Comparison between Vaginal and Abdominal Myomectomy / 中国微创外科杂志

ABSTRACT

Objective To investigate the clinical value of vaginal myomectomy. Methods From March 2005 to May 2008,78 women with abnormal uterine bleeding were diagnosed with submucous myoma by hysteroscopy combined with ultrasonography. All the myomas were located in the lower uterine segment,and the diameter of the tumor ranged from 30 mm to 63 mm. The patients were divided into two groups to underwent vaginal myomectomy (vaginal group,36 cases) or abdominal electrotomy (open group,42 cases). The operation time,intraoperative blood loss,postoperative hospital stay and recovery of the two groups were compared. Results The vaginal operation was accomplished in all of the 36 cases. Compared with the open group,the vaginal group had significantly shorter operation time [(64.7?10.4) min vs (71.1?11.3) min,t=-2.599,P=0.011],less intraoperative blood loss [(200.0?38.4) ml vs (253.6?47.6) ml,t=-5.412,P=0.000],quicker recovery of bowel movement [(18.5?4.3) h vs (30.9?4.7) h,t=-12.078,P=0.000],and shorter postoperative hospital stay [(4.9?1.2) d vs (7.0?1.3) d,t=-7.368,P=0.000]. Follow-up was available in all of the 78 cases for 3 to 40 months (mean,28 months),during which no relapse occurred,and no statistical differences in pregnancy rate between the two groups was revealed [2.8% (1/36) vs 4.8% (2/42),?2=0.000,P=1.000]. The operation satisfaction rates in both of the two groups were up to 100%. Conclusions Vaginal myomectomy has advantages in less hemorrhage,fast recovery,short postoperative hospital stay,and low complication rate. For the tumors located in the lower uterine segment or those larger than 30 mm in diameter,vaginal myomectomy is an alternative to hysteroscopic electrotomy.