Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

Butori, N; Tixier, Hervé; Filipuzzi, Laurence; Mutamba, William; Guiu, Boris; Cercueil, Jean-Pierre; Douvier, S.; Shrivastava, Paul; Krausé, D.; Loffroy, Romaric

doi:10.1016/j.ejrad.2009.09.028

Cited by 31 publications

(26 citation statements)

References 30 publications

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“…Uterine artery ligation has been attempted before laparoscopic myomectomy to disrupt fibroid vascularization [12,13]. In 2 distinct case series, Butori et al [14] and Dumousset et al [15] suggested that preoperative UAE devascularized fibroids before myomectomy and facilitated “easier” dissection of fibroids without complications. Patients underwent both abdominal and laparoscopic myomectomy, but no controls were available to compare operative outcomes.…”

Section: Introductionmentioning

confidence: 99%

Uterine artery embolization immediately preceding laparoscopic myomectomy

Goldman

Hirshfeld-Cytron

Pavone

et al. 2011

International Journal of Gynecology & Obstetrics

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Objective To determine whether performing uterine artery embolization (UAE) immediately before laparoscopic myomectomy can facilitate a minimally invasive surgical approach for larger uterine fibroids. Methods In a retrospective case–control study, laparoscopic myomectomy with and without preoperative UAE was examined. Data were analyzed from 26 laparoscopic myomectomies performed by a single surgeon at Northwestern University Feinberg School of Medicine between 2004 and 2010. Controls were matched for age, calendar year, surgeon, and number of fibroids removed. Surgical outcomes included preoperative clinical uterine size, operative time, operative blood loss, and postoperative myoma specimen weight. Data were analyzed via 2-tailed Student t test. Results Twelve women underwent laparoscopic myomectomy within 169±16 minutes (mean±SEM) of preoperative UAE. Fourteen control patients underwent laparoscopic myomectomy alone. The UAE group had a greater mean preoperative clinical uterine size (19.7 versus 12.4 weeks, P<0.001) and a greater mean myoma specimen weight measured postoperatively (595.3 versus 153.6 grams, P<0.05). There were no significant differences in operative time or blood loss, and there were no intra-operative complications. Conclusion UAE performed immediately before laparoscopic myomectomy facilitated minimally invasive surgery for larger uteri and larger uterine myomas, with no differences in operative time or blood loss.

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Section: Introductionmentioning

confidence: 99%

Uterine artery embolization immediately preceding laparoscopic myomectomy

Goldman

Hirshfeld-Cytron

Pavone

et al. 2011

International Journal of Gynecology & Obstetrics

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“…The avascular state of the uterus promotes easier removal of myomas and lowers risk for complications. (13). This combination procedure may also decrease hospital stay, as many potential postoperative complications may be avoided (17).…”

Section: Discussionmentioning

confidence: 97%

“…Other studies have reported hospital stay ranging from 2.1-3.5 days (22,23,28) for patients with LM alone. Shorter hospital stays also lower medical cost for patients (13). The average cost for UAE varies, however, is definitely less than the cost for hospitalization after hysterectomy (29)(30)(31).…”

Section: Discussionmentioning

confidence: 97%

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Combined myomectomy and uterine artery embolization

McLucas

Voorhees

2014

Minimally Invasive Therapy & Allied Technologies

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“…Preoperative uterine artery embolization has been has been shown to reduce blood loss [49], but with associated risks and cost. Its use should therefore be restricted to women with large, multiple fibroids, who refuse blood products.…”

Section: Use Of Vasopressin and Uterine Artery Occlusion To Reduce Inmentioning

confidence: 99%

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

Dixit

Jesner

Modarres

2016

Curr Obstet Gynecol Rep

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Although a variety of pharmacological and radiological treatment options are available, surgery in the form of myomectomy or hysterectomy provides a quick and effective relief of many symptoms, albeit with attendant surgical risks. In this article, we discuss endoscopic surgical treatments, their relative benefits, and their risks, including risk of morcellation. Patient selection and preoperative preparation for various surgical approaches is discussed. Overall, the evidence base for surgical treatments, including endoscopic, is weak, and, therefore, a pragmatic approach is outlined.

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Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

Cited by 31 publications

References 30 publications

Uterine artery embolization immediately preceding laparoscopic myomectomy

Uterine artery embolization immediately preceding laparoscopic myomectomy

Combined myomectomy and uterine artery embolization

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

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