A multicenter randomized, controlled study comparing laparoscopic versus minilaparotomic myomectomy: reproductive outcomes

A myoma uteri diagnosztikája és kezelése

“…Az endoszkópia ismert előnyei itt is érvényesülnek: kevesebb a műtét során a vérvesztés, gyorsabb a felépülés, kisebb a posztoperatív fájdalom [47]. A panaszok csökkenésében, a műtét utáni reproduktív mutatókban különbség egyik típus javára sem figyelhető meg [48]. A műtéti idő, különösen a tanuló fázisban, az endoszkópos eljárásoknál hosszabb, azonban minden körülményt figyelembe véve megfelelő kondíciók mellett a laparoszkópos mód az előnyösebb.…”

Should we operate on fibroids before IVF?

“…They considered 243 studies for evaluation, of which 23 were recognized randomized studies but only three studies complied with the level of evidence that was set [29][30][31]. The only study that qualified to answer the first question on the effects of fibroids on fertility included 170 patients and looked only at cases with one fibroid greater than 4 cm in diameter [29].…”

“…As for the alternative surgical approaches, they identified two studies fulfilling the set criteria and found no difference if the myomectomy was performed by the classical route of laparotomy or laparoscopy [30,31]. It is possible that laparoscopy, with its slower learning curve, may present a choice for the more experienced endoscopic surgeons, an issue that is not addressed in these studies.…”

Reconstructive Endoscopic Myomectomy

“…Inclusion criteria include age ≤42 years, the presence of at least one symptomatic myoma >3 cm, and a number of myomas equal or less than seven (26). Some authors (27,28) suggested that no more than three or four myomas with diameters <7-8 cm are to be removed; Nevertheless, the decision should be individualized according to the surgical skills, facilities, age and the pathologic findings (29,30).…”