Six RCTs were included in the review (n=576 patients); five RCTs were considered to be high quality. Follow-up ranged from six months to 52 months.
Heterogeneity between studies was not statistically significant for any outcome, except for full recuperation at day 15 and postoperative pregnancy.
Meta-analysis of three RCTs (n=317 patients) showed that haemoglobin drop was significantly lower in the laparoscopic myomectomy group (WMD -1.07mg%, 95% CI -1.22 to -0.92) compared with the open myomectomy group.
Meta-analysis of two RCTs (n=80 patients) showed blood loss was significantly lower in the laparoscopic myomectomy group (WMD -34.12mL, 95% CI -58.64 to -9.60) compared with the open myomectomy group.
Meta-analysis of two RCTs (n=186 patients) showed that pain intensity (VAS score) was significantly lower in the laparoscopic myomectomy group (WMD -2.26, 95% CI -2.69 to -1.83) compared with the open myomectomy group.
Meta-analysis of four RCTs (n=357 patients) showed that operation time was significantly longer in the laparoscopic myomectomy group (WMD 13.28min, 95% CI 9.38 to 17.18) compared with the open myomectomy group.
In a narrative synthesis, the authors stated that the overall rate of patients recovered at day 15 was much higher in the laparoscopic myomectomy group compared with the open myomectomy group.
Meta-analysis of five RCTs (n=535 patients) showed that, overall, fewer complications were associated with laparoscopic myomectomy (OR 0.47, 95%CI 0.26 to 0.85) compared with the open myomectomy group, but there was no significant difference in the rate of major complications (two RCTs, n=279 patients).
There was no significant difference reported in the rate of recurrence (three RCTs, n=252 patients) or postoperative pregnancy (two RCTs, n=251 patients).
A funnel plot of trials reporting on operation time suggested minimal publication bias.