腹腔镜子宫肌瘤切除术后子宫肌瘤复发的短期风险及其相关危险因素

Q3 Medicine Shiraz E Medical Journal Pub Date : 2023-10-02 DOI:10.5812/semj-132683
Zahra Asgari, Seyedeh Azam Pourhoseini, Reihaneh Hosseini, Behnaz Ghavami, Bahareh Meibodi, Ali Akbari
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引用次数: 0

摘要

背景:虽然腹腔镜子宫肌瘤切除术是治疗子宫肌瘤的有效方法,但对于其复发率和相关危险因素尚无明确的共识。目的:探讨腹腔镜子宫肌瘤切除术后子宫肌瘤的复发率及其危险因素。方法:在一项历史队列研究中,172例接受腹腔镜子宫肌瘤切除术的患者,随访时间至少为2年。每半年用超声检查一次肌瘤复发情况。在logistic回归模型中比较复发组和非复发组患者的人口学、临床、外科、超声和实验室指标。结果:患者平均年龄35±5.7岁(18 ~ 47岁)。平均随访时间为26.3±4.2个月(24 ~ 28个月)。172例患者中病变复发25例(14.5%)。在单因素分析中,较高的年龄(OR:1.111, P = 0.015)、较高的体重指数(OR: 1.124, P = 0.024)、促性腺激素释放激素(GnRH)治疗(OR = 3.83, P = 0.027)和超过1个肌瘤(OR: 2.60, P = 0.032)与肌瘤复发相关。在多重分析中,较高的体重指数(OR: 1.222, P = 0.003)是肌瘤复发的重要危险因素。结论:腹腔镜子宫肌瘤切除术是治疗子宫肌瘤的有效方法,可作为育龄患者保留子宫的手术选择。正如本研究所揭示的那样,对于具有多种危险因素的患者,可能会采用更彻底的外科手术。
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Short-Term Risk of Fibroid Recurrence After Laparoscopic Myomectomy and Its Associated Risk Factors
Background: Although laparoscopic myomectomy is an effective procedure for the treatment of uterine myoma, there is no clear consensus regarding its rate of recurrence and associated risk factors. Objectives: This study aimed to investigate the recurrence rate of myoma and its risk factors after laparoscopic myomectomy. Methods: In a historical cohort study, 172 patients who underwent laparoscopic myomectomy and had a minimum follow-up of 2 years were included. Myoma recurrence was checked semiannually by ultrasound imaging. The demographic, clinical, surgical, sonographic, and laboratory indices of the patients were compared between the recurrent and nonrecurrent groups, both in logistic regression models. Results: The mean age of the patients was 35 ± 5.7 years (range: 18 - 47 years). Their mean follow-up time was 26.3 ± 4.2 months (range: 24 - 28). The lesion recurred in 25 (14.5%) out of 172 patients. In the univariate analysis, higher age (OR:1.111, P = 0.015), higher body mass index (OR: 1.124, P = 0.024), gonadotropin-releasing hormone (GnRH) therapy (OR = 3.83, P = 0.027), and more than 1 myoma (OR: 2.60, P = 0.032) were associated with myoma recurrence. In the multiple analysis, a higher body mass index (OR: 1.222, P = 0.003) was a significant risk factor for myoma recurrence. Conclusions: Laparoscopic myomectomy is an effective procedure for the treatment of uterine myoma and can be used as a uterus-preserving surgical alternative in patients of reproductive age. A more radical surgical procedure might be used for patients with multiple risk factors, as revealed in the present study.
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Shiraz E Medical Journal
Shiraz E Medical Journal Medicine-Medicine (all)
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