Comparative study between robotic laparoscopic myomectomy and abdominal myomectomy

摘要

To compare short-term surgical outcomes of robotic and abdominal myomectomy and to analyze the factors affecting the short-term outcomes. Retrospective study of a consecutive case series at Emory Saint Joseph’s Hospital, Atlanta, USA. From February 2007 to June 2009, 122 patients with symptomatic leiomyomata underwent either robotic assisted laparoscopic myomectomy (RALM, n = 77) or abdominal myomectomy (AM, n = 45). The variables investigated included the type of surgery, age, BMI, gravity, parity, number of leiomyomata, diameter of largest tumor size, total operative time, estimated blood loss, and length of hospital stay. No significant differences were found between the two groups regarding age, gravity and parity. However, BMI, number of leiomyomata and tumor sizes were significantly higher in AM compared to RALM. The total operative time was significantly longer in RALM compared to AM. The total estimated blood loss and length of hospital stay were significantly lower in RALM compared to the AM group. The predicted odds of staying one day or less in the hospital for patients receiving RALM was 193.5 times the odds for patients receiving AM when adjusted for the number of leiomyomata and the tumor size. The probability of one day admission or less in the hospital was significantly increased for patients receiving RALM. RALM has shorter hospital stay, less blood loss and increased operative time compared to AM, regardless of tumor size and number of tumors. Although operative time was increased with the RALM procedure, blood loss and hospital stay were integral outcomes in the study result.