Ablação histeroscópica do endométrio: resultados após seguimento clínico de 5 anos

Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter.

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Treatment of Uterine Myomas by Radiofrequency Thermal Ablation: A 10-Year Retrospective Cohort Study

Yin

Chen

Yang

et al. 2015

Reprod. Sci.

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Comparative Study between Endometrial Resection and Electrocoagulation in Patients with Abnormal Uterine Bleeding

Elias¹,

Dias²,

Leite³

et al. 2017

OJOG

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Objective: To compare clinical outcomes between two first-generation endometrial ablation techniques. Design: Prospective comparative coorte. Setting: Tertiary public hospital, university teaching center. Seventy-three patients with abnormal uterine bleeding unresponsive to clinical treatment submitted to endometrial ablation from October 2011 to September 2013. Methods and Main Outcome Measures: Patients were assigned to either monopolar U-shaped electrode resection with rollerball electrocoagulation (group A, n = 36) or rollerball electrocoagulation alone (group B, n = 37). Mean follow-up length was 359 (280 -751) and 370 days (305 -766) in groups A and B, respectively. Bleeding pattern, associated symptoms, failure/success rates were assessed 30, 90, 180 and 360 days post-procedure. Findings: Patient characteristics were similar in both groups (P ≥ 0.05). Surgery duration (mean of 48.5 [±12.0] vs. 31.9 [±5.6] min, P < 0.001) and medium distention use (5.700 mL vs. 3.500 mL, P < 0.01) were decreased in group B. Post-ablation clinical improvement was considerable in both groups. Vaginal discharge incidence after the procedure was lower in group B (30.5% vs. 8.1%, P < 0.05). Hysterectomy rate was 9.6%. Overall success rate was 86.1% and 88.1% in groups A and B, respectively. Conclusions: Endometrial ablation using rollerball electrocoagulation alone may be considered safer than resection with rollerball electrocoagulation, which requires shorter surgical time and less distention medium, and is associated with lower postoperative vaginal discharge incidence. Success rate did not # Adjunct Professor III and Principal Investigator.How to cite this paper: Elias, L.V.,

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Ablação histeroscópica do endométrio: resultados após seguimento clínico de 5 anos

Cited by 2 publications

References 21 publications

Treatment of Uterine Myomas by Radiofrequency Thermal Ablation: A 10-Year Retrospective Cohort Study

Treatment of Uterine Myomas by Radiofrequency Thermal Ablation: A 10-Year Retrospective Cohort Study

Comparative Study between Endometrial Resection and Electrocoagulation in Patients with Abnormal Uterine Bleeding

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