Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. sun.aijun10@ gmail.com
Chin Med J (Engl). 2011 May;124(9):1322-6.
Adenomyoma is a very serious disease which influence the quality of life and leads to the infertility, and hysterectomy at the end. Unfortunetly, we still have no effective way to treat this kind of diseases. This study was aimed to evaluate the efficacy and surgical characteristics of modified adenomyomectomy.
This is a retrospective study and the subjects were collected in the past 5 years. We divided the subjects by the two different surgical procedures. Cases of adenomyoma patients who underwent conservative surgery, modified adenomyomectomy or wedge resection of the adenomyoma lesion were distributed to two groups retrospectively. Surgical characteristics, symptom relief, and recurrence were analysed in each group.
General characteristics, including operation time, blood loss, and postoperative complication were similar in both groups. In the modified adenomyometomy group, the median follow-up time was 27.6 months and the rate of relief of dysmenorrhea and menorrhagia symptoms were 91.2% and 40.0%, respectively. In the wedge resection group, the rate of reliefe of dysmenorrhea and menorrhagia symptoms were 88.9% and 50.0%, respectively. Patients in both groups had statistically significant symptom relief, but there was no statistical difference between them. During the following time, ultrasonography relapse rate in modified modified adenomyomectomy group is significantly lower than the wedge resection group 15.0% vs. 69.2% (P < 0.001). The relapse rate, in terms of symptoms, was 5.0% in the modified adenomyomectomy group, which was similar to the relapse rate in the wedge resection group. In terms of reproductive outcome, 33.3% of the patients with infertility complications in the modified adenomyomectomy group became pregnant. Among them, the rate of pregnancy by assisted reproductive techniques was 45.5%, which was significantly higher than the rate of natural pregnancy, 23.1% (P = 0.039).
Modified adenomyomectomy appears to be a safe and effective operative method that shows advantages in reducing the rate of relapse after surgery.
子宫腺肌瘤是一种非常严重的疾病，会影响生活质量并导致不孕，最终需要进行子宫切除术。不幸的是，我们目前仍然没有有效的治疗方法。本研究旨在评估改良子宫腺肌瘤切除术的疗效和手术特点。
这是一项回顾性研究，研究对象为过去 5 年内收集的病例。我们根据两种不同的手术方式将研究对象分为两组。回顾性地将接受保守手术、改良子宫腺肌瘤切除术或子宫腺肌瘤病灶楔形切除术的子宫腺肌瘤患者病例分配到两组中。对两组患者的手术特点、症状缓解情况和复发情况进行分析。
两组患者的一般特征，包括手术时间、出血量和术后并发症，均相似。改良子宫腺肌瘤切除术组的中位随访时间为 27.6 个月，痛经和月经过多症状缓解率分别为 91.2%和 40.0%。楔形切除术组的痛经和月经过多症状缓解率分别为 88.9%和 50.0%。两组患者的症状缓解均有统计学意义，但两组之间无统计学差异。在随后的时间里，改良改良子宫腺肌瘤切除术组的超声复发率明显低于楔形切除术组（15.0%对 69.2%，P < 0.001）。改良子宫腺肌瘤切除术组的症状复发率为 5.0%，与楔形切除术组相似。在生育结局方面，改良子宫腺肌瘤切除术组中 33.3%的不孕并发症患者怀孕。其中，辅助生殖技术受孕率为 45.5%，明显高于自然受孕率 23.1%（P = 0.039）。
改良子宫腺肌瘤切除术是一种安全有效的手术方法，在降低术后复发率方面具有优势。
