Meng Tingzhu, Cheng Shiyu, Li Xin, Gao Han, Li Yanli, Du Mei, Shi Jie
Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medical College, Wuhan University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41697. doi: 10.1097/MD.0000000000041697.
At present, there is unclear on the risk factors of recurrence after myomectomy. In this study, we hope to provide reference for the choice of treatment for patients with uterine fibroids and provide basis for the subsequent prediction of recurrence. From October 2020 to October 2022, we enrolled 240 patients with uterine fibroids in Hubei Maternal and Child Health Hospital. According to the inclusion criteria, the collected clinical data of these patients were analyzed and divided into 2 groups according to whether there was recurrence 6 months after surgery(a recurrence group [52 cases] and a non-recurrence group [78 cases]). We compared and analyzed the relevant factors. Univariate analysis showed that there was no significant relationship between fibroid diameter, postoperative pregnancy, contraceptive method, hyperlipidemia, diabetes, endometriosis and postoperative recurrence (P > .05). While, age, number of pregnancies, number of fibroids, type of fibroids, body mass index, endometrial hyperplasia or endometrial polyp were significantly correlated with postoperative recurrence (P < .05). Multivariate Logistic regression analysis demonstrated that body mass index > 24, number of pregnancies > 2, multiple myoma, intermyoma and endometrial hyperplasia were independent risk factors for postoperative myoma recurrence (P < .05). Body mass index > 24, number of pregnancies > 2, multiple fibroids, intermyowall fibroids, and endometrial hyperplasia are all independent risk factors for recurrence after laparoscopic myomectomy in patients with uterine fibroids. Patients with these independent risk factors should be closely reviewed. If they have multiple independent risk factors and have no fertility requirements are present, hysterectomy may be recommended.
目前,子宫肌瘤剔除术后复发的危险因素尚不清楚。在本研究中,我们希望为子宫肌瘤患者的治疗选择提供参考,并为后续复发预测提供依据。2020年10月至2022年10月,我们纳入了湖北省妇幼保健院的240例子宫肌瘤患者。根据纳入标准,对这些患者收集的临床资料进行分析,并根据术后6个月是否复发分为2组(复发组[52例]和未复发组[78例])。我们对相关因素进行了比较和分析。单因素分析显示,肌瘤直径、术后妊娠、避孕方法、高脂血症、糖尿病、子宫内膜异位症与术后复发之间无显著关系(P>0.05)。而年龄、妊娠次数、肌瘤数量、肌瘤类型、体重指数、子宫内膜增生或子宫内膜息肉与术后复发显著相关(P<0.05)。多因素Logistic回归分析表明,体重指数>24、妊娠次数>2、多发性肌瘤、肌壁间肌瘤和子宫内膜增生是术后肌瘤复发的独立危险因素(P<0.05)。体重指数>24、妊娠次数>2、多发性肌瘤、肌壁间肌瘤和子宫内膜增生均是子宫肌瘤患者腹腔镜肌瘤剔除术后复发的独立危险因素。具有这些独立危险因素的患者应密切复查。如果他们有多个独立危险因素且无生育要求,可建议行子宫切除术。