¹Hub E Ali, ²Shazia Saaqib, ³Dr Nazia Ayyub Butt, ⁴Dr Seemab Shaukat, ⁵Dr Nayab, ⁶Dr Irum Maqsood
¹Assistant Professor, Mayo Hospital, Lahore
²Assistant Professor, Obstetrics and Gynaecology, Allama Iqbal Medical College
³Assistant Professor, OBGYN AIMC / Jinnah Hospital, Lahore
⁴Assistant Professor, Shifa International Hospital, Islamabad
⁵Associate Professor, PIMS Islamabad
⁶Assistant Professor, Bolan Medical College, Quetta
ABSTRACT:
Background: Uterine fibroids were considered as one of the most prevalent benign tumors in women of child-bearing age and commonly resulted in the manifestation of abnormal uterine bleeding, pain in the pelvis area and infertility. Both laparoscopic and open surgeries of the myomectomy technique was considered a desirable treatment option among women who needed to get fertility intact. The laparoscopic and open myomectomy was still a controversial issue, mainly in relation to the outcomes of the operations, post-surgery recovery and morbidity.
Purpose: The research was carried out to compare the clinical outcomes, surgical effectiveness, and postoperative recovery of laparoscopic and open myomectomy as a form of managing uterine fibroids.
Methods: The study was a comparative observational study, conducted at Mayo Hospital, Lahore, between May 2024 and April 2025 (one year) and used a sample size of 90 women diagnosed with symptomatic fibroids of the uterus that necessitated surgical intervention. The respondents were split into two groups; Group A (n=45) was laparoscopic myomectomies and Group B (n=45) was open myomectomies. The variables that were measured included operative time, intraoperative loss of blood, postoperative pain, length of stay in the hospital and complications. The statistical analysis was carried out with the help of SPSS version 25.0 and the p-value less than 0.05 was taken as significant.
Results: Laparoscopic group showed much less intraoperative blood loss (180+60 mL) and shorter hospitalization (2.1+0.8 days) in relation to the open myomectomy group (310+90 mL and 4.8+1.2 days, respectively; p=0.001). The laparoscopic group also had a significant lower score in postoperative pain and complication rate. The average time to the operating table in laparoscopic cases however (120 25minutes) was also greater than in cases of open surgery (95 20 minutes; p<0.01). There was no considerable variation in the rate of recurrence of fibroid in the follow-up period.
Conclusion: Laparoscopic myomectomy turned out to be a safer and better minimally invasive option compared to open myomectomy with reduced blood loss and quicker recovery and decreased hospital stay even though it took a longer time to perform. The results favored the growing use of laparoscopic methods of treating uterine fibroids, especially in facilities where the surgical skills are highly developed.
Keywords: Uterine fibroids, Laparoscopic myomectomy, Open myomectomy, Surgical outcomes, Mayo Hospital Lahore
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Editor-in-Chief
Liam A. Phillips, California, Los Angeles
Associate Editors
Andrew Adler, USC-Brookings Schaeffer Initiative for Health Policy, The Brookings Institution
Lucas F. Figueroa, Univercity of California, Lesley
Sidra Hamad, California, Los Angeles
Nicholas Hernandez, University of California, Merced
Vimon F. Haeder, Texas A&M University
Forrin Moucheraud, University of California, Los Angeles
kayeh Nikpay, University of Minnesota