Comparison of Surgical Outcomes Between Single-Site Laparoscopic Adenomyomectomy and Fundusectomy: Experience from a Single Center.

Objective

This study aimed to introduce clinical experience using a new surgical technique, single-port access laparoscopic fundusectomy, a more efficient uterus-sparing surgical method for adenomyosis in patients with no plans for pregnancy.

Methods

We performed single-port access laparoscopic myomectomy in 141 patients and single-port access laparoscopic fundusectomy in 124 patients and compared the surgical outcomes.

Results

Significant differences in surgical outcomes were observed between the two operating methods. Operative time was 158.19 min (±42.93) in the fundusectomy group and 179.11 min (±56.95) in the adenomyomectomy group (p = 0.001). Estimated blood loss was 175.04 mL (±142.76) in the fundusectomy group and 347.97 mL (±409.78) in the adenomyomectomy group (p = 0.000). The fundusectomy group showed smaller uterus size and volume, and lower postoperative CA125 levels than the adenomyomectomy group for 24 months (p = 0.000).

Conclusions

This study suggests that single-port access laparoscopic fundusectomy is more effective in terms of operative time, estimated blood loss, and postoperative CA125 decrease than single-port access laparoscopic adenomyomectomy.