Long-term outcomes of single-port laparoscopic myomectomy using a modified suture technique
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ObjectiveTo evaluate the long-term outcomes, including the pregnancy outcome and recurrence rate after single-portlaparoscopic myomectomy (LM) using a modified suture technique with a Hem-o-lok clip (Choi’s LM) and conventional4-port LM. MethodsA retrospective study of patients who underwent Choi’s LM (n=55) and 4-port LM (n=102) in a single institutionalhospital was conducted. Patients with <3 symptomatic myomas sized <10 cm each and operated on by a singlesurgeon were included. Recurrence was confirmed when a myoma measuring ≥3 cm was detected. ResultsThe patients in both groups had similar demographic characteristics. Single (76.4% vs. 62.7%) and intramural(52.7% vs. 56.9%) tumors were commonly detected in both groups in the mean diameter (6.8±1.5 cm vs. 7.0±1.6 cm;P=0.40). In Choi’s LM, 16 patients (29.1%) needed an additional port; those who were nulliparous and/or had a largeleiomyoma more frequently required an additional port (P=0.023 and 0.04, respectively). During a median follow-upperiod of 69 months, 17 patients (7.1% vs. 14.6%) had recurrence. The size of dominant myomas at recurrence wassignificantly smaller in patients who underwent Choi’s LM (3.4±0.7 cm vs. 5.7±2.4 cm; P=0.004). All 13 patients in bothgroups who successfully conceived had a full-term delivery. No major complications occurred during pregnancy. ConclusionAlthough an additional port was frequently used, the long-term outcomes of patients who experienced recurrenceand pregnancy after Choi’s LM were acceptable. Considering its usability, Choi’s LM is feasible for the treatment ofuterine leiomyoma.
Abstract
ObjectiveTo evaluate the long-term outcomes, including the pregnancy outcome and recurrence rate after single-portlaparoscopic myomectomy (LM) using a modified suture technique with a Hem-o-lok clip (Choi’s LM) and conventional4-port LM. MethodsA retrospective study of patients who underwent Choi’s LM (n=55) and 4-port LM (n=102) in a single institutionalhospital was conducted. Patients with <3 symptomatic myomas sized <10 cm each and operated on by a singlesurgeon were included. Recurrence was confirmed when a myoma measuring ≥3 cm was detected. ResultsThe patients in both groups had similar demographic characteristics. Single (76.4% vs. 62.7%) and intramural(52.7% vs. 56.9%) tumors were commonly detected in both groups in the mean diameter (6.8±1.5 cm vs. 7.0±1.6 cm;P=0.40). In Choi’s LM, 16 patients (29.1%) needed an additional port; those who were nulliparous and/or had a largeleiomyoma more frequently required an additional port (P=0.023 and 0.04, respectively). During a median follow-upperiod of 69 months, 17 patients (7.1% vs. 14.6%) had recurrence. The size of dominant myomas at recurrence wassignificantly smaller in patients who underwent Choi’s LM (3.4±0.7 cm vs. 5.7±2.4 cm; P=0.004). All 13 patients in bothgroups who successfully conceived had a full-term delivery. No major complications occurred during pregnancy. ConclusionAlthough an additional port was frequently used, the long-term outcomes of patients who experienced recurrenceand pregnancy after Choi’s LM were acceptable. Considering its usability, Choi’s LM is feasible for the treatment ofuterine leiomyoma.
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