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Recurrence rate after laparoscopic myomectomy
F R Nezhat1, M Roemisch, C H Nezhat
1Stanford University School of Medicine, Department of Gynecology and Obstetrics, California, USA.
Study Objective:
To determine the recurrence rate of myomas after laparoscopic myomectomy.
Design:
Retrospective review (Canadian Task Force classification II-2).
Setting:
Tertiary referral center.
Patients:
One hundred fourteen women (age 25-51 yrs, median 38 yrs) who were followed for an average of 37 months (range 6-120 mo).
Intervention:
Laparoscopic myomectomy.
Measurements And Main Results:
Follow-up data were obtained by chart review and from returned questionnaires. Variables were date of surgery, first diagnosis of recurrence, and last follow-up visit. There were 38 (33.3%) recurrences after an average interval of 27 months. Twenty-four of these women did not require treatment. Eight underwent a second laparoscopic myomectomy, and one had a third. One patient had myomectomy and then hysterectomy, and six patients chose hysterectomy to treat the first recurrence. Cumulative risk of recurrence (Kaplan-Meier curve) was 10.6% after 1 year, 31.7% after 3 years, and 51.4% after 5 years.
Conclusion:
Although laparoscopic myomectomy is associated with less morbidity than removal by laparotomy, our results suggest that recurrence of myomas may be higher with the laparoscopic approach. Of 38 women with recurrent myoma, however, only 14 (36.8%) required additional surgery.