Recurrence of uterine myoma after myomectomy: Open myomectomy versus laparoscopic myomectomy

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  • Kotani, Yasushi
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Tobiume, Takako
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Fujishima, Risa
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Shigeta, Mamoru
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Takaya, Hisamitsu
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Nakai, Hidekatsu
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Suzuki, Ayako
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Tsuji, Isao
    Department of Obstetrics and Gynecology, Kyoto Graduate School of Medicine, Kyoto University
  • Mandai, Masaki
    Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine
  • Matsumura, Noriomi

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Abstract

Aim: Open myomectomy (OM) was previously frequently performed; however, laparoscopic myomectomy (LM) has recently become more common. Nevertheless, myoma can recur after both LM and OM. In this study, we report our retrospective investigation of myoma recurrence by comparing LM and OM. Mathods: A total of 474 patients underwent LM and 279 patients underwent OM. The patients were followed‐up postoperatively from six months to eight years. Recurrence was confirmed when a myoma with a diameter of ≥ 1 cm was detected. Post‐LM, post‐OM and cumulative recurrence rates were investigated, and a Cox hazard test was performed. Results: The cumulative recurrence rates between the two groups were 76.2% (LM) vs. 63.4% (OM) at eight years postoperatively. A log‐rank test revealed a significant difference between the two groups. Cox hazard testing revealed that LM, a larger number of enucleated myoma masses and the absence of postoperative gestation significantly contributed to the postoperative recurrence rate. Conclusions: LM yielded a higher recurrence rate than OM, likely a result of manual myoma removal in OM, which is a more exhaustive extraction of smaller myoma masses than performed in LM. In other words, fewer residual myoma masses after OM contribute to a lower postoperative recurrence rate.

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