Analysis of Clinical Efficacy and Safety of Laparoscopic Myomectomy for Uterine Fibroids

Background: Uterine fibroids are the most common benign tumors of the female reproductive tract. Open surgery and laparo-scopic myomectomy are clinically recommended for the management of uterine fibroids. However, the selection of appropriate surgical methods for patients remains a critical issue to be addressed.Objective: To assess the clinical efficacy and safety of laparoscopic myomectomy for uterine fibroids.Methods: This study used 60 patients diagnosed with uterine fibroids in our hospital from July 2019 to July 2021, as research subjects. The patients were randomly and equally assigned to 2 groups which received either open surgery (control group) or laparoscopic myomectomy (experimental group), with 30 patients in each group. The choice of surgical method was open to all the patients. The primary endpoint was clinical efficacy, while secondary endpoits comprised surgical indices, serum levels of estradiol (E2) and follicle-stimulating hormone (FSH), and postoperative complications.Results: The two groups of patients had well-balanced baseline profiles (p > 0.05). Laparoscopic myomectomy was associated with less intraoperative hemorrhage (67.16 & PLUSMN; 15.49 mL vs. 141.42 & PLUSMN; 36.57 mL, p < 0.01) and shorter surgical wound length (24.39 & PLUSMN; 1.96 mm vs. 65.76 & PLUSMN; 2.14 mm,p < 0.01), operation time (79.25 & PLUSMN; 4.19 min vs. 96.33 & PLUSMN; 5.64 min,p < 0.01), and hospital stay (5.33 & PLUSMN; 1.89 days vs. 9.82 & PLUSMN; 2.04 days, p < 0.01), when compared with open surgery. After laparoscopic myomectomy, patients exhibited a 58.46 & PLUSMN; 5.98 pmol/L decrease in E2 level and a 2.68 & PLUSMN; 1.22 U/L increase in FSH level. The final levels of E2 and FSH in laparoscopic myomectomy patients were significantly lower than the corresponding levels in patients treated with open surgery (254.91 & PLUSMN; 7.41 vs. 216.87 & PLUSMN; 5.14 pmol/L, 24.54 & PLUSMN; 1.46 vs. 21.25 & PLUSMN; 1.21 U/L,p < 0.01). Laparoscopic myomectomy resulted in lower incidence of complications (6.66%) than open surgery (60%), and in significantly better clinical efficacy than open surgery (p < 0.05).Conclusions: Laparoscopic myomectomy reduced intraoperative bleeding of patients with uterine fibroids, lowered the incidence of postoperative complications, reduced serum levels of E2 and FSH, shortened operation time and hospital stay, and enhanced clinical outcomes. However, there is need for further trials before clinical promotion of this surgical approach for fibroids.