Long-Term Efficacy of Laparoscopic or Robotic Adenomyomectomy with or without Medical Treatment for Severely Symptomatic Adenomyosis

Chong, Gun Oh; Lee, Yoon Hee; Hong, Dae Gy; Cho, Young Lae; Lee, Yoon Soon

doi:10.1159/000441783

Cited by 19 publications

(28 citation statements)

References 24 publications

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“…The traditional hysterectomy remains the main therapeutic strategy in the long term. However, considering the relevant technical progress of conservative surgical techniques in recent years and the expansion of lesion removal, the short‐term efficacy of conservative surgical techniques is significant in improving adenomyosis‐related dysmenorrhea and abnormal uterine bleeding 17 …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adenomyomectomy combined with levonorgestrel‐releasing intrauterine system in the treatment of adenomyosis: Feasibility and effectiveness

Sun

Zhang

You

et al. 2020

J of Obstet and Gynaecol

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Aim To evaluate the clinical efficacy and safety of laparoscopic adenomyomectomy combined with intraoperative replacement of levonorgestrel‐releasing intrauterine system (LNG‐IUS) in the treatment of symptomatic adenomyosis. Methods This is a case‐series study in a university medical center. A total of 52 patients with symptomatic adenomyosis were treated by laparoscopic adenomyomectomy combined with intraoperative replacement of LNG‐IUS from January 2015 to July 2018. Visual analog scale, menstrual flow and uterine volume were compared before and after the surgery (3, 12 and 24 months). Meanwhile, LNG‐IUS‐induced adverse reactions (e.g. irregular vaginal bleeding, amenorrhea, expulsion, and perforation) were also recorded. Results All operations were successfully completed via laparoscopy without conversion to laparotomy. No severe complications were noted during the surgical procedure or follow‐up period. The mean postoperative visual analog scale and menstrual flow scores and the volume of the uterus were significantly decreased (all P < 0.001) at 3, 12, and 24 months postoperatively, compared with preoperative scores. The clinical effective rates among the patients with dysmenorrhea were 98%, 96% and 96% at 3, 12 and 24 months after the operation, respectively. And the clinical effectiveness rate of menorrhagia was 97.6%, 95.2% and 95.2% at 3, 12 and 24 months after treatment, respectively. Among all related adverse reactions, amenorrhea was the most common (n = 12, 23.1%). There was one case of LNG‐IUS perforation (1.9%) and two cases of expulsion (3.8%). Conclusion Laparoscopic adenomyomectomy combined with intraoperative replacement of LNG‐IUS is a novel and effective conservative surgical procedure for symptomatic adenomyosis treatment.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic adenomyomectomy combined with levonorgestrel‐releasing intrauterine system in the treatment of adenomyosis: Feasibility and effectiveness

Sun

Zhang

You

et al. 2020

J of Obstet and Gynaecol

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“…The mean operative time was 159.25 minutes, and the EBL was 117.5 mL. Chong et al [13] reported long-term efficacy in 8 cases of robotic adenomyomectomy. The authors excised 78.0 g of adenomyotic tissue and the operative time was 204.2 minutes, and EBL was 48 mL.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few studies have compared surgical outcomes between robotic and laparoscopic surgeries. Chong et al [13] reported a longer operative time but similar length of hospitalization and EBL in the robotic versus the laparoscopic adenomyomectomy group. [13] In addition, suturing time was significantly longer in the robotic than in the laparoscopic adenomyomectomy group (79.8 ± 23.4 vs 39.7 ± 17.9 min, P < .001).…”

Section: Discussionmentioning

confidence: 99%

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A comparison of surgical outcomes between robot and laparoscopy-assisted adenomyomectomy

Shim

Jo²,

Kim³

et al. 2019

Medicine

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We aimed to investigate the feasibility of robotic adenomyomectomy and compared surgical outcomes between laparoscopic and robotic approaches for adenomyomectomy. We retrospectively reviewed the data of women who were diagnosed with adenomyosis and underwent adenomyomectomy through a minimally invasive approach between January 2014 and March 2018 at the CHA Gangnam Medical Center, Seoul, Republic of Korea. Patient demographics and operation-related outcomes were compared between the robotic and laparoscopic surgery groups. We evaluated 43 women who underwent adenomyomectomy through a minimally invasive approach (21 underwent a laparoscopic and 22 underwent a robotic adenomyomectomy). All 22 women who had originally been scheduled to undergo robotic adenomyomectomy could successfully undergo the robotic surgery without requiring conversion to laparotomy and/or serious complications. No statistically significant differences in patient demographics were observed between the robotic and the laparoscopic surgery groups. No significant intergroup difference was observed in the operative time, estimated blood loss, weight of the resected nodule, and length of hospitalization (160.0 vs 212.5 min, P = .106; 500.0 vs 300.0 mL, P = .309; 60.0 vs 70.0 g, P = .932; and 5.0 vs 6.0 days, P = .277). No serious perioperative complications were observed in either group. Robotic adenomyomectomy is feasible for women with adenomyosis. Surgical outcomes of robotic adenomyomectomy were comparable to those of a laparoscopic approach. There was, however, no superiority of robotic adenomyomectomy in terms of surgical outcomes. Further multicenter prospective studies using standardized surgical procedures are needed to confirm the conclusion of this study.

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“…On the other hand, minimally invasive procedures may be used to treat ADS. In a recent study it was estimated that laparoscopic or robotic adenomyomectomy was feasible and safe for women with severely symptomatic ADS who requested uterine preservation (19). ADS does not usually cause marked pathological changes in the serosa of the uterus.…”

Section: Discussionmentioning

confidence: 99%

The effect of adenomyosis on the outcomes of laparoscopic hysterectomy

Yavuzcan

Başbuğ

Baştan

et al. 2016

J Turkish German Gynecol Assoc

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Long-Term Efficacy of Laparoscopic or Robotic Adenomyomectomy with or without Medical Treatment for Severely Symptomatic Adenomyosis

Cited by 19 publications

References 24 publications

Laparoscopic adenomyomectomy combined with levonorgestrel‐releasing intrauterine system in the treatment of adenomyosis: Feasibility and effectiveness

Laparoscopic adenomyomectomy combined with levonorgestrel‐releasing intrauterine system in the treatment of adenomyosis: Feasibility and effectiveness

A comparison of surgical outcomes between robot and laparoscopy-assisted adenomyomectomy

The effect of adenomyosis on the outcomes of laparoscopic hysterectomy

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