Laparoscopically assisted Adenomyomectomy Using the Double/Multiple-Flap Method with Temporary Occlusion of the Bilateral Uterine Artery and Utero-Ovarian Vessels in Comparison with the Double/Multiple-Flap Only Method
Autor: | Min Hu, Shunjie Zheng, Mingjun Shao, Dawei Cui, Limei Ji, Lanying Jin |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Visual analogue scale bilaterale Arteria uterina 03 medical and health sciences 0302 clinical medicine vorübergehende Okklusion medicine.artery Maternity and Midwifery medicine Operating time Adenomyosis GebFra Science uteroovarielle Gefäße Uterine artery Adenomyoma 030219 obstetrics & reproductive medicine business.industry temporary occlusion utero-ovarian vessels Obstetrics and Gynecology double/multiple flap Adenomyomektomie medicine.disease Surgery bilateral uterine artery Doppel-/Mehrfach-Lappen Ovarian vessels In utero 030220 oncology & carcinogenesis Original Article adenomyomectomy business Temporary occlusion |
Zdroj: | Geburtshilfe und Frauenheilkunde |
ISSN: | 1438-8804 0016-5751 |
Popis: | Introduction Adenomyomectomy is the most conservative surgical treatment for adenomyosis. However, the surgical efficacy of this treatment and the best approach to use are still debated. We aimed to evaluate the efficacy of laparoscopic adenomyomectomy using the double/multiple-flap method combined with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels to treat symptomatic adenomyosis. Patients We recruited 155 patients with symptomatic adenomyosis and divided them into group A (n = 76) and group B (n = 79), with each group treated using a different surgical approach. All eligible women were informed of the potential complications, benefits, and alternatives of each approach before they were assigned into one of the two groups. In group A, we performed laparoscopic adenomyomectomy with the double/multiple-flap method while in group B, we performed a double/multiple-flap adenomyomectomy combined with temporary occlusion of the bilateral uterine artery and utero-ovarian vessels. Over a 24-month follow-up period, we evaluated operating time, intraoperative blood loss, visual analog scale (VAS) scores, anti-Mullerian hormone levels, uterine volume, and relief of menorrhagia. Results There were no significant differences between groups A and B with respect to VAS scores, relief of menorrhagia and uterine volume at 3 months, 6 months, 12 months and 24 months after surgery (p > 0.05). Both groups showed significant improvement of these parameters after surgery compared with preoperative values (p 0.05). Levels of AMH did not differ significantly between the groups throughout the follow-up period (p > 0.05). Conclusion Laparoscopic adenomyomectomy with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels offers a feasible surgical option to treat symptomatic adenomyoma. |
Databáze: | OpenAIRE |
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