Risk Factors Associated With The Recurrence Of Uterine Leiomyoma Following Laparoscopic Myomectomy-Meta-analysis

Background: Uterine leiomyoma are the most common benign gynecologic tumors.Leiomyomas originate from uterine smooth muscle and can be either solitary or multiple lesions.Symptomatic fibroids occur in up to 25% of women.Various clinical symptoms may accompany them,depending on size,location,and number.Larger,multiple,intramural or subserosal fibroids typically result in pressure symptoms.Surgical and non-surgical treatments are available for symptomatic patients.Objective: To determine the risk factors responsible for the recurrence of Uterine Leiomyoma following laparoscopic myomectomyMethod: Electronic databases and manual searching were performed from 2000 to 2018 to identify all eligible published literature.Medline,Pub Med,EMBASE,Web of Science,Cochrane library,Wang fang,Zhiwang were searched with following keywords:Uterine fibroid/leiomyoma/myoma,Laparoscopic Myomectomy,recurrence,risk factors.No language restrictions were made.The corresponding articles listed in the reference section were also meticulously scrutinized to identify relevant literature.Published systemic reviews and meta-analysis on the topic were also searched to identify the eligible studies.Results: A total of 6 studies were included finally with 846 patients and 264 recurrent cases in which association of risk factors with recurrence of UL after LM was investigated.The results of our meta-analysis found that age at the time of operation ?35,fibroid size ?10cm,fibroid number ?2,BMI over 25 kg/m2 and preoperative nulliparity had pooled RR(95%CI)and P value as 1.76 [1.28,2.41](P = 0.0004)1.51 [1.17,1.95](P = 0.002)2.06 [1.68,2.53](P < 0.00001)1.52 [1.11,2.09],(P = 0.010)2.62 [1.35,5.09](P = 0.004)respectively.Conclusion: According to our result,following risk factors such as patient's age ?35,Nulliparous women,BMI ?25kg/m2,fibroid number ?2 and fibroid size ?10cm are strongly associated with the recurrence of uterine leiomyoma following Laparoscopic myomectomy so early preventive measures should be taken to prevent the recurrence.