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| The effect of laparoscopic or laparotomy for myomectomy on perioperative stress status and later pregnancy outcomes of patients with uterine myome |
| Nanan City Hospital of Fujian Province, Fujian Province, 362300 |
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Abstract Objective: To investigate the effect of laparoscopic or laparotomy for myomectomy on perioperative stress status and later pregnancy outcomes of patients with uterine myome. Methods: 100 patients with uterine myome were selected from February 2014 to June 2016, and they were divided into two groups according to the random number table. The patients in laparoscopic group (50 cases) underwent laparoscopic myomectomy, and patients in laparotomy group (50 cases) underwent myomectomy by laparotomy. The situations during operation, the later pregnancy outcomes, and the serum level s of reduced glutathione peroxidase (GSH-PX), serum malondialdehyde (MDA), Differences in superoxide dismutase (SOD), epinephrine (E), and norepinephrine (NE) of patients before and after operation were compared between the two groups. Results: The operation time of patients in laparoscopic group was significant longer than that of patients in laparotomy group (P<0.05). The intraoperative blood loss volume and the number of tumors removed of patients in laparoscopic group were significant less than those of patients in laparotomy group (P<0.05). The postoperative exhaust time, time of stay on bed, and time of stay in hospital post operation of patients in laparoscopic group were all significant shorter than those of patients in laparotomy group (P<0.05), and the average postoperative temperature of patients in laparoscopic group was significant lower than that of patients in laparotomy group (P<0.05). The rate of recurrent pregnancy of patients in laparoscopic group was significant lower than that of patients in open operation group (P<0.05). The rate of vaginal delivery of patients in laparoscopic group was significant higher than that of patients in laparotomy group (P<0.05). The cesarean section rate of patients in laparoscopic group was significant lower than that of patients in laparotomy group (P<0.05). The serum levels of GSH-PX, MDA, SOD, E and NE of patients in laparoscopic group were significant lower than those of patients in laparotomy
group (P<0.05). Conclusion: Patients experienced laparoscopic uterine myomectomy have less trauma and mild postoperative stress response, and can recovery rapidly. Laparoscopic uterine myomectomy has less effect on later pregnancy outcomes of patients, so it is the best choice for patients with uterine myome.
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