Ustünsöz Bahri, Uğurel Mehmet Sahin, Bozlar Uğur, Duru Namik Kemal, Ustünsöz Ayfer
Department of Radiology, Gülhane Military Medical Academy, Ankara, Turkey.
Diagn Interv Radiol. 2007 Dec;13(4):210-2.
To determine whether uterine artery embolization (UAE) prior to myomectomy is more effective than myomectomy alone.
The study included 15 consecutive infertile women with uterine fibroids > 10 cm (Group I) that underwent UAE with spherical particles using a microcatheter technique and a unilateral femoral approach between March 2005 and January 2007. The day after embolization all cases underwent myomectomy since the protocol for large fibroids in our hospital is myomectomy only. The control group was composed of 15 patients who underwent myomectomy only (Group II). Group II was established based on fibroid size (14 +/- 3 cm). Operating time, estimated blood loss and transfusion, complications, and hospital stay were calculated by retrospective chart reviews, and comparisons were made between the groups with Student's t-test.
Mean operating time was 138 min in Group I and 240 minutes in Group II (P < 0.01). Mean estimated blood loss was 250 ml in Group I and 690 ml in Group II (P < 0.01). There was no need for transfusion in Group I, while transfusion was needed in 2 cases (13%) in Group II. Mean hospital stay in Group I was 5 days versus 8 days in Group II. Complications, including subsequent hysterectomy, were seen in 2 cases and bowel-bladder injuries in 1 case in Group II (a total of 20%), while no complications were observed in Group I. One of the cases in Group I later conceived and gave birth to a healthy child.
UAE prior to myomectomy is more effective than myomectomy alone.
确定子宫肌瘤切除术前行子宫动脉栓塞术（UAE）是否比单纯子宫肌瘤切除术更有效。
该研究纳入了15例连续的患有大于10 cm子宫肌瘤的不孕女性（I组），她们于2005年3月至2007年1月期间采用微导管技术和单侧股动脉入路，使用球形颗粒进行UAE。栓塞术后次日，所有病例均接受子宫肌瘤切除术，因为我院对于大肌瘤的治疗方案是仅行子宫肌瘤切除术。对照组由15例仅接受子宫肌瘤切除术的患者组成（II组）。II组根据肌瘤大小（14±3 cm）设立。通过回顾性病历审查计算手术时间、估计失血量和输血量、并发症及住院时间，并采用Student t检验对两组进行比较。
I组平均手术时间为138分钟，II组为240分钟（P<0.01）。I组平均估计失血量为250 ml，II组为690 ml（P<0.01）。I组无需输血，而II组有2例（13%）需要输血。I组平均住院时间为5天，II组为8天。II组有2例出现并发症，包括随后的子宫切除术，1例出现肠膀胱损伤（共20%），而I组未观察到并发症。I组中有1例患者后来受孕并产下一名健康婴儿。
子宫肌瘤切除术前行UAE比单纯子宫肌瘤切除术更有效。
