Objective To systematically evaluate the effectiveness and cost of laparoscopic myomectomy (LM) vs. traditional abdominal myomectomy (TAM) in treating Chinese patients with hysteromyoma.
Methods Such databases as The Cochrane Library (Issue 4, 2012), PubMed, EMbase, CNKI, CBM and WanFang Data were searched from their inception to September, 2012 to collect the randomized controlled trials (RCTs) about LM vs. TAM in treating Chinese patients with hysteromyoma, and the references of the included studies were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the methodological quality. Then meta-analysis was conducted using RevMan 5.2 software.
Results A total of 8 RCTs involving 1 000 Chinese patients were included. The results of meta-analysis showed that, LM was superior to TAM in postoperative exhaust time (WMD= ?15.21, 95%CI ?20.19 to ?10.24, P lt;0.000 01) and postoperative hospital stay (WMD= ?3.07, 95%CI ?4.25 to ?1.90, P lt;0.000 01), with significant differences. But it was inferior to TAM in operation time (WMD=28.33, 95%CI 18.07 to 38.59, P lt;0.000 01) and hospital costs (WMD=2 028.87, 95%CI 1 190.75 to 2 866.98, P lt;0.000 01), with a significant difference. There was no significant difference in intraoperative bleeding amount between the two groups (WMD= ?2.78, 95%CI ?41.56 to 36.00, P=0.89).
Conclusion This study shows LM is superior to TAM in fastening postoperative recovery and shortening hospital stay, but it is longer in operation time and higher in cost. The intraoperative bleeding amount is similar in the two groups. Due to low methodological quality and small sample size of the included studies, this conclusion has to be further proved by more high-quality RCTs.
Citation： ZHAO Bingfeng,HUANG Xuegui,BAO Min,XIA Tao. Effectiveness and Cost of Laparoscopic versus Traditional Abdominal Myomectomy in China: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2013, 13(4): 461-467. doi: 10.7507/1672-2531.20130079 Copy