The Effects Of Transabdominal Myomectomy And Laparoscopic Myomectomy On Postoperative Pregnancy: A Meta-analysis

Objective: To evaluate the effect of open and laparoscopic hysteromyomectomy on postoperative pregnancy outcomes.Methods: By using the computer to search the relevant documents in Chinese websites such as CNKI,Veep database,Wanfang database and English website Pub Med,The Cochrane Library,Web of Science,etc.,the time of searching was Jianku until December 2019.Selected independently by two researchers literature,incorporating the required literature.The main outcome measures were pregnancy rate,interval between pregnancy and surgery,uterine rupture rate,postpartum hemorrhage,abortion rate,preterm birth rate and complications during pregnancy.The software Rev Man 5.3 is used to analyze the relevant data and data extracted.Results: A total of 30 literatures were included,including 20 cohort studies and 10 randomized controlled trials(RCTs),with a total of 3767 patients.The results of meta-analysis showed that the time of operation was lower than that of open group [MD =3.47,95% CI(0.64?6.30),P =0.02] and postpartum hemorrhage were lower than that of open group [OR =1.95,95% CI(1.04?3.68),P =0.04].However,the incidence of uterine rupture in open group was significantly lower than that in laparoscopic group [OR =039,9] 5% CI(0.17 to 0.87),P =0.02],and the difference was statistically significant.Postoperative pregnancy rate [OR =0.87,95% CI(0.74-0.04),P =0.12],abortion rate [OR =1.12,95% CI(0.80-1.56),P =0.51],preterm birth rate [OR =1.37,95% CI(0.88-2.14),P =0.16],caesarean section rate [OR =0.84,95% CI(0.56-1.26),P =0.39],postoperative pregnancy and The incidence of complications [OR =1.73,95% CI(0.94-3.16),P =0.08] was not statistically significant between the open and laparoscopic groups.Conclusion: The present evidence shows that the time of postpartum hemorrhage after hysteromyomectomy is lower than that of open group,but the risk of uterine rupture during pregnancy is higher than that of open group.the difference between the two groups was not statistically significant regarding its postoperative pregnancy rate,abortion rate,preterm birth rate,cesarean section rate and the incidence of complications during pregnancy.Because the quality of the research included in this study is not very high,the results need more forward-looking high-quality research to provide reference.