Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis
Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis
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DOI：
10.1111/jog.12649
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发表时间：
2015-06-01
影响因子：
1.6
通讯作者：
Im, Kyong Shil
中科院分区：
文献类型：
--
作者：
Kwon, Yong-Soon;Roh, Hyun Jin;Im, Kyong Shil
AimThis study aims to determine the reasonable and safety of adenomyomomectomy with transmittance occlusion of uterine arteries（TOUA）in patients with symptomatic diffuse uterine adenomyosis.Material and MethodsTwenty-six patients with symptomatic diffuse uterine adenomyosis carried out adenomyomectomy with TOUA by a single surgeon at蔚山University Hospital between May 2011 and September 2012.手术结局包括手术时间、术中血管、神经和盆腔器官损伤以及手术失血量。我们评估的程度改善痛经和月经过多在4个月的后续完成后，辅助促性腺激素释放激素激动剂。ResultsThe患者的平均年龄为37.73岁（范围，27-49岁）。平均总手术时间为95.0分钟（范围，60- 145分钟; SD，34.49）。平均估计失血量为191.54 mL（范围，80- 400 mL; SD，110.91），无子宫动脉或盆腔神经损伤病例。TOUA平均时间为9.79min（范围，6- 16 min; SD，2.74）。平均住院时间为5.65天（范围，4-7天; SD，0.85）。在平均13.5个月的随访期内，没有需要再次手术或再次给药的重大并发症。在7个月的随访后，子宫腺肌瘤切除术与TOUA，痛经和月经过多完全缓解观察到在94.4%和100%的patients，respectively.ConclusionsAdenomyomectomy与TOUA可能是一种安全有效的手术方法，在妇女有症状的弥漫性子宫腺肌病，以保持生育能力。
AimThis study aimed to determine the feasibility and safety of adenomyomectomy with transient occlusion of uterine arteries (TOUA) in patients with symptomatic diffuse uterine adenomyosis.Material and MethodsTwenty-six patients with symptomatic diffuse uterine adenomyosis underwent adenomyomectomy with TOUA by a single surgeon at Ulsan University Hospital between May 2011 and September 2012. Surgical outcomes included operative time, intraoperative injury to blood vessels, nerves, and pelvic organs and operative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia at the 4-month follow-up after completion of adjuvant gonadotrophin-releasing hormone agonist.ResultsThe mean age of patients was 37.73 years (range, 27-49 years). The mean total surgical time was 95.0min (range, 60-145min; SD, 34.49). The mean estimated blood loss was 191.54mL (range, 80-400mL; SD, 110.91) and there were no cases of injury to the uterine arteries or pelvic nerves. The mean time of TOUA was 9.79min (range, 6-16min; SD, 2.74). The mean duration of hospital stay was 5.65 days (range, 4-7 days; SD, 0.85). There were no major complications requiring reoperation or readministration during the mean follow-up period of 13.5 months. At the 7-month follow-up after adenomyomectomy with TOUA, complete remission of dysmenorrhea and menorrhagia was observed in 94.4% and 100% of patients, respectively.ConclusionsAdenomyomectomy with TOUA could be a safe and effective surgical method in women with symptomatic diffuse uterine adenomyosis to preserve fertility.