Uterine Vascular Occlusion in Management of Leiomyomas: Laparoscopy vs Laparotomy

Study Objective: To compare the difference between laparoscopic uterine vessel occlusion (LUVO) and ultra-minilaparotomy (UMLT) uterine vessel occlusion (UVO) in the management of symptomatic uterine myomas with 2-year follow-up. Design: Observational study (Canadian Task Force classification II-3). Setting: University-associated hospital. Patients: Ninety-one patients with symptomatic leiomyoma. Interventions: Uterine vessel occlusion via laparoscopy (n = 51) or UMLT access (n = 40). Measurements and Main Results: Outcome was determined by comparing operative time, complications, successful operation rate, postoperative pain, time to resumption of a regular diet, time to return to work, 2-year symptom control, relapse of symptoms, and repeat intervention between both groups. There were no statistical differences in 2-year symptom control, relapse of symptoms, repeat intervention, surgical complications, and successful operation rate between the 2 groups; however, LUVO yielded shorter operative time, less operative pain, shorter time to resumption of a regular diet, and earlier return to work, compared with UMLT-UVO. Conclusion: If UVO is chosen for management of symptomatic uterine myoma, both the LUVO and UMLT are acceptable options, with similar therapeutic outcomes; however, LUVO might yield more rapid postoperative recovery.