Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan.
Department of Obstetrics and Gynecology, Tokai University, Kanagawa, Japan.
J Obstet Gynaecol. 2022 Jul;42(5):1211-1216. doi: 10.1080/01443615.2021.1945011. Epub 2021 Sep 23.
The aim of this study was to evaluate temporal changes in endometrial blood flow after laparoscopic myomectomy (LM). Nineteen infertile women with uterine fibroids who underwent LM were included. The uterine radial artery resistance index (RA-RI) and recovery index were measured before and at 1 week and 3 months after LM. The median RA-RI at 1 week but not 3 months after LM was significantly higher than before. The median recovery indexes at 1 week and 3 months after LM were 14.3% and 1.3%, respectively. Although there was no significant correlation between the patient's age and recovery index at 1 week ( = 0.28, = .24) after LM, a moderately significant correlation was observed at 3 months ( = 0.54, = .002). In conclusion, the endometrial blood flow after LM changed over time, and recovery of blood flow was negatively correlated with patient age.IMPACT STATEMENT Uterine blood flow is important for wound healing after myomectomy, but no studies have evaluated endometrial blood flow after myomectomy. The endometrial blood flow impedance of RA-RI increased after LM and returned to before surgery at 3 months postoperatively. RA-RI recovery index negatively correlated with patient age. The changes in endometrial blood flow impedance after myomectomy suggest that endometrial blood flow may be involved in wound healing at the enucleation site. The impairment of endometrial blood flow recovery after myomectomy due to increased age may provide a rationale for individualised wound healing after myomectomy. The measurement of endometrial blood flow may be useful in personalising the assessment of the waiting period for pregnancy after myomectomy.
本研究旨在评估腹腔镜子宫肌瘤剔除术（LM）后子宫内膜血流的时间变化。纳入了 19 例因子宫肌瘤而不孕的妇女，她们均接受了 LM。手术前、术后 1 周和 3 个月测量子宫放射状动脉阻力指数（RA-RI）和恢复指数。术后 1 周的 RA-RI 中位数高于术前，但术后 3 个月则无差异。术后 1 周和 3 个月的恢复指数中位数分别为 14.3%和 1.3%。尽管患者年龄与术后 1 周的恢复指数之间无显著相关性（ = 0.28， = 0.24），但与术后 3 个月的相关性较强（ = 0.54， = 0.002）。总之，LM 后子宫内膜血流随时间发生变化，血流恢复与患者年龄呈负相关。
IMPACT 陈述：子宫肌瘤剔除术后子宫血流对伤口愈合很重要，但目前尚无研究评估子宫肌瘤剔除术后的子宫内膜血流。RA-RI 的子宫内膜血流阻抗在 LM 后增加，并在术后 3 个月恢复到术前水平。RA-RI 恢复指数与患者年龄呈负相关。子宫肌瘤剔除术后子宫内膜血流阻抗的变化表明，子宫内膜血流可能参与了剔除部位的伤口愈合。由于年龄增加导致的子宫肌瘤剔除术后子宫内膜血流恢复受损，可能为个体化子宫肌瘤剔除术后的伤口愈合提供依据。子宫内膜血流的测量可能有助于个体化评估子宫肌瘤剔除术后妊娠等待期。
