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Perioperative and reproductive outcomes’ comparison of mini-laparotomy and laparoscopic myomectomy in the management of uterine leiomyomas: a systematic review

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Abstract

Objective

To evaluate and compare mini-laparotomy (MLPT) with laparoscopic (LPS) myomectomy perioperative and reproductive outcomes.

Methods

We systematically searched for related articles in the MEDLINE, Embase, Web of Science and the Cochrane library databases. Nine studies (4 randomized, 3 retrospective, 1 prospective and 1 case–control study) which involved 1723 patients met the inclusion criteria and were considered eligible for inclusion.

Results

Demographic characteristics were similar between the two groups. LPS was associated with shorter hospital stay (p = 0.04), lower blood loss (p < 0.00001), shorter duration of median ileus (p < 0.00001) and fewer episodes of postoperative fever (p = 0.04). None of the reproductive factors examined (pregnancy rate, preterm delivery, vaginal delivery and delivery with caesarean section) in women diagnosed with unexplained infertility and/or symptomatic leiomyomas reached statistical significance although the results represent a small size effect.

Conclusion

Our analysis demonstrated that LPS seems to be an alternative, safe and reliable surgical procedure for uterine leiomyoma treatment and in everyday practice seems to offer improved outcomes—regarding at least the perioperative period—over MLPT.

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Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. 2nd Department of Obstetrics and Gynecology, General and Maternity Hospital Helena Venizelou, Christou Vournazou Str. 1, 11521, Athens, Greece

    Eleni Tsiampa

  2. Laparoscopic Department of Obstetrics and Gynecology, Iaso General Hospital, Athens, Greece

    Konstantinos Tsiampas

  3. Urology Department, Ippokrateio General Hospital, Athens, Greece

    Filippos Kapogiannis

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  1. Eleni Tsiampa
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  2. Konstantinos Tsiampas
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  3. Filippos Kapogiannis
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Contributions

Protocol/project development: ET. Data collection or management: ET, FK. Data analysis: KT, FK. Manuscript writing/editing: ET, KT, FK.

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Correspondence to Eleni Tsiampa.

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Tsiampa, E., Tsiampas, K. & Kapogiannis, F. Perioperative and reproductive outcomes’ comparison of mini-laparotomy and laparoscopic myomectomy in the management of uterine leiomyomas: a systematic review. Arch Gynecol Obstet 309, 821–829 (2024). https://doi.org/10.1007/s00404-023-07168-5

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