10.1016/j.fertnstert.2006.12.048CrossRefPubMed

19.

Palomba S, Zupi E, Falbo A et al (2007) A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes. Fertil Steril 88(4):933–941. https://doi.org/10.1016/j.fertnstert.2006.12.047CrossRefPubMed

20.

Cicinelli E, Tinelli R, Colafiglio G, Saliani N (2009) Laparoscopy vs minilaparotomy in women with symptomatic uterine myomas: a prospective randomized study. J Minim Invasive Gynecol 16(4):422–446. https://doi.org/10.1016/j.jmig.2009.03.011CrossRefPubMed

21.

Ciavattini A, Tsiroglou D, Tranquilli AL, Litta P (2010) Laparoscopic versus ultraminilaparotomic myomectomy for the treatment of large uterine myomas. Acta Obstet Gynecol Scand 89(1):151–155. https://doi.org/10.3109/00016340903295592CrossRefPubMed

22.

Malzoni M, Tinelli R, Cosentino F, Iuzzolino D, Surico D, Reich H (2010) Laparoscopy versus minilaparotomy in women with symptomatic uterine myomas: short-term and fertility results. Fertil Steril 93(7):2368–2373. https://doi.org/10.1016/j.fertnstert.2008.12.127CrossRefPubMed

23.

Shin DG, Yoo HJ, Lee YA, Kwon IS, Lee KH (2017) Recurrence factors and reproductive outcomes of laparoscopic myomectomy and minilaparotomic myomectomy for uterine leiomyoma. Obstet Gynecol Sci 60(2):193–199. https://doi.org/10.5468/ogs.2017.60.2.193CrossRefPubMedPubMedCentral

24.

Wen KC, Sung PL, Chang WH et al (2018) A case-control study to compare the outcome of women treated by two minimally invasive procedures-ultraminilaparotomy myomectomy and laparoscopic myomectomy. Taiwan J Obstet Gynecol 57(2):264–269. https://doi.org/10.1016/j.tjog.2018.02.016CrossRefPubMed

25.

Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March2011]. The Cochrane Collaboration, 2011. www.cochranehandbook.org

26.

Clarke M, Horton R (2001) Bringing it all together: Lancet-Cochrane collaborate on systematic reviews. Lancet 357(9270):1728. https://doi.org/10.1016/S0140-6736(00)04934-5CrossRefPubMed

27.

Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22(4):719–748. https://doi.org/10.1093/jnci/22.4.719CrossRefPubMed

28.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):77–88. https://doi.org/10.1016/0197-2456(86)90046-2CrossRef

29.

Adamyan LV (2003) Minimally invasive surgery in gynaecologic practice. Int J Obstet Gynecol 82(3):347–355. https://doi.org/10.1016/S0020-7292(03)00216-9CrossRef

30.

Glasser M (2005) Minilaparotomy myomectomy: a minimally invasive alternative for the large fibroid uterus. J Min Inv Gynecol 12(3):275–283. https://doi.org/10.1016/j.jmig.2005.03.009CrossRef

31.

Canis M, Rabischong B, Houlle C et al (2002) Laparoscopic management of adnexal masses: a gold standard? Curr Opin Obstet Gynecol 14(4):423–428. https://doi.org/10.1097/00001703-200208000-00010CrossRefPubMed

32.

Alborzi S, Ghannadan E, Alborzi S, Alborzi M (2009) A comparison of combined laparoscopic uterine artery ligation and myomectomy versus laparoscopic myomectomy in treatment of symptomatic myoma. Fertil Steril 92(2):742–747. https://doi.org/10.1016/j.fertnstert.2008.06.0CrossRefPubMed

33.

Gambadauro P (2012) Dealing with uterine fibroids in reproductive medicine. J Obstet Gynaecol 32(3):210–216. https://doi.org/10.3109/01443615.2011.644357CrossRefPubMed

34.

Glasser MH (2005) Minilaparotomy myomectomy: a minimallyinvasive alternative for the large fibroid uterus. J MinimInvasive Gynecol 12(3):275–283. https://doi.org/10.1016/j.jmig.2005.03.009CrossRef

35.

Pelosi MA, Pelosi MA (2004) Pelosi mini-laparotomy hysterectomy: a non-endoscopic minimally invasive alternative to laparoscopy and laparotomy. Surg Technol Int 13:157–167PubMed

36.

Rossetti A, Sizzi O, Soranna L, Cucinelli F, Mancuso S, Lanzone A (2001) Long-term results of laparoscopic myomectomy: recurrence rate in comparison with abdominal myomectomy. Hum Reprod 16(4):770–774. https://doi.org/10.1093/humrep/16.4.770CrossRefPubMed

37.

Dubuisson JB, Facounnier A, Fourchette V, Babaki-Fard K, Coste J, Chapron C (2001) Laparoscopic myomectomy: predicting the risk of conversion to an open procedure. Hum Reprod 16(8):1726–1731. https://doi.org/10.1093/humrep/16.8.172CrossRefPubMed

38.

Malzoni M, Rotondi M, C. Perone C, et al (2003) Fertility after laparoscopic myomectomy of large uterine myomas: operative technique and preliminary results. Eur J Gynaecol Oncol 24(1):79–82PubMed

39.

Sizzi O, Rossetti A, Malzoni M et al (2007) Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 14(4):453–462. https://doi.org/10.1016/j.jmig.2007.01.013CrossRefPubMed

40.

Malzoni M, Sizzi O, Rossetti A, Imperato F (2006) Laparoscopic myomectomy: a report of 982 procedures. Surg Technol Int 15:123–129 (PMID: 17029172)PubMed

41.

