Comparison of outcomes after laparoscopic myomectoy with morcellation versus laparatomy myomectoy without morcellation

This is a non-randomized clinical trial (quasi-experimental) that aims to compare the results of the peritoneal washing and peri-operative outcomes in laparoscopic myomectomy with morcellation versus laparotomy myomectomy without morcellation in patients whom referred to Arash Hospital for myomectomy. We include all woman who meet the established criteria for myomectomy in Arash Hospital. Subjects should be aged between 18 and 45 years old without known or suspected history of cancers and have Normal menstrual cycle. in the case of abnormal uterine bleeding , an endometrial biopsy will be performed. in the laparoscopic myomectomy group, patients who have a history of uterine, ovary or colon cancer in her own or her first degree relatives diagnosed under the age of 50 years, will be excluded. All participants in laparoscopy group will provide written informed consent recommended by FDA panel outlining the risks of morcellation and of unsuspected malignant myoma (In this case, the malignancy can be diffused and the prognosis will be significantly worsened) . Sample size: 144 (72 in the laparoscopic (interventional) group and 72 in the laparotomy group (control) ) in the laparoscopic group abdominal washing will be done in two steps. First step after myomectomy and suturing the myoma bed, and the second step after the morcellation will be done. In the laparotomy group, washings step will be performed one time after the end of the myomectomy and closing the bed, the uterus is returned to the pelvis. Pathological assessment for detecting The presence of spindle cells in peritoneal washings will perform by using cell block technique. Peri-operative outcomes including the duration of surgery, pre and postoperative hemoglobin levels, hospitalization time and re-admission will be compared between two groups.

Tehran University Of Medical Sciences