Laparoscopic transient uterine artery occlusion and myomectomy for symptomatic uterine myoma.

摘要

OBJECTIVE: To compare clinical outcomes of laparoscopic transient uterine artery ligation plus myomectomy (LTUAL) to simple laparoscopic myomectomy (LM) for symptomatic myomas. DESIGN: Comparative observational study. SETTING: Medical centers. PATIENT(S): One hundred sixty-seven patients with symptomatic myomas. INTERVENTION(S): Eighty-four patients underwent LTUAL and LM; 83 patients underwent LM only. MAIN OUTCOME MEASURE(S): Operative time, blood loss, gonadal hormone level, uterine artery resistance index, menorrhea, pregnancy rate, and recurrence rate of myoma. RESULT(S): The intraoperative blood loss in the LTUAL group was lower than in the LM group. The menstrual blood volume (MBV) and the menstrual period of the LTUAO group was unchanged after operation relative to the prediseased volume. No significant difference was found in the resistance index of the uterine artery blood flow, the recurrence rate, and the fertility rate between the LTUAL and LM groups. CONCLUSION(S): LTUAL and LM are a promising surgical treatment for symptomatic uterine myoma and did not produce any appreciable adverse effect on fertility.