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Laparoscopic Surgery for Focal Adenomyosis

BACKGROUND AND OBJECTIVES: For conservative surgical treatment of focal uterine adenomyosis, laparoscopic adenomyomectomy has been increasingly performed, so that reassessment to determine the safety and efficacy of the laparoscopic surgical technique in a larger number of cases and reevaluation for...

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Autores principales: Kwack, Jae-Young, Kwon, Yong-Soon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464959/
https://www.ncbi.nlm.nih.gov/pubmed/28642638
http://dx.doi.org/10.4293/JSLS.2017.00014
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author Kwack, Jae-Young
Kwon, Yong-Soon
author_facet Kwack, Jae-Young
Kwon, Yong-Soon
author_sort Kwack, Jae-Young
collection PubMed
description BACKGROUND AND OBJECTIVES: For conservative surgical treatment of focal uterine adenomyosis, laparoscopic adenomyomectomy has been increasingly performed, so that reassessment to determine the safety and efficacy of the laparoscopic surgical technique in a larger number of cases and reevaluation for reproducibility for laparoscopic adenomyomectomy is needed. We evaluate the clinical outcomes of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA) for focal uterine adenomyosis performed by a single surgeon at a single institute. METHODS: Patients (N = 105) with symptomatic focal uterine adenomyosis underwent laparoscopic adenomyomectomy with TOUA by a single surgeon at Ulsan University Hospital from May 1, 2011, through September 30, 2016. Surgical outcomes included operative time; intraoperative injury to blood vessels, nerves, and pelvic organs; and intraoperative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia and relapsing or remnant adenomyosis lesion by ultrasonography at the 7-momth follow-up after the operation. Then, all patients were followed up at 6-month intervals at the outpatient clinic. RESULTS: The mean patient age was 41.98 ± 4.73 years. The mean TOUA and operative times were 4.46 ± 2.68 and 75.14 ± 20.56 min, respectively. The mean estimated blood loss was 148.19 ± 101.69 mL. No conversion to laparotomy or major complications occurred. At the 7-month follow-up, complete remission of dysmenorrhea and menorrhagia had occurred in 93.02% and 76.92% of patients, respectively. CONCLUSIONS: Laparoscopic adenomyomectomy with TOUA is a safe and effective surgical treatment modality for women with symptomatic focal uterine adenomyosis who want to preserve fertility.
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spelling pubmed-54649592017-06-22 Laparoscopic Surgery for Focal Adenomyosis Kwack, Jae-Young Kwon, Yong-Soon JSLS Scientific Paper BACKGROUND AND OBJECTIVES: For conservative surgical treatment of focal uterine adenomyosis, laparoscopic adenomyomectomy has been increasingly performed, so that reassessment to determine the safety and efficacy of the laparoscopic surgical technique in a larger number of cases and reevaluation for reproducibility for laparoscopic adenomyomectomy is needed. We evaluate the clinical outcomes of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA) for focal uterine adenomyosis performed by a single surgeon at a single institute. METHODS: Patients (N = 105) with symptomatic focal uterine adenomyosis underwent laparoscopic adenomyomectomy with TOUA by a single surgeon at Ulsan University Hospital from May 1, 2011, through September 30, 2016. Surgical outcomes included operative time; intraoperative injury to blood vessels, nerves, and pelvic organs; and intraoperative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia and relapsing or remnant adenomyosis lesion by ultrasonography at the 7-momth follow-up after the operation. Then, all patients were followed up at 6-month intervals at the outpatient clinic. RESULTS: The mean patient age was 41.98 ± 4.73 years. The mean TOUA and operative times were 4.46 ± 2.68 and 75.14 ± 20.56 min, respectively. The mean estimated blood loss was 148.19 ± 101.69 mL. No conversion to laparotomy or major complications occurred. At the 7-month follow-up, complete remission of dysmenorrhea and menorrhagia had occurred in 93.02% and 76.92% of patients, respectively. CONCLUSIONS: Laparoscopic adenomyomectomy with TOUA is a safe and effective surgical treatment modality for women with symptomatic focal uterine adenomyosis who want to preserve fertility. Society of Laparoendoscopic Surgeons 2017 /pmc/articles/PMC5464959/ /pubmed/28642638 http://dx.doi.org/10.4293/JSLS.2017.00014 Text en © 2017 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Paper
Kwack, Jae-Young
Kwon, Yong-Soon
Laparoscopic Surgery for Focal Adenomyosis
title Laparoscopic Surgery for Focal Adenomyosis
title_full Laparoscopic Surgery for Focal Adenomyosis
title_fullStr Laparoscopic Surgery for Focal Adenomyosis
title_full_unstemmed Laparoscopic Surgery for Focal Adenomyosis
title_short Laparoscopic Surgery for Focal Adenomyosis
title_sort laparoscopic surgery for focal adenomyosis
topic Scientific Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464959/
https://www.ncbi.nlm.nih.gov/pubmed/28642638
http://dx.doi.org/10.4293/JSLS.2017.00014
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