BACKGROUND: We assessed the results and impact of blockage of utero-ovarian anastomoses (UOA) on clinical outcome in women treated by laparoscopic uterine artery occlusion for uterine fibroids. METHODS: Between 2004 and 2005, we prospectively analyzed the clinical data for 23 laparoscopic uterine artery occlusion cases combined with blockage of utero-ovarian anastomoses (Group A) and 67 laparoscopic uterine artery occlusion cases alone (Group B). RESULTS: Of these 23 patients with UOA (mean age, 36.7+/-2.8 years), 10 patients (43.4%) had anastomoses bilaterally and 13 patients (56.6%) had unilateral anastomoses. Mean fibroid size reduction after LUAO and anastomoses blockage was 32.5% from baseline (P<0.001). In patients with LUAO, the mean DF size after surgery was estimated at 38.7+/-19.2 mm, which translated to a mean fibroid size reduction of 30.6% from baseline (P<0.001). No case of clinical failure or recurrence was found in Group A patients with UOA (mean follow-up, 15.6 months), who were treated with combined surgery. At a mean clinical follow-up of 18.2 months (Group B), 6 patients (8.9%) elected to undergo further surgical intervention for clinical failure and recurrence, including 4 myomectomies and 2 hysterectomies. The statistical difference between groups was not significant (P=0.33). CONCLUSION: Laparoscopic blockage of utero-ovarian anastomoses combined with uterine artery occlusion is a safe, feasible surgical procedure in women with symptomatic fibroids. Combining the uterine artery occlusion and blockage of UO anastomoses may be a useful procedure for the decreasing rate of clinical failure and recurrence. This premise should be confirmed in a larger prospective multicenter study.
BACKGROUND: We assessed the results and impact of lateral uterine artery dissection on clinical outcome following laparoscopic myomectomy. METHODS: We retrospectively analyzed the clinical data for 27 laparoscopic myomectomy cases (Group I) and 54 laparoscopic myomectomy cases combined with lateral uterine artery dissection (Group II) between January 2001 and August 2004 in one center. Only 81 patients who had dominant fibroids between 4 cm and 10 cm in diameter were included in the study. We assessed the clinical outcomes: perioperative blood loss, operating time, hospital stay, complications, hemoglobin decrease, inflammatory response, and tissue markers (C-reactive protein, white blood cells, creatinine kinase) changes. RESULTS: The mean operating time was 70.37 minutes in group I and 78.61 minutes in group II. The mean length of hospital stay was 2.7 days versus 2.2 days, respectively (P>0.05). The difference in intraoperative blood loss was 70.1 mL (147.7 mL vs 77.3 mL, Group I) and 33.9 mL (105 mL vs 71.1 mL, Group II); estimated postoperative blood loss was statistically significant (P<0.001, P<0.05, respectively). Group 2 demonstrated a less intense stress response in C-reactive protein (P<0.001) and white blood cell count (P<0.05). CONCLUSION: The dissection of the uterine artery in laparoscopic myomectomy is a feasible operative procedure with a low rate of complications. The procedure reduced perioperative blood loss and resulted in significant improvement in fibroid-related symptoms.
- MeSH
- arterie chirurgie MeSH
- délka pobytu MeSH
- dospělí MeSH
- financování organizované MeSH
- krvácení při operaci statistika a číselné údaje MeSH
- laparoskopie MeSH
- leiomyom chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory dělohy chirurgie MeSH
- retrospektivní studie MeSH
- uterus krevní zásobení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- MeSH
- apoptóza účinky záření MeSH
- buněčné dělení fyziologie účinky léků MeSH
- etoposid farmakologie MeSH
- finanční podpora výzkumu jako téma MeSH
- fixní kombinace léků MeSH
- fragmentace DNA MeSH
- kolchicin MeSH
- lidé MeSH
- nádorové buňky kultivované účinky léků ultrastruktura MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
