Department of Obstetrics and Gynecology, Spedali Civili of Brescia, 25123 Brescia, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.
Medicina (Kaunas). 2021 Jan 21;57(2):92. doi: 10.3390/medicina57020092.
: Cervical leiomyomas are a rare benign disease. Although they are mainly treated surgically, currently, there is not a standardized treatment for cervical leiomyomas. This study aims to summarize current literature evidence about treatment options for cervical leiomyomas. : A systematic research of the literature was conducted in Scopus, PubMed/MEDLINE, ScienceDirect, and the Cochrane Library, including observational prospective and retrospective studies, case series and case reports. We collected data regarding studies related to treatment options for cervical leiomyomas, evaluating the following aspects: study design, population, treatment type, rate of surgical complications, and fertility outcome. : According to literature research, 38 articles were included. Among 214 patients, the weighted average age was 39.4 years-old; 23 patients were pregnant. Most of the leiomyomas (78%) were extracervical; in 22% of cases (29 patients) were intracervical; 188 patients (88%) received surgical treatment, 6 (3%) received exclusive conservative management and 21 (10%) underwent interventional radiology treatment. One hundred twenty-seven patients (67.5%) underwent myomectomy, while 54 (28.7%) and 7 (3.7%) hysterectomy and trachelectomy, respectively. Cervical myomectomy was performed by open surgery in 21 out of 127 cases (16.5%), while in 92 (72.4%) and 6 (4.7%) patients the surgical approach was performed by traditional and robot-assisted laparoscopy, respectively. The total rate of surgical complications was 5.6%. : Surgery is the primary therapeutic option for cervical leiomyomas with a low rate of surgical complications. Interventional radiology techniques have reported promising but still limited results.
子宫平滑肌瘤是一种罕见的良性疾病。尽管它们主要通过手术治疗，但目前对于子宫平滑肌瘤还没有标准化的治疗方法。本研究旨在总结目前关于子宫平滑肌瘤治疗选择的文献证据。
我们在 Scopus、PubMed/MEDLINE、ScienceDirect 和 Cochrane 图书馆中进行了系统的文献研究，包括观察性前瞻性和回顾性研究、病例系列和病例报告。我们收集了与子宫平滑肌瘤治疗选择相关的研究数据，评估了以下方面：研究设计、人群、治疗类型、手术并发症发生率和生育结局。
根据文献研究，共纳入 38 篇文章。在 214 名患者中，加权平均年龄为 39.4 岁；23 名患者怀孕。大多数平滑肌瘤（78%）位于宫颈外；22%（29 名患者）位于宫颈内；188 名患者（88%）接受了手术治疗，6 名（3%）接受了单纯保守治疗，21 名（10%）接受了介入放射治疗。127 名患者（67.5%）接受了子宫肌瘤切除术，54 名（28.7%）和 7 名（3.7%）分别接受了子宫切除术和宫颈切除术。127 例子宫肌瘤切除术中有 21 例（16.5%）采用开放性手术，92 例（72.4%）和 6 例（4.7%）分别采用传统腹腔镜和机器人辅助腹腔镜手术。手术并发症总发生率为 5.6%。
手术是治疗子宫平滑肌瘤的主要选择，手术并发症发生率低。介入放射技术报告了有前途但仍有限的结果。
