open access

Vol 94, No 5 (2023)
Research paper
Published online: 2022-05-30
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A contrastive study on the clinical efficacy and safety oflaparoscopic myomectomy and high intensity focused ultrasound in the treatment of uterine fibroids

Yingqiang Ren1, Yutan Li1, Yuanfang Pu1
DOI: 10.5603/GP.a2022.0034
·
Pubmed: 35894494
·
Ginekol Pol 2023;94(5):358-365.
Affiliations
  1. Department of Gynecology, The People’s Hospital of Nanchuan, Chongqing, China

open access

Vol 94, No 5 (2023)
ORIGINAL PAPERS Gynecology
Published online: 2022-05-30

Abstract

Objectives: This study intended to compare the safety and clinical efficacy between two treatments of uterine fibroids: laparoscopic myomectomy (LM) and high intensity focused ultrasound (HIFU).
Material and methods: Clinical data were collected from 587 uterine fibroid patients who were treated in The People’s Hospital of Nanchuan, Chongqing from January 1, 2018 to December 31, 2019. Among the patients, 287 cases were treated with HIFU (observation group), and 300 cases were treated with LM (control group). The progression-free survival (PFS) was taken as the primary endpoint. The secondary endpoints included operation results (including operative time, intraoperative blood loss, and intraoperative fluid replacement), complications, hemoglobin level one month after surgery and clinical efficacy. In addition, the fibroid volume of the observation group before treatment and 3, 6, and 12 months after treatment were also analyzed.
Results: The operative time of observation group was evidently shortened compared to the control group, and the intraoperative blood loss and intraoperative fluid replacement of observation group were also considerably reduced (all p < 0.05), but there was no significant difference in the hemoglobin level between the two groups one month after surgery (p > 0.05). In terms of curative effect, the total effective rate of HIFU group and LM group was 98.6% (283/287) and 95.3% (286/300) respectively, with statistically significant difference (p < 0.05). In terms of complications, the incidence of bleeding and infection in HIFU group was obviously lower than that in LM group (both p < 0.05), while no significant differences were observed in the remaining complications (all p > 0.05). Fibroid volume comparisons before treatment
and 3, 6 and 12 months after operation in observation group showed that fibroid volume decreased significantly (all p < 0.05). The median follow-up time was 30.6 months. The mean PFS of patients in the observation group and control group was 29.71 months (95% CI 28.24–29.75) and 26.74 months (95% CI 26.49–28.33), respectively (HR 0.47; 95% CI, 0.29 to 0.76; Log-rank p = 0.0019).
Conclusions: HIFU could improve the intraoperative efficacy and reduce the complications of patients with uterine fibroids and has excellent performance in improving clinical efficacy and prolonging PFS. HIFU can be used as an alternative to surgical treatment.

Abstract

Objectives: This study intended to compare the safety and clinical efficacy between two treatments of uterine fibroids: laparoscopic myomectomy (LM) and high intensity focused ultrasound (HIFU).
Material and methods: Clinical data were collected from 587 uterine fibroid patients who were treated in The People’s Hospital of Nanchuan, Chongqing from January 1, 2018 to December 31, 2019. Among the patients, 287 cases were treated with HIFU (observation group), and 300 cases were treated with LM (control group). The progression-free survival (PFS) was taken as the primary endpoint. The secondary endpoints included operation results (including operative time, intraoperative blood loss, and intraoperative fluid replacement), complications, hemoglobin level one month after surgery and clinical efficacy. In addition, the fibroid volume of the observation group before treatment and 3, 6, and 12 months after treatment were also analyzed.
Results: The operative time of observation group was evidently shortened compared to the control group, and the intraoperative blood loss and intraoperative fluid replacement of observation group were also considerably reduced (all p < 0.05), but there was no significant difference in the hemoglobin level between the two groups one month after surgery (p > 0.05). In terms of curative effect, the total effective rate of HIFU group and LM group was 98.6% (283/287) and 95.3% (286/300) respectively, with statistically significant difference (p < 0.05). In terms of complications, the incidence of bleeding and infection in HIFU group was obviously lower than that in LM group (both p < 0.05), while no significant differences were observed in the remaining complications (all p > 0.05). Fibroid volume comparisons before treatment
and 3, 6 and 12 months after operation in observation group showed that fibroid volume decreased significantly (all p < 0.05). The median follow-up time was 30.6 months. The mean PFS of patients in the observation group and control group was 29.71 months (95% CI 28.24–29.75) and 26.74 months (95% CI 26.49–28.33), respectively (HR 0.47; 95% CI, 0.29 to 0.76; Log-rank p = 0.0019).
Conclusions: HIFU could improve the intraoperative efficacy and reduce the complications of patients with uterine fibroids and has excellent performance in improving clinical efficacy and prolonging PFS. HIFU can be used as an alternative to surgical treatment.

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Keywords

laparoscopic myomectomy; uterine fibroids; high intensity focused ultrasound; clinical efficacy; safety

About this article
Title

A contrastive study on the clinical efficacy and safety oflaparoscopic myomectomy and high intensity focused ultrasound in the treatment of uterine fibroids

Journal

Ginekologia Polska

Issue

Vol 94, No 5 (2023)

Article type

Research paper

Pages

358-365

Published online

2022-05-30

Page views

463

Article views/downloads

238

DOI

10.5603/GP.a2022.0034

Pubmed

35894494

Bibliographic record

Ginekol Pol 2023;94(5):358-365.

Keywords

laparoscopic myomectomy
uterine fibroids
high intensity focused ultrasound
clinical efficacy
safety

Authors

Yingqiang Ren
Yutan Li
Yuanfang Pu

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