Laparoscopic Versus Laparotomic Myomectomy: A Retrospective Cohort Study

Objective: Leiomyomas are the most common tumors of the female pelvis and uterus. Surgical excision of leiomyomas is still the most accepted treatment. This surgery can be done by laparotomy (LT) or minimally invasive approach. It is known that laparoscopy (LS) is superior to LT in terms of bleeding, postoperative pain control, and fast recovery. This study aims to report a 7-year single-center experience of patients who underwent myomectomy. Materials and Methods: A total of 291 patients who underwent myomectomy, 61 in the LS and 230 in the LT were included in the study. Their clinical and operative data were searched retrospectively using patient files and hospital's database. Results: The postoperative analgesic requirements of the patients were significantly higher in LT group than LS group. Hospital stay was longer in the LT group. Postoperative hemoglobin and hematocrit levels of the patients in the LT group were significantly lower (p=0.010). The endometrial cavity was entered more frequently into LT group (p=0.004). Conclusion: Laparoscopic myomectomy was found to be superior to laparotomic myomectomy in terms of decrease in postoperative hemoglobin level, need for postoperative analgesia, and hospital stay. In addition, LS can be superior to LT about entering to endometrial cavity because of better visualization of endomyometrium. Keywords: Laparoscopy, laparotomy, leiomyoma, myomectomy, surgery