Background Isobaric gasless laparoscopy and minilaparotomy have been used as more recent minimally invasive approaches to myomectomy. This randomized trial aimed to compare the surgical and immediate postoperative outcomes for myomectomy performed by isobaric gasless laparoscopy with those for minilaparotomy. Methods A total of 100 patients with symptomatic uterine myomas requiring myomectomy were randomly allocated to the gasless laparoscopy group or the minilaparotomy group. The randomization procedure was based on a computer-generated list. The primary outcome was a comparison of the discharge times between the two procedures. A power calculation verified that more than 26 patients for each group was necessary to detect a difference of more than 24 h in discharge time with an alpha error level of 5% and a beta error of 80%. Continuous outcome variables were analyzed using the Student's t-test. Discrete variables were analyzed with the chi-square test or Fisher's exact test. A p value less than 0.05 was considered statistically significant. Results The mean discharge time was longer for minilaparotomy than for gasless laparoscopy (98.4 +/- 1.4 vs 52.8 +/- 1.6 h; p < 0.001). Gasless laparoscopy resulted in shorter times for canalization (21.6 +/- 1.1 vs 32 +/- 1.3 h; p < 0.05) and surgery (79.5 +/- 25.1 vs 103.5 +/- 24.9 min; p < 0.001). The intraoperative blood loss was less with gasless laparoscopy (154.2 +/- 1.2 vs 188.6 +/- 1.3 ml; p < 0.001). No intraoperative complications occurred, and no case was returned to the theater in either group. No conversion to standard laparotomy was necessary. Conclusions Isobaric gasless laparoscopy and minilaparotomy can be suitable options for uterine myomectomy. Several surgical and immediate postoperative outcomes were significantly better in the gasless laparoscopy group than in the minilaparotomy group. However, further controlled prospective studies are required to confirm the results.

Sesti, F., Capobianco, F., Capozzolo, T., Pietropolli, A., & Piccione, E. (2008). Isobaric gasless laparoscopy versus minilaparotomy in uterine myomectomy: a randomized trial. SURGICAL ENDOSCOPY, 22(4), 917-923 [10.1007/s00464-007-9516-1].

Isobaric gasless laparoscopy versus minilaparotomy in uterine myomectomy: a randomized trial

SESTI, FRANCESCO;PIETROPOLLI, ADALGISA;PICCIONE, EMILIO
2008

Abstract

Background Isobaric gasless laparoscopy and minilaparotomy have been used as more recent minimally invasive approaches to myomectomy. This randomized trial aimed to compare the surgical and immediate postoperative outcomes for myomectomy performed by isobaric gasless laparoscopy with those for minilaparotomy. Methods A total of 100 patients with symptomatic uterine myomas requiring myomectomy were randomly allocated to the gasless laparoscopy group or the minilaparotomy group. The randomization procedure was based on a computer-generated list. The primary outcome was a comparison of the discharge times between the two procedures. A power calculation verified that more than 26 patients for each group was necessary to detect a difference of more than 24 h in discharge time with an alpha error level of 5% and a beta error of 80%. Continuous outcome variables were analyzed using the Student's t-test. Discrete variables were analyzed with the chi-square test or Fisher's exact test. A p value less than 0.05 was considered statistically significant. Results The mean discharge time was longer for minilaparotomy than for gasless laparoscopy (98.4 +/- 1.4 vs 52.8 +/- 1.6 h; p < 0.001). Gasless laparoscopy resulted in shorter times for canalization (21.6 +/- 1.1 vs 32 +/- 1.3 h; p < 0.05) and surgery (79.5 +/- 25.1 vs 103.5 +/- 24.9 min; p < 0.001). The intraoperative blood loss was less with gasless laparoscopy (154.2 +/- 1.2 vs 188.6 +/- 1.3 ml; p < 0.001). No intraoperative complications occurred, and no case was returned to the theater in either group. No conversion to standard laparotomy was necessary. Conclusions Isobaric gasless laparoscopy and minilaparotomy can be suitable options for uterine myomectomy. Several surgical and immediate postoperative outcomes were significantly better in the gasless laparoscopy group than in the minilaparotomy group. However, further controlled prospective studies are required to confirm the results.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/40 - Ginecologia e Ostetricia
eng
Con Impact Factor ISI
adult; analytical error; article; bleeding; calculation; chi square test; clinical trial; controlled clinical trial; controlled study; female; Fisher exact test; hospital discharge; human; laparoscopy; laparotomy; major clinical study; myomectomy; outcome variable; peroperative complication; priority journal; randomization; randomized controlled trial; standard; statistical significance; Student t test; treatment outcome; uterus myoma; Adult; Analysis of Variance; Chi-Square Distribution; Female; Humans; Laparoscopy; Laparotomy; Leiomyoma; Treatment Outcome; Uterine Neoplasms
Sesti, F., Capobianco, F., Capozzolo, T., Pietropolli, A., & Piccione, E. (2008). Isobaric gasless laparoscopy versus minilaparotomy in uterine myomectomy: a randomized trial. SURGICAL ENDOSCOPY, 22(4), 917-923 [10.1007/s00464-007-9516-1].
Sesti, F; Capobianco, F; Capozzolo, T; Pietropolli, A; Piccione, E
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/38777
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