A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: short-term outcomes

Palomba, Stefano; Zupi, Errico; Russo, Tiziana; Falbo, Angela; Marconi, Daniela; Tolino, Achille; Manguso, Francesco; Mattei, Alberto; Zullo, Fulvio

doi:10.1016/j.fertnstert.2006.12.048

Cited by 97 publications

(113 citation statements)

References 30 publications

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“…Several randomized prospective studies have compared the early outcome of myomectomy by laparotomy with that obtained with minilaparotomy (5,21,24). Our data were consistent with the results from Benassi et al, including similar blood loss and hemoglobin difference and fewer days of spontaneous recanalization and postoperative hospital stay (21).…”

Section: Discussionsupporting

confidence: 90%

“…In recent years, the concept has been applied in the management of uterine myomas and other gynecologic disease (18)(19)(20)(21)(22)(23)(24). In addition, there is an urge to reduce intraoperative and postoperative complications, to increase the compliance of patients, and to reduce cost.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, we are faced with an expensive operation in terms of the dedicated and used-and-wasted (disposable) instruments and the lengthy training of surgeons who must acquire new and relatively unfamiliar manual skills (14,15), although the modern trend favors laparoscopy in place of laparotomy in the majority of gynecologic surgeries (3,16,17). Minilaparotomy, frequently adopted by general surgeons, could be a valid and cost-effective alternative to laparoscopy (18)(19)(20)(21)(22)(23)(24). It does fulfill the criteria of minimally invasive surgery because of the better economy without compromising the postoperative recovery of the patients, compared with laparoscopy (2,18).…”

mentioning

confidence: 99%

See 2 more Smart Citations

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

Wen

Sung

Chao

et al. 2008

Fertility and Sterility

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Wen

Sung

Chao

et al. 2008

Fertility and Sterility

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“…For current meta-analysis, we chose the following main outcome measures: blood loss at time of surgery, postoperative hemoglobin (Hb) drop, length of hospitalization, suturing time, total operative time, evidence of complications, and surgical difficulty. Surgical difficulty related to the suture of uterine wall defect was assessed on a visual analogical scale (VAS) with values from 1 (low difficulty) to 10 (high difficulty) [6, 11, 19, 28]. …”

Section: Methodsmentioning

confidence: 99%

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

Gardella

Dominoni

Iacobone

et al. 2018

Gynecol Obstet Invest

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Background: This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy. Methods: Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017. Results: Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] –0.650, 95% CI –1.420 to –0.119, p = 0.098, test for heterogenity p < 0.0001, I² = 95.54%), Hb drop (SMD –1.452, 95% CI –3.590 to 0.687, p = 0.183, test for heterogenity p < 0.0001, I² = 99.08%), suturing difficulty (SMD –0.638, 95% CI –0.935 to –0.342, p ≤ 0.001, test for heterogenity p = 0.25, I² = 27.84%), suturing time (SMD –1.197, 95% CI –1.848 to –0.549, p ≤0.001, test for heterogenity p = 0.0001, I² = 83.30%) and total operative time (SMD –0.687, 95% CI –0.804 to –0.569, p ≤ 0.001, test for heterogenity p = 0.292, I² = 17.44%). Barbed suture demonstrated to be better in comparison with the control group even with regard to the length of hospitalization (SMD –0.278, 95% CI –0.543 to 0.012, p = 0.040, test for heterogenity p = 0.025, I² = 61.85%), and to perioperative complications (SMD 0.708, 95% CI 0.503–0.996, p = 0.048, test for heterogenity p = 0.79, I² = 0%). Conclusion: Barbed suture significantly facilitates laparoscopic myomectomy by reducing the total operative/suturing time, estimated blood loss/Hb drop, and reduction of perioperative complications.

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“…Recientemente se publicó un estudio randomizado multicéntrico comparando la miomectomía laparoscópica con la realizada por minilaparotomía, que demostró beneficios a favor de la minilaparotomía en términos del tiempo de enucleación del mioma y número de histerotomías. Sin embargo, la laparoscopia fue mejor en términos de pérdidas hemáticas durante la cirugía, de las variaciones en los niveles de hemoglobina, del uso de drogas analgésicas en el postoperatorio y del tiempo de hospitalización (19). Pareciera, de acuerdo a la evidencia disponible, que ambas técnicas ofrecen ventajas y desventajas, haciendo que la elección dependa principalmente de la experiencia del cirujano y de la complejidad del caso particular.…”

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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A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: short-term outcomes

Cited by 97 publications

References 30 publications

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

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

What Is the Role of Barbed Suture in Laparoscopic Myomectomy? A Meta-Analysis and Pregnancy Outcome Evaluation

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

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