Ahmad Farooq, Khan Ayesha Islam, Asif Aiza, Ahmed Sophia, Nisar Mudasar, Fatima Eman, Khan Faryal, Razzaq Anza, Tahir Asma, Khalid Abdur Rehman, Azeemuddin Muhammad
Department of Medicine, Allama Iqbal Medical College, Quaid-i-Azam Campus, Allama Shabbir Usmani Road, Lahore, Punjab 54700, Pakistan.
Department of Medicine, Allama Iqbal Medical College, Quaid-i-Azam Campus, Allama Shabbir Usmani Road, Lahore, Punjab 54700, Pakistan.
Eur J Obstet Gynecol Reprod Biol. 2025 Jun;310:113954. doi: 10.1016/j.ejogrb.2025.113954. Epub 2025 Apr 5.
The objective of this systematic review and meta-analysis was to assess the clinical efficacy of percutaneous microwave ablation (PMWA) therapy for treating uterine fibroids and to explore regional variations in its effectiveness.
PubMed, Google Scholar, and CochraneLibrary were searched using keywords such as "leiomyoma," "fibroid," and "microwave ablation" to identify clinical trials and observational studies involving women with symptomatic uterine fibroids treated with PMWA therapy. Data on the outcomes of symptom severity, quality of life, fibroid volume, and hemoglobin concentration were extracted to calculate weighted mean differences (WMD) with 95% confidence intervals. Subgroup analyses based on study type and location were conducted. The quality and risk of bias of the included studies were evaluated using the National Institutes of Health quality assessment tools. Heterogeneity was assessed using Higgins I statistics.
Out of 1,068 initial records, 14 studies comprising 754 patients with symptomatic uterine fibroids were included. There was a significant reduction in symptom severity (WMD = -33.3; 95 %CI: -41.16, -25.46; p < 0.001; I = 99 %) and fibroid volume (WMD = -89.26 cm; 95 % CI: -130.64, -47.87; p < 0.01; I = 99 %)., along with a significant improvement in quality of life (WMD = 27.21; 95 % CI:21.70,32.72; p < 0.01; I = 91 %) and hemoglobin concentration (WMD = 3.20 g/dl; 95 %CI:2.71,3.69; p < 0.01;I = 83 %). Subgroup analysis identified study location as a significant moderator for fibroid volume reduction, with Asian studies showing a greater decrease than European studies.
The analysis suggests that PMWA therapy is an efficacious treatment for uterine fibroids, with consistent outcomes in both Asian and European populations. However, high heterogeneity among the included studies limits the interpretation of results.
本系统评价和荟萃分析的目的是评估经皮微波消融（PMWA）治疗子宫肌瘤的临床疗效，并探讨其有效性的区域差异。
使用“平滑肌瘤”“肌瘤”和“微波消融”等关键词在PubMed、谷歌学术和考克兰图书馆进行检索，以识别涉及接受PMWA治疗的有症状子宫肌瘤女性的临床试验和观察性研究。提取症状严重程度、生活质量、肌瘤体积和血红蛋白浓度等结局数据，计算加权平均差（WMD）及95%置信区间。基于研究类型和地点进行亚组分析。使用美国国立卫生研究院质量评估工具评估纳入研究的质量和偏倚风险。使用希金斯I统计量评估异质性。
在1068条初始记录中，纳入了14项研究，共754例有症状子宫肌瘤患者。症状严重程度（WMD = -33.3；95%CI：-41.16，-25.46；p < 0.001；I = 99%）和肌瘤体积（WMD = -89.26 cm；95%CI：-130.64，-47.87；p < 0.01；I = 99%）显著降低，生活质量（WMD = 27.21；95%CI：21.70，32.72；p < 0.01；I = 91%）和血红蛋白浓度（WMD = 3.20 g/dl；95%CI：2.71，3.69；p < 0.01；I = 83%）显著改善。亚组分析确定研究地点是肌瘤体积缩小的显著调节因素，亚洲研究显示的缩小幅度大于欧洲研究。
分析表明，PMWA治疗子宫肌瘤有效，在亚洲和欧洲人群中结果一致。然而，纳入研究间的高度异质性限制了结果的解释。
