Effects of laparoscopic versus minilaparotomic myomectomy on uterine leiomyoma: a meta-analysis.

A meta-analysis was conducted to assess the effects of laparoscopic versus minilaparotomic myomectomy on uterine leiomyoma in premenopausal women. We performed a computerized search of MEDLINE, Embase, and the Cochrane Library from 1996 to 2104. From 711 studies, a total of 4 studies met our inclusion criteria, and a meta-analytic technique was used to study the 4 randomized controlled trials involving 577 women with symptomatic uterine leiomyoma. Compared with the minilaparotomic myomectomy group, the laparoscopic myomectomy group showed a significantly less hemoglobin drop and blood loss, lower postoperative analgesic use, shorter duration of postoperative ileus, shorter hospitalization days and recovery time, and higher levels in the pregnancy rate per cycle and the live birth rate per cycle. There was no significant difference between the 2 groups regarding the operating time, complications, laparotomic conversion rate, cumulative pregnancy rate, cumulative live birth rate, and abortion rates. When performed by experienced surgeons in selected patients (e.g., symptomatic leiomyoma women who have the indications for surgery), laparoscopic myomectomy is a better choice than minilaparotomic myomectomy.