Comparison of Surgical Outcomes Between Single-Site Laparoscopic Adenomyomectomy and Fundusectomy: Experience from a Single Center

TL;DR

This study compares two minimally invasive surgeries for adenomyosis and finds that fundusectomy is more efficient and less blood-intensive than myomectomy.

Contribution

The study introduces and evaluates fundusectomy as a novel, uterus-sparing surgical technique for adenomyosis.

Findings

Fundusectomy had shorter operative time (158.19 min) compared to adenomyomectomy (179.11 min).

Fundusectomy resulted in significantly less blood loss (175.04 mL) than adenomyomectomy (347.97 mL).

Fundusectomy showed lower postoperative CA125 levels and smaller uterus size over 24 months.

Abstract

Objective: This study aimed to introduce clinical experience using a new surgical technique, single-port access laparoscopic fundusectomy, a more efficient uterus-sparing surgical method for adenomyosis in patients with no plans for pregnancy. Methods: We performed single-port access laparoscopic myomectomy in 141 patients and single-port access laparoscopic fundusectomy in 124 patients and compared the surgical outcomes. Results: Significant differences in surgical outcomes were observed between the two operating methods. Operative time was 158.19 min (±42.93) in the fundusectomy group and 179.11 min (±56.95) in the adenomyomectomy group (p = 0.001). Estimated blood loss was 175.04 mL (±142.76) in the fundusectomy group and 347.97 mL (±409.78) in the adenomyomectomy group (p = 0.000). The fundusectomy group showed smaller uterus size and volume, and lower postoperative CA125 levels than the adenomyomectomy group for 24 months (p = 0.000). Conclusions: This study suggests that single-port access laparoscopic fundusectomy is more effective in terms of operative time, estimated blood loss, and postoperative CA125 decrease than single-port access laparoscopic adenomyomectomy.

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