Intraoperative And Postoperative Complications Following Open, Laparoscopic, And Hysteroscopic Myomectomies In Saudi Arabia

BackgroundThe aim of this study was to broaden our knowledge regarding the complications of myomectomy to better understand how to prevent them from occurring. Another aim was to compare surgical approaches, especially with the current research limitations surrounding this topic in Saudi Arabia.MethodsThis retrospective study was conducted in a cohort of 263 women who underwent surgical myomectomy, without any exclusion criteria. We used our hospital electronic medical records program called Phoenix to obtain all the data regarding clinical presentation, intraoperative findings, intraoperative and postoperative complications, and hospital stay, and then statistically analyzed these findings.ResultsResults were divided depending on the type of surgery. The mean age of open, laparoscopic, and hysteroscopic myomectomy groups were 40.82 years, 42.05 years, and 44.43 years, respectively. There were 213 (80.98%) open, 34 (12.93%) laparoscopic, and 16 (6.09%) hysteroscopic myomectomies. The most common indication in all groups was bleeding. The mean estimated blood loss and duration of surgery for open, laparoscopic, and hysteroscopic myomectomy groups were: 576.13 mL and 103.05 min, 333.21 mL and 56.91 min, and 306.29 mL and 104.19 min, respectively. The total complication rate for each group was 10.8% in open, 2.94% in laparoscopic, and 6.25% in hysteroscopic myomectomies.ConclusionLaparoscopy is considered the more effective option for myomectomy than both laparotomy and hysterectomy in terms of surgery duration, hospital stay, and prevalence of complications. However, it is a technically challenging operation that requires experienced surgeons to perform. Based on the information we gathered, we recommend our institute to implement laparoscopy instead of laparotomy myomectomy, which is the current standard procedure in our hospital.