Abdominal myomectomy (AM) and laparoscopic myomectomy (LM) are commonly see surgery for the uterine fibroids, several randomized controlled trials (RCTs) have compared the role of AM and LM, the results remained inconsistent. Therefore, we attempted this meta-analysis to analyze the role of LM versus AM in patients with uterine fibroids. We searched PubMed et al. databases from inception date to July 31, 2019 for RCTs that compared LM versus AM in patients with uterine fibroids. Two authors independently screened the studies and extracted data from the published articles. Summary odd ratios(OR) or mean differences(MD) with 95% confidence intervals(CI) were calculated for each outcome by means of fixed- or random-effects model. Twelve RCTs with a total of 1783 patients were identified, with 887 patients for and 897 patients for AM. Compared with AM, LM could significantly decrease the blood loss (OR = − 29.78, 95% CI -57.62– − 0.95), shorten the duration of postoperative ileus (OR = − 10.91, 95% CI -18.72– − 3.11), reduce the length of hospital stay (OR = − 1.57, 95% CI -2.05– − 1.08), but LM was associated with longer duration of operation (OR = 16.10, 95% CI 6.52–25.67) and higher medical cost (OR = 17.61, 95% CI 7.34–27.88). LM seems to be a better choice for patients with uterine fibroids, more related studies are needed to identify the role of LM and AM for the treatment of uterine fibroids.

中文翻译：

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腹腔镜与子宫肌瘤切除术对子宫肌瘤患者的疗效和费用：系统评价和荟萃分析。

腹部子宫肌瘤切除术（AM）和腹腔镜子宫肌瘤切除术（LM）普遍用于子宫肌瘤手术，一些随机对照试验（RCTs）比较了AM和LM的作用，结果仍然不一致。因此，我们尝试通过荟萃分析来分析LM与AM在子宫肌瘤患者中的作用。我们搜索了PubMed等。从开始日期到2019年7月31日的RCT数据库，用于比较子宫肌瘤患者的LM与AM。两位作者独立筛选了研究，并从已发表的文章中提取了数据。通过固定或随机效应模型计算出每个结局的汇总奇数比（OR）或均值差（MD）和95％置信区间（CI）。确定了12项RCT，共1783例患者，其中887例针对AM，897例针对AM。与AM相比，LM可显着减少失血量（OR = − 29.78，95％CI -57.62– − 0.95），缩短术后肠梗阻的持续时间（OR = − 10.91，95％CI -18.72– − 3.11），缩短住院时间停留（OR = − 1.57，95％CI -2.05– − 1.08），但是LM与手术时间更长（OR = 16.10，95％CI 6.52–25.67）和较高的医疗费用（OR = 17.61，95％CI）相关7.34–27.88）。LM对于子宫肌瘤患者似乎是一个更好的选择，需要更多相关研究来确定LM和AM在子宫肌瘤治疗中的作用。但是LM与手术时间更长（OR = 16.10，95％CI 6.52–25.67）和更高的医疗费用（OR = 17.61，95％CI 7.34–27.88）相关。LM对于子宫肌瘤患者似乎是一个更好的选择，需要更多相关研究来确定LM和AM在子宫肌瘤治疗中的作用。但是LM与手术时间更长（OR = 16.10，95％CI 6.52–25.67）和更高的医疗费用（OR = 17.61，95％CI 7.34–27.88）相关。LM似乎是子宫肌瘤患者的更好选择，还需要更多相关研究来确定LM和AM在子宫肌瘤治疗中的作用。