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. 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.

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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

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