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Characteristics and efficacy of modified adenomyomectomy in the treatment of uterine adenomyoma

Chinese Medical Journal 2011年第9期124卷 1322-1326页

作者： SUN Ai-jun LUO Min WANG Wei CHEN Rong LANG Jing-he Department of Obstetrics and Gynecology Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences Beijing 100730 China

Background Adenomyoma is a very serious disease which influence the quality of life and leads to the infertility, and hysterectomy at the end. Unfortunetly, we still have no effective way to treat this kind of diseases. This study was aimed to evaluate the efficacy and surgical characteristics of modified adenomyomectomy. Methods This is a retrospective study and the subjects were collected in the past 5 years. We divided the subjects by the two different surgical procedures. Cases of adenomyoma patients who underwent conservative surgery, modified adenomyomectomy or wedge resection of the adenomyoma lesion were distributed to two groups retrospectively. Surgical characteristics, symptom relief, and recurrence were analysed in each group. Results General characteristics, including operation time, blood loss, and postoperative complication were similar in both groups. In the modified adenomyometomy group, the median follow-up time was 27.6 months and the rate of relief of dysmenorrhea and menorrhagia symptoms were 91.2% and 40.0%, respectively. In the wedge resection group, the rate of reliefe of dysmenorrhea and menorrhagia symptoms were 88.9% and 50.0%, respectively. Patients in both groups had statistically significant symptom relief, but there was no statistical difference between them. During the following time, ultrasonography relapse rate in modified modified adenomyomectomy group is significantly lower than the wedge resection group 15.0% vs. 69.2% （P 〈0.001）. The relapse rate, in terms of symptoms, was 5.0% in the modified adenomyomectomy group, which was similar to the relapse rate in the wedge resection group. In terms of reproductive outcome, 33.3% of the patients with infertility complications in the modified adenomyomectomy group became pregnant. Among them, the rate of pregnancy by assisted reproductive techniques was 45.5%, which was significantly higher than the rate of natural pregnancy, 23.1% （P =0.039）. Conclusion Modified adenomyomectomy appears

关键词： adenomyomectomy wedge resection adenomyoma lesion efficacy pregnancy relapse

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