Objective: To compare the operative data and early postoperative outcomes for myomectomy performed by minilaparotomy (MLT) with isobaric laparoscopic assisted minilaparotomy myomectomy (LM) in a series of patients with large uterine myomas (>or=5 cm) randomly assigned to each surgical technique.
Study design: 80 patients were randomized blindly using a computer randomization list to MLT (n=40) or LM (n=40).
Results: The mean (+/-SD) operating time was significantly shorter after LM than after MLT (75.50+/-25.70 vs 96.00+/-26.20 min; p<0.01). Intraoperative blood loss was less with LM (72.15+/-44.00 vs 96.21+/-38.50 ml; p<0.05), and DeltaHb was less with LM (1.21+/-0.55 vs 1.64+/-0.57; p<0.05). No intraoperative complications occurred, and no case was returned to the theater in either group. No conversion to standard laparotomy was necessary. Hospitalization was shorter after LM than after MLT (4.30+/-1.20 vs 6.90+/-2.70 days; p<0.01). Postoperative ileus was shorter after LM than after MLT (26.20+/-4.20 vs 40.50+/-4.90h; p<0.01). The mean VAS score at 12h for abdominal pain was 5.5+/-0.7 in the LM group and 5.2+/-0.8 in MLT group (p<0.05), whereas it was analogous in the two groups at 24h, and at 48h was 3.4+/-1.1 in the LM group and 4.2+/-1.1 in the MLT group (p<0.05), and no difference between two groups was detected in the overall mean (at 12, 24 and 48h).
Conclusions: Several surgical and immediate postoperative outcomes were significantly better in the LM group than in the MLT group.