A Prospective Matched Case-Control Study of Laparoendoscopic Single-Site vs Conventional Laparoscopic Myomectomy

Abstract

Study Objective: To compare operative and obstetric outcomes of laparoendoscopic single-site myomectomy (LESS-M) vs conventional laparoscopic myomectomy (LM). Design: Prospective matched case-control study. Setting: A university hospital and a tertiary care center. Patients: Forty-five women underwent LESS-M, and 90 women underwent conventional LM. Intervention: LESS-M or conventional LM. Measurements and Main Results: Operative and obstetric outcomes. There were no significant differences between the 2 groups in demographic characteristics, operative time (135 vs 140 minutes), change in hemoglobin concentration (1.9 vs 1.95 g/dL), return of bowel activity (35 vs 28 hours), hospital stay (5 vs 5 days), or complication rate (11.1% vs 8.9%). Insofar as obstetric outcomes, no significant differences were observed between the 2 groups for duration of follow-up (24.4 vs 23.2 months), pregnancy rate in patients who desired pregnancy (66.7% vs 50.0%), full-term delivery rate (66.7% vs 58.3%), and time to first pregnancy after surgery (7.6 vs 10.1 months). Conclusion: LESS-M is feasible and safe and has comparable obstetric outcomes to conventional LM in selected women with symptomatic myomas. However, a large prospective randomized study is needed.