Nakamura Kohei, Nakayama Kentaro, Sanuki Kaori, Minamoto Toshiko, Ishibashi Tomoka, Sato Emi, Yamashita Hitomi, Ishikawa Masako, Kyo Satoru
Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 6938501, Japan.
Oncol Lett. 2017 Dec;14(6):7783-7790. doi: 10.3892/ol.2017.7208. Epub 2017 Oct 18.
This study aimed to describe the long-term outcomes of patients with menorrhagia treated with microwave endometrial ablation (frequency, 2.45 GHz), as well as to identify factors associated with recurrence or re-surgery. This retrospective cohort study was conducted from 2007 to 2015 at Shimane University Hospital in Japan. Patients with severe menorrhagia and a desire to preserve their uterus were included in the study. Clinical factors associated with recurrence of menorrhagia or re-surgery were analyzed with a multivariable logistic regression model. Of 160 microwave endometrial ablation candidates, 100 had uterine myomas, 20 adenomyosis, 26 functional excessive menstruation, and 12 endometrial polyps. In the full cohort, age (<40) and uterine cavity length (≥10) were associated with recurrence of menorrhagia and re-surgery. Among patients with myomas, age (<48) and number of myomas (≥4) were associated with recurrence, and largest myoma size (≥5) and preoperative hemoglobin level (<9 mg/dl) were associated with re-surgery. Among subjects with adenomyosis, uterine cavity length (≥10) was associated with recurrence. Microwave endometrial ablation is thought to be a highly efficacious method to control menorrhagia caused by functional bleeding and endometrial polyps. However, microwave endometrial ablation may be less effective for patients younger than 48 years with myomas, especially those with 4 or more myomas, or with a myoma 5 cm or larger in size, and for patients with adenomyosis who have a thickened myometrium. These clinical factors may be useful predictors of success in selecting candidates for microwave endometrial ablation.
本研究旨在描述接受微波子宫内膜切除术（频率2.45 GHz）治疗的月经过多患者的长期预后，并确定与复发或再次手术相关的因素。这项回顾性队列研究于2007年至2015年在日本岛根大学医院进行。研究纳入了患有严重月经过多且希望保留子宫的患者。采用多变量逻辑回归模型分析与月经过多复发或再次手术相关的临床因素。在160名微波子宫内膜切除术候选者中，100人患有子宫肌瘤，20人患有子宫腺肌病，26人患有功能性月经过多，12人患有子宫内膜息肉。在整个队列中，年龄（<40岁）和子宫腔长度（≥10 cm）与月经过多复发和再次手术相关。在子宫肌瘤患者中，年龄（<48岁）和肌瘤数量（≥4个）与复发相关，最大肌瘤大小（≥5 cm）和术前血红蛋白水平（<9 mg/dl）与再次手术相关。在子宫腺肌病患者中，子宫腔长度（≥10 cm）与复发相关。微波子宫内膜切除术被认为是控制功能性出血和子宫内膜息肉引起的月经过多的一种高效方法。然而，微波子宫内膜切除术对于年龄小于48岁的子宫肌瘤患者可能效果较差，尤其是那些有4个或更多肌瘤、或肌瘤大小为5 cm或更大的患者，以及子宫肌层增厚的子宫腺肌病患者。这些临床因素可能是选择微波子宫内膜切除术候选者成功与否的有用预测指标。
