Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy
Purpose To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies.Materials and methods A total of 75 patients diagnosed with types 0–III of uterine fibroids were enrolled. Based on...
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Taylor & Francis Group
2024-12-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2024.2365974 |
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| author | Yuchun He Min Wu Xu Guo Feng Ran Haiyan Li Daibi Zhang Yaqin Wang Jin Zeng Xuelian Chen Linghui Zhai Xiaohui Li Tingting Lei |
| author_facet | Yuchun He Min Wu Xu Guo Feng Ran Haiyan Li Daibi Zhang Yaqin Wang Jin Zeng Xuelian Chen Linghui Zhai Xiaohui Li Tingting Lei |
| author_sort | Yuchun He |
| collection | DOAJ |
| description | Purpose To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies.Materials and methods A total of 75 patients diagnosed with types 0–III of uterine fibroids were enrolled. Based on the Size, Topography, Extension of the base, Penetration and lateral Wall position (STEPW) classification scoring system, 25 cases with a score ≥ 5 points were treated with HIFU followed by hysteroscopic myomectomy (HIFU + HM group), whereas 50 cases with a score < 5 points were treated with hysteroscopic myomectomy (HM group).Results The median preoperative STEPW score was 7 in the HIFU + HM group and 2 in the HM group. The average non-perfused volume (NPV) ratio achieved in fibroids after HIFU was 86.87%. Patients in the HIFU + HM group underwent hysteroscopic myomectomy one to four days after HIFU, and downgrading was observed in 81.81% of fibroids. The operation time for patients in the HIFU + HM group was 73 min and the success rate of myomectomy in a single attempt was 60%. The volume of distention medium used during the operation was greater in the HIFU + HM group than in the HM group (15,500 ml vs. 7500 ml). No significant difference was observed between the two groups in terms of intraoperative blood loss, the incidence of intraoperative and postoperative complications, menstrual volume score, or uterine fibroid quality of life score.Conclusion HIFU can be utilized as a preoperative treatment for large submucosal fibroids prior to hysteroscopic myomectomy. HIFU offers a novel approach in the management of this subset of patients. |
| format | Article |
| id | doaj-art-d0f367a5007543c8b8f36f5da44c673e |
| institution | Kabale University |
| issn | 0265-6736 1464-5157 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | International Journal of Hyperthermia |
| spelling | doaj-art-d0f367a5007543c8b8f36f5da44c673e2025-01-03T09:30:27ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572024-12-0141110.1080/02656736.2024.2365974Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomyYuchun He0Min Wu1Xu Guo2Feng Ran3Haiyan Li4Daibi Zhang5Yaqin Wang6Jin Zeng7Xuelian Chen8Linghui Zhai9Xiaohui Li10Tingting Lei11Department of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Oncology, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Oncology, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaDepartment of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, ChinaPurpose To investigate the feasibility, safety and efficacy of high intensity focused ultrasound ablation (HIFU) as a preoperative treatment for challenging hysteroscopic myomectomies.Materials and methods A total of 75 patients diagnosed with types 0–III of uterine fibroids were enrolled. Based on the Size, Topography, Extension of the base, Penetration and lateral Wall position (STEPW) classification scoring system, 25 cases with a score ≥ 5 points were treated with HIFU followed by hysteroscopic myomectomy (HIFU + HM group), whereas 50 cases with a score < 5 points were treated with hysteroscopic myomectomy (HM group).Results The median preoperative STEPW score was 7 in the HIFU + HM group and 2 in the HM group. The average non-perfused volume (NPV) ratio achieved in fibroids after HIFU was 86.87%. Patients in the HIFU + HM group underwent hysteroscopic myomectomy one to four days after HIFU, and downgrading was observed in 81.81% of fibroids. The operation time for patients in the HIFU + HM group was 73 min and the success rate of myomectomy in a single attempt was 60%. The volume of distention medium used during the operation was greater in the HIFU + HM group than in the HM group (15,500 ml vs. 7500 ml). No significant difference was observed between the two groups in terms of intraoperative blood loss, the incidence of intraoperative and postoperative complications, menstrual volume score, or uterine fibroid quality of life score.Conclusion HIFU can be utilized as a preoperative treatment for large submucosal fibroids prior to hysteroscopic myomectomy. HIFU offers a novel approach in the management of this subset of patients.https://www.tandfonline.com/doi/10.1080/02656736.2024.2365974High intensity focused ultrasound ablationhysteroscopic myomectomyuterine fibroidspretreatmentdowngrade |
| spellingShingle | Yuchun He Min Wu Xu Guo Feng Ran Haiyan Li Daibi Zhang Yaqin Wang Jin Zeng Xuelian Chen Linghui Zhai Xiaohui Li Tingting Lei Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy International Journal of Hyperthermia High intensity focused ultrasound ablation hysteroscopic myomectomy uterine fibroids pretreatment downgrade |
| title | Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| title_full | Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| title_fullStr | Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| title_full_unstemmed | Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| title_short | Feasibility, safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| title_sort | feasibility safety and efficacy of high intensity focused ultrasound ablation as a preoperative treatment for challenging hysteroscopic myomectomy |
| topic | High intensity focused ultrasound ablation hysteroscopic myomectomy uterine fibroids pretreatment downgrade |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2024.2365974 |
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