Tang Shiwei, Kong Mingxin, Zhao Xinjian, Chen Jun, Wang Chen, Zhang Haibin, Wang Zhongmin
Department of Interventional Radiology, Weifang People's Hospital, Shandong 261000, China.
Department of Interventional Radiology, The Frist Affiliated Hospital of the MedicalCollege of Shihezi University, Xinjiang, 832000, China.
J Interv Med. 2019 Apr 30;1(2):112-120. doi: 10.19779/j.cnki.2096-3602.2018.02.10. eCollection 2018 May.
The aim of this study was to systematically review the safety and efficacy of uterine artery embolization (UAE) versus surgery for symptomatic uterine fibroids. An electronic search of the Cochrane Library, PubMed, Embase and Web of Science databases was conducted from their inception to May 2017 for randomized controlled trials (RCTs) that assessed UAE versus surgery for the treatment of symptomatic uterine fibroids. The references of the included studies were also retrieved. Two reviewers independently screened the studies based on the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. The meta-analysis was conducted using RevMan 5.3 software. A total of seven RCTs involving 859 patients were included. The results of the meta-analysis showed a shorter hospital stay and recovery time for UAE as compared to surgery. Surgery was not reported to be better for improving health-related quality of life in any of the included studies. There were no significant differences in patient satisfaction (1-2 and 5 years), and intra-procedural complications or major complications (1 year). However, the rates of minor complications (1 year) and further interventions (2 and 5 years) were significantly higher in patients who underwent UAE rather than surgery. The rates of pregnancy and live births were significantly lower among patients who underwent UAE than surgery. UAE is safe and effective, and has the advantages of shorter hospital stay and recovery time as compared to surgery. However, UAE has the risk of re-intervention, and lower pregnancy and live birth rates.
本研究旨在系统评价子宫动脉栓塞术（UAE）与手术治疗症状性子宫肌瘤的安全性和有效性。从Cochrane图书馆、PubMed、Embase和Web of Science数据库建库起至2017年5月进行电子检索，以查找评估UAE与手术治疗症状性子宫肌瘤的随机对照试验（RCT）。还检索了纳入研究的参考文献。两名研究者根据纳入和排除标准独立筛选研究、提取数据并评估方法学质量。使用RevMan 5.3软件进行荟萃分析。共纳入7项涉及859例患者的RCT。荟萃分析结果显示，与手术相比，UAE的住院时间和恢复时间更短。在所纳入的任何研究中，均未报告手术在改善健康相关生活质量方面更具优势。患者满意度（1 - 2年和5年）、术中并发症或主要并发症（1年）方面无显著差异。然而，接受UAE而非手术的患者轻微并发症（1年）和进一步干预（2年和5年）的发生率显著更高。接受UAE的患者妊娠率和活产率显著低于手术患者。UAE安全有效，与手术相比具有住院时间和恢复时间更短的优势。然而，UAE存在再次干预的风险，且妊娠率和活产率较低。
