Recurrence of Leiomyomata after Laparoscopic Myomectomy

Doridot, Virginie; Dubuisson, Jean‐Bernard; Chapron, Charles; Fauconnier, Arnaud; Babaki‐Fard, Katayoun

doi:10.1016/s1074-3804(05)60610-x

Cited by 100 publications

(47 citation statements)

References 20 publications

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“…Reports of uterine rupture after laparoscopic myomectomy (17,18,5), although uncommon, emphasize the importance of adequate closure of the myometrial defect. Recurrence of leiomyomata has been reported to be greater after laparoscopic myomectomy compared with laparotomy, and the lack of tactile sensation during laparoscopy may be responsible for these findings (19,5). On the contrary, another study of 81 patients randomized to abdominal or laparoscopic myomectomy were followed postoperatively for 40 months to compare recurrence rates (20).…”

Section: Discussionmentioning

confidence: 99%

Abdominal myomectomy—a safe procedure in an ambulatory setting

Thomas

Winkler

Carr

et al. 2010

Fertility and Sterility

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Section: Discussionmentioning

confidence: 99%

Abdominal myomectomy—a safe procedure in an ambulatory setting

Thomas

Winkler

Carr

et al. 2010

Fertility and Sterility

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“…The endoscopic surgeon, though hampered by the loss of tactile sensation and facing the task of intracorporeal suturing, has the advantage of better endoscopic visualisation both inside and outside the uterus and the additional benefit of a thorough evaluation of the peritoneal cavity. This loss of tactile sensation has been to a certain extent blamed for the surgeon's inability to feel for the smaller myomas that are missed and are thus responsible for the higher recurrence rates, although this issue has not been settled by studies [12,13]. The endoscopic surgeon has also been blamed for indiscriminately performingbecause of the low morbidity associated with the procedure-myomectomies for fibroids that are too small to be responsible for causing infertility [14].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic myomectomy: feasibility and safety—a retrospective study of 762 cases

Paul¹,

Koshy²,

Thomas³

2006

Gynecol Surg

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The objective of this retrospective study of a case series was to evaluate patients with symptomatic uterine myomas managed by laparoscopic myomectomythe clinical features, operative techniques, and intraoperative and postoperative morbidity. The subjects consisted of a total of 762 women who underwent endoscopic surgery for uterine leiomyomas at a private advanced endoscopy and assisted reproductive technology centre over a 13-year period. Data were collected on baseline clinical characteristics, details of surgery, intraoperative and postoperative complications, and hospital stay. A total of 1,375 myomas were removed; the most common indication was infertility (50.9%), and the majority of myomas (49.52%) were intramural. The mean duration of surgery was 95 min, and the average blood loss was 250.5 ml. The average hospital stay was 1.3 days. Major complications included an unexplained postoperative death and one laparotomy for postoperative bleeding. We conclude that laparoscopic myomectomy is a relatively safe procedure. Most cases can be completed by a laparoscopic approach, and the remaining may require a laparoscopic-assisted myomectomy. The risk of complications is comparable to that with the open procedure, whereas morbidity and length of hospital stay are much lower.

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“…On the contrary, some authors reported that preoperative GnRH agonist treatment did not have any influence on fibroid recurrence [68,69]. In an observational study of 296 laparoscopic myomectomies with a mean follow-up of 47 months, preoperative treatment with GnRH agonists did not prove to be a factor predictive of recurrence (p=0.98) [70]. The two factors that appeared to increase the risk of recurrence in this study were nulliparity (p=0.004) and multiple fibroids (p=0.05).…”

Section: Recurrence Of Fibroidsmentioning

confidence: 94%

Role of GnRH agonists prior to endoscopic surgical treatment of fibroids

Theodoridis

Tarlatzis

Bontis

2005

Eur Clinics Obstet Gynecol

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Uterine fibroids are the most common benign tumors found in women of reproductive age and their treatment is mainly by surgery, especially if they are symptomatic. Since the boom in endoscopy, many reports conclude that treatment of fibroids can be performed safely by laparoscopy or hysteroscopy.The development of GnRH analogues is not only a breakthrough in the field of obstetrics and gynecology, but a major leap forward in the treatment of various hormone-dependent diseases in general medicine. Recently GnRH agonistic analogues have been applied to treat various gynecological conditions, such as uterine leiomyomas, endometriosis, dysfunctional uterine bleeding, hyperandrogenism (polycystic ovaries) and infertility, cancer and precocious puberty.GnRH agonist administration prior to the surgical approach to uterine fibroids has a positive role in the management of these tumors, because-despite the expense-they reduce fibroid and uterine volume and intraoperative blood loss and they increase hemoglobin levels prior to surgical intervention. GnRH agonists can be used preoperatively in the field of endoscopic surgery in selected cases, especially in hysteroscopic surgery. However, their exact role in the laparoscopic management of fibroids needs further evaluation.

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Recurrence of Leiomyomata after Laparoscopic Myomectomy

Cited by 100 publications

References 20 publications

Abdominal myomectomy—a safe procedure in an ambulatory setting

Abdominal myomectomy—a safe procedure in an ambulatory setting

Laparoscopic myomectomy: feasibility and safety—a retrospective study of 762 cases

Role of GnRH agonists prior to endoscopic surgical treatment of fibroids

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