Robot-Assisted Laparoscopic Myomectomy versus Abdominal Myomectomy for Large Myomas Sized over 10 cm or Weighing 250 g
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Purpose: 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). Materials and Methods: We included 278 patients who underwent multi-port RALM (n=126) or AM (n=151) for large or heavymyomas in a tertiary care hospital between April 2019 and June 2020. The t-test, chi-square, Bonferroni’s test, and multiple linearregression were used. Results: No differences were observed in age, body mass index, parity, or history of pelvic surgery between the two groups. Myomadiameters were not different (10.8±2.52 cm vs. 11.2±3.0 cm, p=0.233), but myomas were lighter in the RALM group than in theAM group (444.6±283.14 g vs. 604.68±368.35 g, respectively, p=0.001). The RALM group had a higher proportion of subserosalmyomas, fewer myomas, fewer large myomas over >3 cm, lighter myomas, and longer total operating time. However, the RALMgroup also had shorter hospital stay and fewer short-term complications. Estimated blood loss (EBL) was not different betweenthe two groups. The number of removed myomas was the most significant factor (coefficient=10.89, p<0.0001) affecting the EBL. Conclusion: RALM is a feasible myomectomy technique even for large or heavy myomas. RALM patients tend to have shorterhospital stays and fewer postoperative fevers within 48 hours. However, RALM has longer total operating time.
Abstract
Purpose: 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). Materials and Methods: We included 278 patients who underwent multi-port RALM (n=126) or AM (n=151) for large or heavymyomas in a tertiary care hospital between April 2019 and June 2020. The t-test, chi-square, Bonferroni’s test, and multiple linearregression were used. Results: No differences were observed in age, body mass index, parity, or history of pelvic surgery between the two groups. Myomadiameters were not different (10.8±2.52 cm vs. 11.2±3.0 cm, p=0.233), but myomas were lighter in the RALM group than in theAM group (444.6±283.14 g vs. 604.68±368.35 g, respectively, p=0.001). The RALM group had a higher proportion of subserosalmyomas, fewer myomas, fewer large myomas over >3 cm, lighter myomas, and longer total operating time. However, the RALMgroup also had shorter hospital stay and fewer short-term complications. Estimated blood loss (EBL) was not different betweenthe two groups. The number of removed myomas was the most significant factor (coefficient=10.89, p<0.0001) affecting the EBL. Conclusion: RALM is a feasible myomectomy technique even for large or heavy myomas. RALM patients tend to have shorterhospital stays and fewer postoperative fevers within 48 hours. However, RALM has longer total operating time.
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