1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Fertil Steril. 2014 Feb;101(2):472-87. doi: 10.1016/j.fertnstert.2013.10.025. Epub 2013 Nov 26.
To review systematically the literature on uterus-sparing surgical treatment options for adenomyosis.
Systematic literature review.
Tertiary academic center.
PATIENT(S): Women with histologically proven adenomyosis treated with uterus-sparing surgical techniques.
INTERVENTION(S): Conservative uterine-sparing surgery for adenomyosis classified as (1) complete excision of adenomyosis, (2) cytoreductive surgery or incomplete removal of the lesion, or (3) nonexcisional techniques, with studies selected if women with adenomyosis were treated surgically without performing hysterectomy.
MAIN OUTCOME MEASURE(S): The cure rate after interventional strategies, the rate of symptom (dysmenorrhea and menorrhagia) control, and pregnancy rate in each group of intervention.
RESULT(S): A quality assessment tool was used to assess the scientific value of each study. In total, 64 studies dealing with 1,049 patients were identified. After complete excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 82.0%, 68.8%, and 60.5%, respectively. After partial excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 81.8%, 50.0%, and 46.9%, respectively.
CONCLUSION(S): Uterine-sparing operative treatment of adenomyosis and its variants appear to be feasible and efficacious. Well-designed, comparative studies are urgently needed to answer the multiple questions arising from this intriguing intervention.
系统回顾关于子宫腺肌病保留子宫的手术治疗选择的文献。
系统文献回顾。
三级学术中心。
经组织学证实的子宫腺肌病患者，采用保留子宫的手术技术治疗。
保守性子宫腺肌病保留子宫手术分为（1）完全切除子宫腺肌病，（2）减瘤手术或不完全切除病变，或（3）非切除术技术，如果患有子宫腺肌病的女性在不进行子宫切除术的情况下接受手术治疗，则选择研究。
干预策略后的治愈率、症状（痛经和月经过多）控制率以及每组干预措施的妊娠率。
使用质量评估工具评估了每项研究的科学价值。共确定了 64 项涉及 1049 名患者的研究。完全切除后，痛经缓解率、月经过多控制率和妊娠率分别为 82.0%、68.8%和 60.5%。部分切除后，痛经缓解率、月经过多控制率和妊娠率分别为 81.8%、50.0%和 46.9%。
子宫腺肌病及其变体的保留子宫手术治疗似乎是可行和有效的。迫切需要设计良好的比较研究来回答这一引人入胜的干预措施所带来的多个问题。
