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Laparoscopic uterine artery bipolar coagulation plus myomectomy vs traditional laparoscopic myomectomy for “large” uterine fibroids: comparison of clinical efficacy

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Laparoscopic myomectomy is the uterus-preserving surgical approach of choice in case of symptomatic fibroids. However, it can be a difficult procedure even for an experienced surgeon and can result in excessive blood loss, prolonged operating time and postoperative complications. A combined approach with laparoscopic uterine artery occlusion and simultaneous myomectomy was proposed to reduce these complications. The aim of this study was to evaluate the safety and efficacy of the combined laparoscopic approach in women with symptomatic “large” intramural uterine fibroids, compared to the traditional laparoscopic myomectomy alone.

Methods

Prospective nonrandomized case–controlled study of women who underwent a conservative surgery for symptomatic “large” (≥ 5 cm in the largest diameter) intramural uterine fibroids. The “study group” consisted of women who underwent the combined approach (laparoscopic uterine artery bipolar coagulation and simultaneous myomectomy), while women who underwent the traditional laparoscopic myomectomy constituted the “control group”. A comparison between the two groups was performed, and several intraoperative and postoperative outcomes were evaluated.

Results

No significant difference in the overall duration of surgery between women of the “study group” and “control group” emerged; however, a significantly shorter surgical time for myomectomy was observed in the “study group”. The intraoperative blood loss and the postoperative haemoglobin drop were significantly lower in the “study group”. No difference in the postoperative pain between groups emerged, and the postoperative hospital stay was similar in the two groups.

Conclusions

The laparoscopic uterine artery bipolar coagulation and simultaneous myomectomy is a safe and effective procedure, even in women with symptomatic “large” intramural uterine fibroids, with the benefit of a significant reduction in the intraoperative blood loss when compared to the traditional laparoscopic myomectomy.

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Authors and Affiliations

  1. Woman’s Health Sciences Department, Gynecologic Section, Università Politecnica delle Marche, Via F. Corridoni 11, 60123, Ancona, Italy

    Andrea Ciavattini, Nicolò Clemente & Giovanni Delli Carpini

  2. Department of Woman and Child Health, Università di Padova, Padua, Italy

    Carlo Saccardi, Shara Borgato & Pietro Litta

Authors
  1. Andrea Ciavattini
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  2. Nicolò Clemente
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  3. Giovanni Delli Carpini
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  4. Carlo Saccardi
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  5. Shara Borgato
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  6. Pietro Litta
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Contributions

AC, PL: project development, data analysis, manuscript writing. NC, CS, SB: data collection, data analysis, manuscript writing. GDC: data management, data analysis, manuscript writing.

Corresponding author

Correspondence to Andrea Ciavattini.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Local ethic committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ciavattini, A., Clemente, N., Delli Carpini, G. et al. Laparoscopic uterine artery bipolar coagulation plus myomectomy vs traditional laparoscopic myomectomy for “large” uterine fibroids: comparison of clinical efficacy. Arch Gynecol Obstet 296, 1167–1173 (2017). https://doi.org/10.1007/s00404-017-4545-z

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  • DOI: https://doi.org/10.1007/s00404-017-4545-z

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