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Laparoendoscopic single-site myomectomy versus conventional laparoscopic myomectomy: a comparison of surgical
Seul Ki Kim1, Ji Hyun Lee1, Jung Ryeol Lee2
1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Study Objective:
The objective of this study was to evaluate laparoendoscopic single-site myomectomy (LESS-M) for the surgical treatment of fibroids and to compare surgical outcomes and postoperative pain with conventional laparoscopic myomectomy (CLM).
Design:
Retrospective study.
Setting:
University-based hospital.
Patients:
Data were obtained from medical records of patients who underwent LESS-M between August 2011 and June 2012. Considering the surgeon's learning curve for LESS-M, we collected the data after 100 LESS-M procedures were performed. The cases were compared with a historic cohort of patients who underwent CLM performed by the same surgeon between July 2008 and May 2009. A single experienced surgeon performed both procedures in all patients. A total of 118 patients who underwent LESS-M or CLM were included in the study (59 in the LESS-M group and 59 in the CLM group).
Interventions:
None.
Measurements And Main Results:
We analyzed and compared patient basal characteristics and surgical outcomes between the 2 groups. There were no statistically significant differences in basal characteristics (i.e., age, body mass index, number and size of myomas, and type of the largest myoma) between the 2 groups. The surgical outcomes (i.e., operative time, estimated blood loss, postoperative hemoglobin drop, postoperative hospital stay, and postoperative pain scores) were not different statistically between the 2 groups. Moreover, patients did not experience major intraoperative complications. Postoperative complications were wound infections that occurred in 3 patients (2 in the LESS-M and 1 in the CLM groups).
Conclusion:
LESS-M is feasible for less than 5 myomas and offers comparable surgical outcomes with those of CLM after the surgeon's initial learning curve.
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