Weber A M, Munro M G
Cleveland Clinic Foundation, USA.
Medscape Womens Health. 1998 May;3(3):3.
Dysfunctional uterine bleeding (DUB) is a common clinical condition that frequently leads to hysterectomy. Endometrial ablation --a "minimally invasive" surgical technique that removes or destroys the endometrial lining of the uterus -- is a conservative alternative to hysterectomy for DUB. While endometrial ablation has lower immediate costs and shorter recovery than hysterectomy, symptoms are not always resolved. Available data from studies with admittedly incomplete follow-up suggest that up to one quarter of patients treated with endometrial ablation require repeat ablation or subsequent hysterectomy to stop DUB. This suggests that the short-term advantages of endometrial ablation may be offset by possible longer-term disadvantages. The Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB) is a randomized trial designed to compare endometrial ablation against hysterectomy. The primary outcomes address issues of importance to women, such as quality of life and resolution of symptoms that led to surgery. Other outcomes include subsequent surgery and cost-effectiveness of the procedures. The study's target enrollment is 800 women--400 in each treatment group -- from 20 clinical centers throughout the US. The women will be followed for 2 years after surgery. Part of the STOP-DUB is a parallel observational study that involves women who do not choose surgery or who are not eligible for the randomized trial but could become eligible with time. It is anticipated that the result of this research will provide important information to women and their health care professionals as they consider the relative merits of surgical treatments for DUB.
功能失调性子宫出血（DUB）是一种常见的临床病症，常导致子宫切除。子宫内膜消融术——一种“微创”手术技术，可去除或破坏子宫内膜——是治疗DUB的子宫切除术的一种保守替代方案。虽然子宫内膜消融术的直接成本低于子宫切除术，恢复时间也更短，但症状并不总是能得到解决。来自随访不完全的研究的现有数据表明，接受子宫内膜消融术治疗的患者中，多达四分之一需要再次消融或随后进行子宫切除术才能止住DUB。这表明子宫内膜消融术的短期优势可能会被可能存在的长期劣势所抵消。功能失调性子宫出血手术治疗结果项目（STOP-DUB）是一项随机试验，旨在比较子宫内膜消融术和子宫切除术。主要结果涉及对女性重要的问题，如生活质量以及导致手术的症状的解决情况。其他结果包括后续手术以及手术的成本效益。该研究的目标招募人数为800名女性——每个治疗组400名——来自美国各地的20个临床中心。这些女性将在手术后接受2年的随访。STOP-DUB的一部分是一项平行观察性研究，涉及那些不选择手术或不符合随机试验条件但随着时间推移可能符合条件的女性。预计这项研究的结果将为女性及其医疗保健专业人员在考虑DUB手术治疗的相对优缺点时提供重要信息。
