Perioperative Morbidity in Abdominal Myomectomy Versus Abdominal
Hysterectomy for Uterin Fibroids

Kutlugül YÜKSEL, Özlem MORALOĞLU, Melike DOĞANAY, Ümit BİLGE, Leyla MOLLAMAHMUTOĞLU
Ankara-Turkey

OBJECTIVE: The purpose of this study was to compare perioperative morbidity and clinical presentation of abdominal myomectomy and total abdominal hysterectomy for women with uterine fibroids.
STUDY DESIGN: We reviewed the hospital database of 206 patients with uterine fibroid who were treated with abdominal myomectomy (104 patients) and total abdominal hysterectomy (102 patients) at the Zekai Tahir Burak Mother Health Training and Research Hospital, from January 2001 to December 2002. The statistical analyses were performed with SPSS for Windows version 9.0, by using the Chi-Square test and Student's t test. The minimum limit for significance was taken as 0.05. Risk estimates with 95% confidence intervals were calculated.
RESULTS: Patients who underwent myomectomy were significantly younger, and they had smaller uteri than those who abdominal hysterectomy. There were significantly greater prevalences of average operative blood loss among patients who underwent myomectomy than among those who underwent hysterectomy. Postoperative febrile morbidity was significantly less in women with myomectomy (24.2%) compared with those with hysterectomy (24.2% versus 31.3%, p=0.13). There were statistically significant differences in the risk of unintended procedure (2.8% versus 5.8%, p=0.001), mean duration of operating time (mean±S.D.135 min versus 142 min, p=0.00001) and mean duration of hospital stay (mean±SD:3.02±4.3 days versus 3.43±3.3days, p: 0.45), compared to myomectomy and hysterectomy groups, respectively. Total blood loss was also positively correlated with intraoperative removed fibroid number.
CONCLUSION: We conclude that abdominal myomectomy can be considered as a safe alternative to total abdominal hysterectomy for the surgical treatment of uterine myomas.
(Gynecol Obstet Reprod Med 2005; 11:199-202)

Key Words: Uterine fibroids, Perioperative morbidity, Hysterectomy, Myomectomy