Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan-Mar;7(1):10-15.
doi: 10.4103/GMIT.GMIT_11_17. Epub 2018 Feb 16.

The Changes of Surgical Treatment for Symptomatic Uterine Myomas in the Past 15 Years

Weihong Yang  1   2 , Ning Luo  1   2 , Lishan Ma  2   3 , Hong Dai  2   3 , Zhongping Cheng  1   2
Affiliations

The Changes of Surgical Treatment for Symptomatic Uterine Myomas in the Past 15 Years

Weihong Yang et al. Gynecol Minim Invasive Ther. 2018 Jan-Mar.

Abstract

Study objective: The aim of this study is to elaborate the changes of the surgical approach of treatment for uterine myomas in Yangpu Hospital in the past 15 years.

Design: This was retrospective cohort study.

Setting: Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.

Materials and methods: A total of 4113 patients with symptomatic uterine myomas underwent surgical treatments. Interventions: Eight kinds of different surgeries were involved in the study, including abdominal or laparoscopic surgery, hysterectomy, or uterus-sparing myomectomy.

Measurements: The study collected patients' clinical data and reviewed surgical access and approach, complications, and the results of following up.

Results: A total of 1559 cases (37.9%) underwent uterus-sparing myomectomy, 3005 cases (73.1%) performed laparoscopic surgeries. The percentage of laparoscopic surgery was significantly higher than homochronous data of laparotomy after 2003 (P < 0.001). The per year total of uterus-reserved surgery was proved to be negatively correlated with patient's age (R2 = 0.930; P < 0.001). The rate of myomas recurrence was significantly lower in the combined myomectomy and uterine artery occlusion group (4%, 34/910) than in the single myomectomy group (10.5%, 44/420) (P < 0.001).

Conclusions: Retaining uterus and minimally invasive surgery were the important trends of surgical treatment for symptomatic uterine myomas. Laparoscopic uterus-sparing myomectomy may be an alternative to hysterectomy to manage to appropriate patients with uterine myomas.

Keywords: Laparoscopic uterine artery occlusion; laparoscopy; surgical management; uterine myomas; uterus-sparing myomectomy.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The flow path of surgical approach. CISH: Classic intrafascial supracervical hysterectomy, LM: Laparoscopic myomectomy, LAM: Laparoscopic uterine artery occlusion combined with myomectomy, LAVH: Laparoscopic assisted transvaginal hysterectomy, TAH: Total abdominal hysterectomy, SAH: Subtotal abdominal hysterectomy, AM: Abdominal myomectomy, AAM: Abdominal uterine artery occlusion combined with myomectomy. Y: Yes, N: No
Figure 2
Figure 2
The rates of surgical access (laparotomy or laparoscopy) and surgical approach (hysterectomy or myomectomy)
Figure 3
Figure 3
The proportion of different surgical approach in different age of groups
Figure 4
Figure 4
Comparing of the risk of recurrence between UAO combined with myomectomy group and single myomectomy group. UAO: Uterine artery occlusion
See this image and copyright information in PMC

References

    1. Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005;48:312–24. - PubMed
    1. Wallach EE, Vlahos NF. Uterine myomas: An overview of development, clinical features, and management. Obstet Gynecol. 2004;104:393–406. - PubMed
    1. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–7. - PubMed
    1. Bulun SE. Uterine fibroids. N Engl J Med. 2013;369:1344–55. - PubMed
    1. Vilos GA, Allaire C, Laberge PY, Leyland N Special Contributors. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015;37:157–78. - PubMed