A comparison of abdominal,vaginal and laparoscopic myomectomy

Objective To compare the characteristics of abdominal,vaginal and laparoscopic myomectomy,and to provide valuable information for choosing approach of myomectomy. Method We compared outcomes of abdominal myomectomy (Open Group,n =147),laparoscopic myomectomy (Laparoscopic Group,n =128) and vaginal myomectomy (Vaginal Group,n =86) in respect of operative time,hemorrhage volume,time to normal temperature,recovery time of bowel movement,and discharge time after operation. Result The mean operative time of Vaginal Group (58.6±10.7) min was the shortest (P 0.05) and there was no significant difference between Open Group (87.9±21.4) min and Laparoscopic Group (96.7±26.2) min. The mean hemorrhage volume intraoperation was significantly less in the Vaginal Group (51.9±16.7) mL and Laparoscopic Group (102.4±34.7) mL than in the Open Group (153.6±56.6) mL (P 0.05). Shorter time to normal temperature,recovery time of bowel movement,and discharge time after operation were achieved in the both Vaginal Group (66.2h±17.8) h; (19.7h±7.5) h; (5.8±1.6) d and Laparoscopic Group (65.8±19.2) h; (24.3±6.9) h; (6.1±1.7) d than in the Open Group (93.2±24.3) h; (31.6±7.4) h; (8.3±2.1)d,with significant difference (P 0.05). Conclusion Vaginal myomectomy and laparoscopic myomectomy have advantages of micro-invasion,little blood loss,rapid postoperative recovery,and short hospitalization. However,these three approaches had their characters and indications respectively. They could not entirely supersede each other.