High‐intensity focused ultrasound and laparoscopic myomectomy in the treatment of uterine fibroids: a comparative study

Abstract

Objective To compare the clinical efficacies of high-intensity focused ultrasound (HIFU) and laparoscopic myomectomy (LM) in the treatment of uterine fibroids and their effects on patients' quality of life.Design A non-randomised control study.Setting Gynaecological department in a university teaching hospital.Population Patients with uterine fibroids.Methods From November 2014 to November 2015, 166 patients with uterine fibroids were enrolled and underwent HIFU (n = 99) and LM (n = 67) surgeries, respectively. Clinical efficacy, postoperative complications and quality of life after treatment were evaluated using the SF-36 Scale to compare the differences in each variable at the 1-year follow up.Main outcomes measures Differences in efficacy, safety and quality of life between the patients treated with HIFU and LM.Results The 12-month follow-up results showed that the HIFU group had a total effective rate of 99%; only one patient underwent alternative treatment due to non-apparent tumour shrinkage. All patients in the LM group showed complete tumour disappearance. Of these patients, 52 showed significant clinical improvement, 15 with partial clinical improvement, a total effective rate of 98%. There was no significant difference in effectivity rate between the two groups (P > 0.05). Both treatments effectively improved patients' quality of life. Compared with the LM group, patients in the HIFU group experienced no blood loss, a shorter hospital stay and fewer adverse effects and complications, the difference being statistically significant (P < 0.05).Conclusions High-intensity focused ultrasound can be as efficacious as LM therapy and effectively improve patients' quality of life in the treatment of uterine fibroids, with fewer adverse effects and complications, shorter hospital stays, and quicker postoperative recovery compared with LM therapy.Keywords High-intensity focused ultrasound, laparoscopy, quality of life, uterine fibroids.Tweetable abstract Patients with uterine fibroids can be effectively treated with both HIFU and myomectomy.Please cite this paper as: Liu Y, Ran W, Shen Y, Feng W, Yi J. High-intensity focused ultrasound and laparoscopic myomectomy in the treatment of uterine fibroids: a comparative study. BJOG 2017; 124 (S3): 36-39.

Non-invasive therapeutic use of High-Intensity Focused Ultrasound (HIFU) with 3 Tesla Magnetic Resonance Imaging in women with symptomatic uterine fibroids

“…Following 3 years of the 3T MRI guided HIFU procedure application our initial results indicate that in 56% cases the effect of therapy revealed more than 70% of fibroid tissue ablation, which is similar to the results reported by other centers [7,14,15,17,18]. The most common causes of the withdrawal from treatment attempts were largely related to bowel location in relation to the fibroid position.…”

“…In such cases repositioning of the fibroid required some maneuvering and was not always effective. The same type of complication was observed by other authors [7,15,18]. In 2015 Pron [20] presented a meta-analysis of available studies on the use of MRI guided HIFU.…”

“…Magnetic resonance imaging guided high intensity focused ultrasound procedures provide a relatively safe and feasible alternative to surgical resection for the treatment of women with symptomatic uterine myomas [7,12]. The potential of high focused ultrasound energy to interact with various tissues has been known for several years and the first MRI guided HIFU platform received United States FDA approval in 2004 [13].…”

“…Laparoscopic myomectomy and the increasing use of robotic technology for endoscopic procedures could also improve patient outcomes, including decreased recovery time [6]. However, since UAE and MRI guided HIFU are newer techniques compared to surgical myomectomy, it is likely that the increased provider experience coupled with technical innovations could result in significant improvement as these technologies mature [5][6][7].…”

A comparative analysis of pregnancy outcomes of patients with uterine fibroids after high intensity focused ultrasound ablation and laparoscopic myomectomy: a retrospective study

“…The goal of treatment for uterine fibroids is not only to achieve symptom relief, but also to improve pregnancy outcomes. There are many treatments for uterine fibroids, and the choice depends on many factors, such as age, fertility intention, symptoms and the location, size and number of uterine fibroids [12]. Although hysterectomy is considered the most effective approach to treat uterine fibroids, it is not suitable for patients who have the desire to give birth [7].…”