PDF(Pubmed)
Abstract：
Background/Objectives: Our objective was to evaluate changes in the management of symptomatic fibroids after establishing a multidisciplinary fibroid center with minimally invasive gynecologic surgery (MIGS) and interventional radiology (IR). Methods: A retrospective cohort study was conducted at the fibroid center created in September 2020. Patients were offered same-day consults with both MIGS and IR providers. Data were collected for patients with initial consultations from January to June 2019 (pre-fibroid center) and from January to June 2021 (post-fibroid center). Results: Among 615 patients meeting inclusion criteria, 273 had consultations pre-center and 342 post-center. More patients seen post-center had previously attempted medical management (30.1% vs. 20.2%), with a significant proportion having no prior medical or surgical treatment (53.2% vs. 61.5%). Post-center, there were more MIGS consultations (65.5% vs. 53.1%) and a decrease in general gynecology (GYN) consultations (19.0% vs. 25.6%). More patients sought additional opinions post-center (83.6% vs. 67.0%), particularly with MIGS (58.8% vs. 37.0%). General GYNs referred to MIGS (79.3% vs. 73.1%) and IR specialists (16.0% vs. 13.0%) more often in 2021. In 2021, use of MRI increased (66.5% vs. 52.4%), and more patients underwent uterine artery embolization (UAE) within 1 year of consultation compared to the pre-center period (13.8% vs. 6.9%). Conclusions: Patients with symptomatic fibroids often seek the expertise of specialists to explore treatment options. A multidisciplinary fibroid center that integrates efforts of MIGS and IR enables thorough counseling and a rise in the utilization of minimally invasive procedures, including UAE.
摘要：
背景/目标：我们的目标是评估在建立多学科纤维瘤中心，包括微创妇科手术（MIGS）和介入放射学（IR）后，有症状的纤维瘤的管理变化。方法：在2020年9月成立的纤维瘤中心进行了一项回顾性队列研究。患者接受了MIGS和IR提供者的当天咨询。收集了2019年1月至6月（纤维瘤前中心）和2021年1月至6月（纤维瘤后中心）进行初次咨询的患者的数据。结果：在符合纳入标准的615例患者中，273进行了中心前咨询，342进行了中心后咨询。更多在后中心就诊的患者以前曾尝试过医疗管理(30.1%与20.2%），相当大的比例没有事先接受过医疗或手术治疗(53.2%vs.61.5%）。后中心,有更多的MIGS咨询(65.5%vs.53.1%）和普通妇科（GYN）咨询减少（19.0%vs.25.6%）。更多的患者在中心后寻求更多意见(83.6%vs.67.0%），特别是MIGS（58.8%与37.0%）。一般GYNs提到MIGS（79.3%与73.1%）和IR专家（16.0%vs.13.0%），2021年更常见。2021年，MRI的使用增加(66.5%vs.52.4%），与中心前相比，在咨询后1年内接受子宫动脉栓塞（UAE）的患者更多（13.8％vs.6.9%）。结论：有症状的肌瘤患者通常会寻求专家的专业知识来探索治疗方案。一个多学科的纤维瘤中心，整合了MIGS和IR的努力，使彻底的咨询和微创手术的利用上升，包括阿联酋。
