Clinical efficacy of laparoscopic uterine artery ligation combined with myomectomy for the treatment of uterine fibroids
Objective To explore clinical efficacy of laparoscopic uterine artery occlusion combined with myomectomy(LUAO-M)for the treatment of uterine fibroids.Methods A total of 120 patients with uterine fibroids admitted to the Department of Obstetrics and Gynecology at Zhangjiakou Maternal and Child Health Hospital from July 2018 to December 2021 were selected into this study.According to different surgical methods,they were randomly divided into LUAO-M group(n=60)and laparoscopic myomectomy(LM)group(n=60).Retrospective analysis was performed on the serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),and estradiol levels of the two groups of patients before and after surgery at 7 days and 21 days;as well as the serum levels of tumor necrosis factor(TNF)-α,interleukin(IL)-1,and IL-6 before and after surgery at 24 and 72 hours.The two groups of patients were followed up for one year after surgery,and the follow-up content included the alleviation rate of menorrhagia,amenorrhea,fibroid recurrence,uterine volume,and 1-year progression-free survival(PFS)rate.The procedures followed in this study were in accordance with the requirements of the Medical Ethics Committee of Zhangjiakou Maternal and Child Health Hospital and were approved by the hospital's ethics committee(Approval No.2023-012).Informed consents were obtained from all participants.Results ① There was no statistically significant difference in age,fibroid size,number of fibroids,and the composition ratio of fibroid categories between the two groups(P＞0.05).② The intraoperative blood loss,operation time,time to postoperative anal passage gas,and postoperative hospital stay of the LUAO-M group were all less than or shorter than those of the LM group,and the differences were statistically significant(t=6.02,3.10,5.86,2.76;all P＜0.05).③ Repeated measures analysis of variance of FSH,LH,and estradiol levels before and after surgery at 7 days and 21 days for the two groups of patients showed that the interactive effect of different treatment measures and time factors was statistically significant(Ftreatment×time=9.33,50.63,47.32;all Ptreatment × time＜0.001).④ Repeated measures analysis of variance of TNF-α,IL-1,and IL-6 levels before and after surgery at 24 hours and 72 hours for the two groups of patients showed that the interactive effect of different treatment measures and time factors was statistically significant(Ftreatment×time=3.35,10.62,16.53;all Ptreatment×time＜0.001).⑤ The overall incidence rate of postoperative complications in the LUAO-M group was lower than that in the LM group,and the difference between the groups was statistically significant(x2=5.07,P=0.024).Conclusions LUAO-M treatment for uterine fibroids helps to improve patient survival rates,reduce the incidence of complications,and protect ovarian function.
NETL
NSTL
万方数据
