Removal of Fibromyomas by Laparoscopic Surgery After Preoperative GnRH Analogue ‐ An Alternative to Abdominal Hysterectomy or Myomectomy

Publisher Website
Google Scholar
Abstract
EDITORIAL COMMENT: We accepted this paper for publication because it reports a reasonably large experience of dealing with symptomatic fibromyomas of considerable size in women who wished to avoid or reduce the risk of hysterectomy. It should be noted that the fibromyomas in these women were unsuitable for the technique of ‘myolysis ‘reported previously by the authors. Readers interested in this subject are referred to a recent publication of patients treated in Italy where a randomized trial concluded that laparoscopic myomectomy in comparison with laparotomy myomectomy has benefits of a shorter recovery time and less postoperative pain {A). In this series of 40 patients the authors excluded those with more than 4 fibromyomas requiring removal and those with the largest fibromyoma exceeding 6 cm in mean diameter (A). Mais V and colleagues. Laparoscopic versus abdominal myomectomy: A prospective, randomized trial to evaluate benefits in early outcome. Am J Obstet Gynecol 1996; 174: 654–658. It is of interest that in this series ‘to reduce the risk of short‐term myoma recurrence, no patient underwent medical treatment for ovarian suppression before the operation.Summary: Nineteen patients with fibromyomas who had been recommended to have a hysterectomy or abdominal myomectomy were referred as they wished to avoid a hysterectomy (14) or laparotomy incision for a myomectomy (5). Following administration of the GnRH analogue goserelin, laparoscopic surgery was performed on all these patients. Hysterectomy was avoided in all but 1 of the 14 patients and laparotomy myomectomy was avoided in 4 of the 5 patients recommended to have these procedures. The combination of a GnRH analogue and laparoscopic‐based surgery may be an acceptable alternative to both laparotomy myomectomy and hysterectomy in women with fibromyomas requiring surgery.

This publication has 9 references indexed in Scilit: