The Endurance of Dr. Guido’s Team Should Motivate More Physicians

Abstract

The uncommon diseases described in books are more fascinating for the majority of the medical personnel compred to the day-to-day pathologies they encounter in the clinic. The same goes for the public in our opinion. An example of such 'dull' medical condition is the uterine fibroid or myoma. As far as myomas are concerned, even though up to 80% of the women are affected, just 25% of them realize how deeply their lives are influenced by this condition when the symptoms become unbearable [1]. A sympathetic gynecologist sees beyond the great range of symptoms and imaging results by integrating the patients' quality of life in the equation, resulting into a perfect personalized treatment and optimized follow-up.This study was refreshing to read and really stands out from the multitude of other works regarding the treatment of myomas due to the teams perseverance with regards to the patients' postoperative quality of life. A second strong point is the fact that it is multicentric thus gathering heterogenic results that can be generalized to a greater scale. As a third point of discussion we will approach the idea of fertility post-RFVTA as this method preserves the uterus offering the possibility of future childbearing.A quick search will reveal a great number of articles about the operative outcomes: immediately after surgery (equipment feasibility, blood loss, length of hospital stay) [2], shortly after at 12 weeks [3] with focus on the size reduction of the tumors and its implications in reducing the main symptoms or at a 1 year follow-up [4] where the focus is again on the results of the technique. The patients' quality of life is either second placed or not mentioned. Often the new technique is praised and recommended to patients on the base of the limited data obtained from a short observation [3,4], leaving it to the later studies to prove the lack of long term efficacy [5]. The idea that comes to mind is one that we, in the medical world, often discuss: does the surgeon treat the disease or does (s) he treat the patient? Dr. Guido's team approaches a neutral and objective opinion about the radiofrequency volumetric ablation of uterine fibroids. The technique is outstanding of course, but in the present study it is modestly promoted just as a therapeutic option for myomas. It 'met the needs of the study patients' . There were no comparisons with any other treatment options made, however the authors stated, what we personally find to be a golden rule in medicine, that '[. ..] it is important to track the outcomes of new procedures to confirm the durability of the treatment'.Rarely do we personally find results of follow-ups after the study is completed. This study compares the 2-year follow-up to the 1-year results, emphasizing the impact that perseverance regarding patients monitoring has on evaluating a new technique. The 6 patients underwent re-intervention surgeries after 14 months making the success rate of the RFVTA 100% at 1-year and 95.2% at 2-years. This information benefits primarily the patients. By...