Long-Term Efficacy of Laparoscopic or Robotic Adenomyomectomy with or without Medical Treatment for Severely Symptomatic Adenomyosis
Long-Term Efficacy of Laparoscopic or Robotic Adenomyomectomy with or without Medical Treatment for Severely Symptomatic Adenomyosis
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DOI：
10.1159/000441783
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发表时间：
2016-01-01
影响因子：
2.1
通讯作者：
Lee, Yoon Soon
中科院分区：
文献类型：
--
作者：
Chong, Gun Oh;Lee, Yoon Hee;Lee, Yoon Soon
背景/目的：确定腹腔镜或机器人子宫腺肌瘤切除术联合或不联合促性腺激素释放激素（GnRH）治疗严重症状性子宫腺肌病的长期疗效。方法：2008年8月至2011年5月期间，我们前瞻性观察了33例接受腹腔镜或机器人子宫腺肌瘤切除术联合子宫动脉结扎治疗症状性子宫腺肌病的患者。 17 名患者 (52%) 在子宫腺肌瘤切除术后接受了 3 疗程 GnRH 激动剂治疗。结果：平均手术时间为 147.4 +/- 52.0 分钟，平均失血量为 36.1 +/- 37.4 ml。 5例患者术后出现并发症，其中发热4例，肠梗阻1例，盆腔脓肿1例。在 3 年随访期间，患者的症状得到了统计学上显着的缓解。 33 名患者中有 4 名（12%）出现症状复发； 3例患者出现痛经复发，1例患者出现月经过多复发。仅手术治疗和手术药物治疗之间的治疗结果没有显着差异。结论：腹腔镜或机器人子宫腺肌瘤切除术对于症状严重且要求保留子宫的女性来说是可行且安全的。此外，无论术后是否给予 GnRH 激动剂，该手术都能提供长期的症状控制。 (C) 2016 S. Karger AG，巴塞尔
Background/Aims: To determine the long-term efficacy of laparoscopic or robotic adenomyomectomy with or without gonadotropin-releasing hormone (GnRH) for the treatment of severely symptomatic adenomyosis. Methods: Between August 2008 and May 2011, we prospectively observed 33 patients who underwent laparoscopic or robotic adenomyomectomy with uterine artery ligation for the treatment of symptomatic adenomyosis. Seventeen patients (52%) received 3-course GnRH agonist treatment after the adenomyomectomy. Results: The mean operating time was 147.4 +/- 52.0 min, and the mean blood loss was 36.1 +/- 37.4 ml. Postoperative complications occurred in 5 patients, including 4 cases of febrile morbidity, 1 case of ileus and 1 case of pelvic abscess. Patients had statistically significant symptom relief during the 3-year follow-up period. Four of the 33 patients (12%) showed symptom relapse; 3 patients showed a relapse with dysmenorrhea and 1 patient showed a relapse with menorrhagia. There were no significant differences in terms of therapeutic outcomes between surgical-only and surgical-medical treatment. Conclusion: Laparoscopic or robotic adenomyomectomy was feasible and safe for women with severely symptomatic adenomyosis who requested uterine preservation. Moreover, this procedure provided long-term symptom control, regardless of postoperative GnRH agonist administration. (C) 2016 S. Karger AG, Basel