Abstract：
OBJECTIVE: To evaluate the safety and efficacy of myomectomy for recurrent uterine fibroids (UFs) after high-intensity focused ultrasound (HIFU) ablation.
METHODS: This was a retrospective study. Patients who underwent abdominal myomectomy (AM) and laparoscopic myomectomy (LM) from January 2018 to December 2021 at the Three Gorges Hospital of Chongqing University were included. Among them, 73 had undergone prior HIFU ablation (Group 1), while 120 had not undergone HIFU (Group 2). Outcome measures included operating time, estimated blood loss (EBL), blood transfusion, postoperative activity times (PAT), duration of hospital stay (DOHS), and complications.
RESULTS: The operating time was 90.0 min (70.5, 115.0) for Group 1 and 110.0 min (81.5, 130.0) for Group 2 (P < 0.05). During all AM pathways, there were no significant differences observed between the two groups in EBL, blood transfusion, PAT, DOHS, and complications; however, operating time was shorter in Group 1. The operating time, EBL, blood transfusion, PAT, DOHS, and complications were similar in both groups during LM pathway. During the follow-up 40 (range: 24-53) months, the rate of relief, recurrence, and reintervention in Groups 1 and 2 was 78.1% versus 74.1%, 14.6% versus 16.4%, and 3.7% versus 2.6%, respectively (P > 0.05).
CONCLUSIONS: Myomectomy is a safe and effective surgical method for treating recurrent UFs after HIFU. Myomectomy for treating recurrent UFs resulted in a shorter operative and hospital stay, reduced blood loss, faster postoperative recovery, and fewer complications, better symptom relief rates, and lower risk of recurrence or reintervention. These findings indicate that previous HIFU ablation does not worsen the outcomes of the subsequent myomectomy.
METHODS: This was a retrospective study. Patients who underwent abdominal myomectomy (AM) and laparoscopic myomectomy (LM) from January 2018 to December 2021 at the Three Gorges Hospital of Chongqing University were included. Among them, 73 had undergone prior HIFU ablation (Group 1), while 120 had not undergone HIFU (Group 2). Outcome measures included operating time, estimated blood loss (EBL), blood transfusion, postoperative activity times (PAT), duration of hospital stay (DOHS), and complications.
RESULTS: The operating time was 90.0 min (70.5, 115.0) for Group 1 and 110.0 min (81.5, 130.0) for Group 2 (P < 0.05). During all AM pathways, there were no significant differences observed between the two groups in EBL, blood transfusion, PAT, DOHS, and complications; however, operating time was shorter in Group 1. The operating time, EBL, blood transfusion, PAT, DOHS, and complications were similar in both groups during LM pathway. During the follow-up 40 (range: 24-53) months, the rate of relief, recurrence, and reintervention in Groups 1 and 2 was 78.1% versus 74.1%, 14.6% versus 16.4%, and 3.7% versus 2.6%, respectively (P > 0.05).
CONCLUSIONS: Myomectomy is a safe and effective surgical method for treating recurrent UFs after HIFU. Myomectomy for treating recurrent UFs resulted in a shorter operative and hospital stay, reduced blood loss, faster postoperative recovery, and fewer complications, better symptom relief rates, and lower risk of recurrence or reintervention. These findings indicate that previous HIFU ablation does not worsen the outcomes of the subsequent myomectomy.
摘要：
目的：评估高强度聚焦超声（HIFU）消融术后子宫肌瘤切除术治疗复发性子宫肌瘤（UFs）的安全性和有效性。
方法：这是一项回顾性研究。纳入2018年1月至2021年12月在重庆大学三峡医院行腹部子宫肌瘤切除术（AM）和腹腔镜子宫肌瘤切除术（LM）的患者。其中,73人曾接受过HIFU消融（第1组），而120人没有接受HIFU（第2组）。结果指标包括运行时间，估计失血量（EBL），输血,术后活动时间（PAT），住院时间（DOHS），和并发症。
结果：第1组手术时间为90.0min（70.5,115.0），第2组手术时间为110.0min（81.5,130.0）（P<0.05）。在所有AM途径中，在EBL两组之间没有观察到显著差异,输血,PAT,DOHS,和并发症；然而，第1组手术时间较短。操作时间,EBL,输血,PAT,DOHS,在LM途径期间，两组的并发症相似。随访40（范围：24-53）个月，救济的速度，复发,第1组和第2组的再干预分别为78.1%和74.1%，14.6%对16.4%，和3.7%对2.6%，分别为(P>0.05)。
结论：子宫肌瘤切除术是治疗HIFU术后复发性UF的安全有效的手术方法。子宫肌瘤切除术治疗复发性UFs导致更短的手术和住院时间，减少失血,术后恢复更快，更少的并发症，更好的症状缓解率，复发或再干预的风险较低。这些发现表明，先前的HIFU消融不会使随后的子宫肌瘤切除术的结果恶化。
方法：这是一项回顾性研究。纳入2018年1月至2021年12月在重庆大学三峡医院行腹部子宫肌瘤切除术（AM）和腹腔镜子宫肌瘤切除术（LM）的患者。其中,73人曾接受过HIFU消融（第1组），而120人没有接受HIFU（第2组）。结果指标包括运行时间，估计失血量（EBL），输血,术后活动时间（PAT），住院时间（DOHS），和并发症。
结果：第1组手术时间为90.0min（70.5,115.0），第2组手术时间为110.0min（81.5,130.0）（P<0.05）。在所有AM途径中，在EBL两组之间没有观察到显著差异,输血,PAT,DOHS,和并发症；然而，第1组手术时间较短。操作时间,EBL,输血,PAT,DOHS,在LM途径期间，两组的并发症相似。随访40（范围：24-53）个月，救济的速度，复发,第1组和第2组的再干预分别为78.1%和74.1%，14.6%对16.4%，和3.7%对2.6%，分别为(P>0.05)。
结论：子宫肌瘤切除术是治疗HIFU术后复发性UF的安全有效的手术方法。子宫肌瘤切除术治疗复发性UFs导致更短的手术和住院时间，减少失血,术后恢复更快，更少的并发症，更好的症状缓解率，复发或再干预的风险较低。这些发现表明，先前的HIFU消融不会使随后的子宫肌瘤切除术的结果恶化。
