Abstract

Objective

To evaluate the clinical outcomes of transvaginal ultrasound-guided (US-guided) radiofrequency ablation (RFA) combined with mifepristone for the treatment of large uterine fibroids.

Methods

Between June 2016 and December 2018, a total of 30 patients with symptomatic uterine fibroids (≥5cm) who underwent transvaginal US-guided RFA combined with mifepristone were included in this retrospective study. A matching cohort of 30 patients underwent transvaginal US-guided RFA without mifepristone as controls. The technical efficacy, complications and mid-term treatment effectiveness were assessed and compared with the controls.

Results

The mean volume of uterine fibroid was 168.3 ± 40.1 cm³. The mean ablation time was 23.5 ± 11.3 min in the combined treatment group, which was demonstrably less than that of the RFA group, which was 45.7 ± 6.8 min. The mean number of punctures was 2.2 ± 0.6 in the combined treatment group, which was significantly less than that of the RFA group. No major complications occurred. The mean percentages of regression of fibroid at 3 and 12 months after the course of the combined treatment were 73.3% and 90.1%, respectively, which were significantly more than those of the RFA group. Quality of life and symptom scores improved in both groups but to a greater extent in the combined treatment group.

Conclusions

US-guided RFA combined with mifepristone might be a simple, safe and effective alternative for the treatment of large uterine fibroids.

中文翻译：

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射频消融联合米非司酮与射频消融治疗大子宫肌瘤的比较

摘要

客观的

评估经阴道超声引导（美国引导）射频消融（RFA）联合米非司酮治疗大子宫肌瘤的临床效果。

方法

在这项回顾性研究中，2016年6月至2018年12月期间，总共30例接受经阴道US-RFA联合米非司酮联合治疗的有症状子宫肌瘤（≥5cm）患者。一组匹配的30例患者接受了经阴道USF引导的RFA，未使用米非司酮作为对照。评估技术疗效，并发症和中期治疗效果，并与对照进行比较。

结果

子宫肌瘤的平均体积为168.3±40.1 cm ³。联合治疗组的平均消融时间为23.5±11.3分钟，明显少于RFA组的平均消融时间，为45.7±6.8分钟。联合治疗组的平均穿刺次数为2.2±0.6，明显少于RFA组。无重大并发症发生。联合治疗后3个月和12个月的肌瘤平均消退百分比分别为73.3％和90.1％，明显高于RFA组。两组的生活质量和症状评分均得到改善，但联合治疗组的生活质量和症状评分得到了更大程度的改善。

结论

美国指导的RFA联合米非司酮可能是治疗大子宫肌瘤的一种简单，安全和有效的替代方法。