Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g

• Published in: Yonsei medical journal Vol. 61; no. 12; pp. 1054 - 1059
• Main Authors: Lee, Sa Ra, Lee, Eun Sil, Lee, Young-Jae, Lee, Shin-Wha, Park, Jeong Yeol, Kim, Dae-Yeon, Kim, Sung Hoon, Kim, Yong-Man, Suh, Dae-Shik, Kim, Young-Tak
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.12.2020; 연세대학교의과대학
• Subjects: Adult; Female; Humans; Laparoscopy - methods; Leiomyoma - pathology; Leiomyoma - surgery; Length of Stay; Middle Aged; Open Abdomen Techniques - methods; Operative Time; Original; Pregnancy; Retrospective Studies; Robotic Surgical Procedures - methods; Robotics; Treatment Outcome; Uterine Myomectomy - methods; Uterine Neoplasms - pathology; Uterine Neoplasms - surgery; 의학일반; robotic surgical procedures; open abdomen techniques; uterine myomectomy; Fertility
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2020.61.12.1054

Here, we compared the operative and perioperative outcomes between robot-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM) in patients with large (>10 cm) or heavy myomas (>250 g). We included 278 patients who underwent multi-port RALM (n=126) or AM (n=151) for large or heavy myomas in a tertiary care hospital between April 2019 and June 2020. The t-test, chi-square, Bonferroni's test, and multiple linear regression were used. No differences were observed in age, body mass index, parity, or history of pelvic surgery between the two groups. Myoma diameters were not different (10.8±2.52 cm vs. 11.2±3.0 cm, =0.233), but myomas were lighter in the RALM group than in the AM group (444.6±283.14 g vs. 604.68±368.35 g, respectively, =0.001). The RALM group had a higher proportion of subserosal myomas, fewer myomas, fewer large myomas over >3 cm, lighter myomas, and longer total operating time. However, the RALM group also had shorter hospital stay and fewer short-term complications. Estimated blood loss (EBL) was not different between the two groups. The number of removed myomas was the most significant factor (coefficient=10.89, <0.0001) affecting the EBL. RALM is a feasible myomectomy technique even for large or heavy myomas. RALM patients tend to have shorter hospital stays and fewer postoperative fevers within 48 hours. However, RALM has longer total operating time.