Surgical outcomes and complications of myomectomy: a prospective cohort study

Study objective To investigate postoperative surgical and non-surgical complications that occur within 30 days following myomectomy procedures, whether laparoscopic or via open surgery. Design Prospective cohort study Setting Del Ponte Women's and Children's Hospital, Varese, Italy Patients Women undergoing myomectomy either with laparoscopic or open surgery from July 2020 to June 2023 Interventions Data of consecutive patients who underwent abdominal myomectomy procedures, either via laparoscopy or open abdominal surgery were collected. The study examined patient characteristics, size and location of fibroids, surgical data, and complications. Univariate and multivariable analyses were employed to identify factors contributing to postoperative Clavien-Dindo grade ≥ II complications. Measurements and main results Overall 383 patients were included in the study. The univariate analysis showed intramural fibroid type (p = 0.0009), large fibroid size (p = 0.03), and extended operative times (p = 0.05) were associated with postoperative complications. Open surgical approach (p<0.001) and uterine cavity opening (p = 0.02) also contributed to complications. Postoperative anemia emerged as the most prevalent complication. In the multivariable analysis, the open surgical approach emerged as the only independent factor associated with an increased risk of grade ≥ II complications (odds ratio 7.37; p < 0.0001). Conclusion In this study we found an increased likelihood of complications in case of open myomectomy. While the presence of potential selection bias may have impacted this finding, it could provide valuable insights for clinicians and surgical teams in the strategic planning of myomectomy procedures.