Journal of minimally invasive gynecology · 2013
Ultrasound-guided percutaneous microwave ablation for submucosal uterine fibroids.
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Yang Yu, Zhang Jing, Han Zhi-yu, Yu Ming-an, Ma Xia, Zhou Hong-yu, Hao Yan-li, Zhao Lan, Dong Xue-juan, Ge Hai-long
Аннотация
STUDY OBJECTIVE: To prospectively evaluate the efficiency and safety of ultrasound-guided percutaneous microwave ablation (PMWA) in treating symptomatic submucosal uterine myomas.
DESIGN: Self-controlled study (Canadian Task Force classification II-1).
SETTING: Single center.
PATIENTS: Twenty-two premenopausal women with 22 symptomatic submucosal uterine myomas.
INTERVENTION: All patients underwent ultrasound-guided PMWA.
MEASUREMENTS AND MAIN RESULTS: PMWA was performed in 22 premenopausal women with 22 symptomatic submucosal uterine myomas. Mean (SD) patient age was 42 (4.60) years (95% confidence interval [CI], 39.96-44.04). Five symptomatic submucosal uterine myomas were identified as type 0, 7 as type 1, and 10 as type 2. Contrast-enhanced ultrasound and magnetic resonance imaging were performed before and after surgery. Myoma volume, hemoglobin concentration, and scores on the UFS-QOL (Uterine Fibroid Symptom and Quality of Life) questionnaire were recorded before and at 3 and 12 months after ablation. Complications were also recorded. In all patients, therapy was completed with a single ablation. The baseline diameter of the symptomatic submucosal uterine myomas was 4.90 (1.60) cm. Mean myoma volume reduction rate was 81.46% (16.33%) (95% CI, 73.06%-89.86%) at 3 months (p < .001) and reached 90.00% (9.79%) (95% CI, 85.07-95.13) at 12 months (p < .001). At 3 months after ablation, hemoglobin concentration increased from 88.64 (21.87) g/L (95% CI, 78.94-98.34) to 123.21 (15.77) g/L (95% CI, 115.10-131.32) (p < .001), and remained stable at 12 months, with a value of 125.92 (14.90) g/L (95% CI, 117.98-133.86). Scores on the UFS-QOL were comparable, with normal levels observed at 1 year. No major complications were observed. Nine patients were discharged with necrotic masses.
CONCLUSION: PMWA seems to be effective and safe for treatment of submucosal myomas.
DESIGN: Self-controlled study (Canadian Task Force classification II-1).
SETTING: Single center.
PATIENTS: Twenty-two premenopausal women with 22 symptomatic submucosal uterine myomas.
INTERVENTION: All patients underwent ultrasound-guided PMWA.
MEASUREMENTS AND MAIN RESULTS: PMWA was performed in 22 premenopausal women with 22 symptomatic submucosal uterine myomas. Mean (SD) patient age was 42 (4.60) years (95% confidence interval [CI], 39.96-44.04). Five symptomatic submucosal uterine myomas were identified as type 0, 7 as type 1, and 10 as type 2. Contrast-enhanced ultrasound and magnetic resonance imaging were performed before and after surgery. Myoma volume, hemoglobin concentration, and scores on the UFS-QOL (Uterine Fibroid Symptom and Quality of Life) questionnaire were recorded before and at 3 and 12 months after ablation. Complications were also recorded. In all patients, therapy was completed with a single ablation. The baseline diameter of the symptomatic submucosal uterine myomas was 4.90 (1.60) cm. Mean myoma volume reduction rate was 81.46% (16.33%) (95% CI, 73.06%-89.86%) at 3 months (p < .001) and reached 90.00% (9.79%) (95% CI, 85.07-95.13) at 12 months (p < .001). At 3 months after ablation, hemoglobin concentration increased from 88.64 (21.87) g/L (95% CI, 78.94-98.34) to 123.21 (15.77) g/L (95% CI, 115.10-131.32) (p < .001), and remained stable at 12 months, with a value of 125.92 (14.90) g/L (95% CI, 117.98-133.86). Scores on the UFS-QOL were comparable, with normal levels observed at 1 year. No major complications were observed. Nine patients were discharged with necrotic masses.
CONCLUSION: PMWA seems to be effective and safe for treatment of submucosal myomas.