Sinha R, Hegde A, Mahajan C, Dubey N, Sundaram M (2008) Laparoscopic myomectomy: do size, number, and location of the myomas form limiting factors for laparoscopic myomectomy? J Minim Invasive Gynecol 15(3):292–300. https://doi.org/10.1016/j.jmig.2008.01.009CrossRefPubMed

42.

Sinha R, Hegde A, Warty N, Patil N (2003) Laparoscopic excision of very large myomas. J Am Assoc Gynecol Laparosc 10(4):461–468. https://doi.org/10.1016/s1074-3804(05)60145-4CrossRefPubMed

43.

Harris WJ (1992) Uterine dehiscence following laparoscopic myomectomy. Obstet Gynecol 80(32):545–546PubMed

44.

Dubuisson JB, Chavet X, Chapron C, Gregorakis SS, Morice P (1995) Uterine rupture during pregnancy after laparoscopic myomectomy. Hum Reprod 10(6):1475–1477PubMed

45.

Friedman W, Maier RF, Lutttkus A, Schäfer APA, Dudenhausen JW (1996) Uterine rupture after laparoscopic myomectomy. Acta Obstet Gynecol Scand 75:683–684. https://doi.org/10.3109/00016349609054700CrossRef

46.

Liu QW, Han T, Yang M, Tong XW, Wang JJ (2016) A systematic review on efficacy and safety of gasless laparoscopy in the management of uterine leiomyoma. J Huazhong Univ Sci Technolog Med Sci 36(1):142–149. https://doi.org/10.1007/s11596-016-1557-zCrossRefPubMed

47.

Sinha R, Rupa B, Reddy M (2023) Beyond the learning curve: improving outcomes in robotic myomectomy compared to laparoscopic myomectomy. J Robot Surg 17(3):847–852. https://doi.org/10.1007/s11701-022-01470-1CrossRefPubMed

48.

Özbaşlı E, Güngör M (2021) Comparison of perioperative outcomes among robot-assisted, conventional laparoscopic, and abdominal/open myomectomies. J Turk Ger Gynecol Assoc 22(4):312–318. https://doi.org/10.4274/jtgga.galenos.2021.2021.0049CrossRefPubMedPubMedCentral

Titel: Perioperative and reproductive outcomes’ comparison of mini-laparotomy and laparoscopic myomectomy in the management of uterine leiomyomas: a systematic review
verfasst von: Eleni Tsiampa
Konstantinos Tsiampas
Filippos Kapogiannis
Publikationsdatum: 11.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 3/2024
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-023-07168-5

The effects of warm perineal compress on perineal trauma and postpartum pain: a systematic review with meta-analysis and trial sequential analysis

Review

The role of L1CAM as predictor of poor prognosis in stage I endometrial cancer: a systematic review and meta-analysis

Review

Endocervical crypt involvement by high-grade cervical intraepithelial neoplasia and its association with high-grade histopathological recurrence after cervical excision in women with negative excision margins: a systematic review and meta-analysis

Open Access
Review

Psoas abscess in pregnancy: a review of the literature and suggestion of minimally invasive treatment options

Open Access
Maternal-Fetal Medicine

Solitary precaval right renal artery and bilateral double ureter in a patient with high-grade serous ovarian cancer

Open Access
Images in Obstetrics and Gynecology

Expectant management versus systemic methotrexate in the management of persistent pregnancy of unknown location, a seven-year retrospective analysis

General Gynecology

Neu im Fachgebiet Gynäkologie und Geburtshilfe

KI-gestütztes Mammografiescreening überzeugt im Praxistest

16.01.2025
Künstliche Intelligenz im Gesundheitswesen
Nachrichten

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

Einer von sieben Frauen macht die Menopause sehr zu schaffen

15.01.2025
Menopause
Nachrichten

Von mäßigen bis schweren vasomotorischen Beschwerden sind 14,7% der Frauen in der Postmenopause betroffen. Das haben kanadische Forscherinnen in einer Subgruppenanalyse der WARM-Studie herausgefunden.

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Keine eingeschränkten Kassenleistungen bei Schwangerschaft nach IVF

Medikamente in Schwangerschaft und Stillzeit
Nachrichten

Nach privat bezahlter In-vitro-Fertilisation muss die gesetzliche Krankenkasse ein Arzneimittel zum Erhalt der Schwangerschaft bezahlen, so ein Urteil des Sozialgerichts in München.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

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

Abstract

Objective

Methods

Results

Conclusion

Weitere Artikel der Ausgabe 3/2024

The effects of warm perineal compress on perineal trauma and postpartum pain: a systematic review with meta-analysis and trial sequential analysis

The role of L1CAM as predictor of poor prognosis in stage I endometrial cancer: a systematic review and meta-analysis

Endocervical crypt involvement by high-grade cervical intraepithelial neoplasia and its association with high-grade histopathological recurrence after cervical excision in women with negative excision margins: a systematic review and meta-analysis

Psoas abscess in pregnancy: a review of the literature and suggestion of minimally invasive treatment options

Solitary precaval right renal artery and bilateral double ureter in a patient with high-grade serous ovarian cancer

Expectant management versus systemic methotrexate in the management of persistent pregnancy of unknown location, a seven-year retrospective analysis

Neu im Fachgebiet Gynäkologie und Geburtshilfe

KI-gestütztes Mammografiescreening überzeugt im Praxistest

Einer von sieben Frauen macht die Menopause sehr zu schaffen

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

Keine eingeschränkten Kassenleistungen bei Schwangerschaft nach IVF

Update Gynäkologie

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten