Laparoscopic myomectomy versus open myomectomy in uterine fibroid treatment: A meta-analysis

• Main Authors: Probo Yudha Pratama Putra, Arlinda Silva Prameswari, Mochammad Ma'roef, Aida Musyarrofah, Halida Nelasari
• Format: Article
• Language: English
• Published: KeAi Communications Co., Ltd. 2021-09-01
• Series: Laparoscopic, Endoscopic and Robotic Surgery
• Subjects: Uterine fibroid; Laparoscopic myomectomy; Open myomectomy
• Online Access: http://www.sciencedirect.com/science/article/pii/S2468900921000396

Objective: Uterine fibroids are the most commonly occurring benign solid tumors in women, and laparoscopic or open myomectomy constitutes the primary option for treatment. However, both methods are under debate currently in terms of efficacy and safety. In this meta-analysis we assessed the efficacy and safety of the two procedures. Methods: We conducted a comprehensive literature search of PubMed, ScienceDirect, and the Cochrane Library in December 2020. The search terms included “open myomectomy”, “myomectomies”, “laparoscopic”, and “uterine fibroids”. We then selected the randomized control trials published from 1996 to 2019 and compared laparoscopic and open myomectomies. Results: We included 10 studies of 449 patients who underwent laparoscopic myomectomy and 449 patients who underwent open myomectomy. The data revealed that laparoscopic myomectomy was associated with reduced blood loss (MD = −34.43; 95% CI, −34.92 to −33.94; p < 0.001), an attenuated decline in hemoglobin (MD = −1.04; 95% CI, −1.14 to −0.93; p < 0.001), less post-operative pain at 24 h (MD = −0.51; 95% CI, −0.83 to −0.19; p = 0.002), and fewer overall complications (OR = 0.42; 95% CI, 0.24 to 0.71; p = 0.001) relative to open myomectomy; but the former possessed a longer operative time (MD = 12.96; 95% CI, 9.94 to 15.97; p < 0.001). There were no significant differences in pregnancy rate (OR = 1.39; 95% CI, 0.72 to 2.68; p = 0.33) or recurrence rate of postoperative uterine fibroids (OR = 1.15; 95% CI, 0.60 to 2.18; p = 0.67) between the two groups. Conclusion: Laparoscopic myomectomy displayed superior results compared to open myomectomy, although the former involved a longer operating time.