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ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 1  |  Page : 10-15

The changes of surgical treatment for symptomatic uterine myomas in the past 15 Years


1 Department of Gynecology and Obstetrics, Tenth People's Hospital; Department of Gynecology, Gynecologic Minimally Invasive Surgery Research Center, Tongji University School of Medicine, Shanghai, P.R.China
2 Department of Gynecology, Gynecologic Minimally Invasive Surgery Research Center; Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, P.R.China

Correspondence Address:
Dr. Zhongping Cheng
Director of Department of Gynecology and Obstetrics, Tenth People's Hospital, Tongji University School of Medicine, 301, Yan Chang Road, 200072, Shanghai
P.R.China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_11_17

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Study Objective: The aim of this study is to elaborate the changes of the surgical approach of treatment for uterine myomas in Yangpu Hospital in the past 15 years. Design: This was retrospective cohort study. Setting: Yangpu Hospital, Tongji University School of Medicine, Shanghai, China. Materials and Methods: A total of 4113 patients with symptomatic uterine myomas underwent surgical treatments. Interventions: Eight kinds of different surgeries were involved in the study, including abdominal or laparoscopic surgery, hysterectomy, or uterus-sparing myomectomy. Measurements: The study collected patients' clinical data and reviewed surgical access and approach, complications, and the results of following up. Results: A total of 1559 cases (37.9%) underwent uterus-sparing myomectomy, 3005 cases (73.1%) performed laparoscopic surgeries. The percentage of laparoscopic surgery was significantly higher than homochronous data of laparotomy after 2003 (P < 0.001). The per year total of uterus-reserved surgery was proved to be negatively correlated with patient's age (R2 = 0.930; P < 0.001). The rate of myomas recurrence was significantly lower in the combined myomectomy and uterine artery occlusion group (4%, 34/910) than in the single myomectomy group (10.5%, 44/420) (P < 0.001). Conclusions: Retaining uterus and minimally invasive surgery were the important trends of surgical treatment for symptomatic uterine myomas. Laparoscopic uterus-sparing myomectomy may be an alternative to hysterectomy to manage to appropriate patients with uterine myomas.


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