Operative and obstetrical outcomes after single-port laparoscopic myomectomy: A retrospective single center analysis of 504 cases.

STUDY OBJECTIVE

To analyze the obstetrical and operative outcomes of 504 cases of single-port laparoscopic myomectomy (SPLM).

DESIGN

Single-center retrospective study SETTING: A tertiary university hospital PARTICIPANTS: A total of 502 patients (504 SPLM procedures) who underwent SPLM for symptom relief or growing myomas between October 2009 and April 2020.

INTERVENTIONS

Data on patient demographics, operative variables (estimated blood loss, hemoglobin decrease, operation time, perioperative complications, and postoperative hospital stay), and obstetrical outcomes (the surgery-to-pregnancy interval and birth-related outcomes) were obtained from medical records and analyzed.

MEASUREMENTS AND MAIN RESULTS

The mean age of patients was 40.6 ± 6.6 years. Patients had removed an average of 2.3 ± 2.2 myomas; the largest myoma size was 6.8 ± 2.4 cm. The mean operation time, postoperative hemoglobin decrease, and postoperative hospital stay duration were 112.9 ± 45.3 min, 1.7 ± 1.1 g/dL, and 2.2 ± 1.4 days, respectively. The overall rate of postoperative complications was 7.7% (39/504) and common complications were transfusions (3.2%, 16/504) or wound problems (3.0%, 15/504). Conversion to multi-port or open myomectomy was required in 0.8% of cases (4/504). A total of 376 women were of child-bearing age and 56 attempted to become pregnant post-surgery. The mean interval from surgery to pregnancy was 15.6 ± 12.2 months. Obstetrical outcomes were pregnancy (75.0%, 42/56), live birth (69.6%, 39/56), and miscarriage (3.6%, 2/56). One pregnant woman was lost to follow-up. The 39 live births predominantly involved full-term delivery (92.3%, 36/39), mostly via cesarean section (92.3%, 36/39). No postpartum complications were reported. The 2 most common obstetrical complications were preterm labor (7.7%), and gestational diabetes (5.1%).

CONCLUSIONS

SPLM appears to be an effective procedure with good operative and postoperative obstetrical outcomes for women with myomas who require surgery and may wish to subsequently become pregnant.