腹腔鏡補助下子宮筋腫核出術と腹腔鏡下子宮筋腫核出術の侵襲についての比較検討

抄録

Background: In regard to myomectomy carried out using a laparoscope, there has been a recent transition from laparoscopic-assisted myomectomy (LAM) via a small incision to total laparoscopic myomectomy (LM). However, there are few reports documenting that LM is actually less invasive than LAM. Here, we compared the difference in invasiveness between LAM and LM.
Method: We compared the data from 111 patients undergoing LAM and 85 patients undergoing LM at our hospital, after obtaining informed consent, between January 2009 and December 2012. We limited our analysis to patients in whom the specimen weight was 600 g or lower and excluded those who underwent simultaneous multiple organ surgery, such as surgical manipulation of the ovary. Variables for comparison were: the amount of blood loss, the operative time, the white blood cell count on postoperative day 1, the CRP level on postoperative day 3, and the postoperative maximum score on the VAS scale.
Results: In the absence of any significant difference in the weight of the extracted specimens, the number of resected myomas was significantly larger in the LAM group. The intraoperative blood loss and the operative time were significantly lower and shorter, respectively, in the LAM group; however, the CRP level on postoperative day 3 and the postoperative maximum score on the VAS scale were significantly lower in the LM group. No significant difference was observed in the white blood cell count on postoperative day 1.
Conclusion: These results suggest that LM is less invasive than LAM in the early postoperative stage.