Abstract | BACKGROUND: This study compares results of endometrial ablation alone and in combination with myoma coagulation. Subsequent surgery rates were 38% for ablation alone and 12% for combined therapy. OBJECTIVE: STUDY DESIGN: RESULTS: Of the patients undergoing ablation alone, 20 (38%) of 52 required a second surgery for continued symptoms during a mean follow-up of 47 months. Five of these patients (9.6%) underwent hysterectomy. Of the patients who underwent endometrial ablation plus myoma coagulation (myolysis), 11 (12.5%) of 88 required a repeat surgical procedure during a mean follow-up of 25 months. Five of these patients (5.7%) underwent hysterectomy. Volumetric measurements revealed an average reduction in fibroid volume of 54.5% in this patient group following treatment with a gonadotropin-releasing hormone ( GnRH) agonist and combined myoma coagulation and endometrial ablation surgery. Of the 28 patients who underwent myoma coagulation plus resection, five (18%) required a repeat procedure. Of these five, one (4%) required hysterectomy. Fibroid volume in this group was reduced by a mean of 72.6% following administration of a GnRH agonist and combined laparoscopic and hysteroscopic surgery as described. The rate of reoperation was significantly lower among patients receiving endometrial ablation with myoma lysis with or without resection compared with those undergoing endometrial ablation alone (P<0.01). CONCLUSIONS:
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Authors | H A Goldfarb |
Journal | JSLS : Journal of the Society of Laparoendoscopic Surgeons
(JSLS)
1999 Oct-Dec
Vol. 3
Issue 4
Pg. 253-60
ISSN: 1086-8089 [Print] United States |
PMID | 10694070
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Topics |
- Adult
- Catheter Ablation
(methods)
- Combined Modality Therapy
- Endometrium
(surgery)
- Female
- Follow-Up Studies
- Humans
- Hysteroscopy
(methods, statistics & numerical data)
- Laser Coagulation
(methods)
- Leiomyoma
(mortality, surgery)
- Menorrhagia
(surgery)
- Middle Aged
- Survival Analysis
- Treatment Outcome
- Uterine Neoplasms
(mortality, surgery)
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