Fibroma surgery: Difference between revisions
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===Uterine fibroma=== | ===Uterine fibroma=== | ||
====Hysterectomy==== | ====Hysterectomy==== | ||
*The [[standard]] treatment for [[uterine fibroids]] include [[Uterus|uteru]]<nowiki/>s [[resection]] ([[Hysterectomy|hysterectomy]])<nowiki/> | *The [[standard]] treatment for [[uterine fibroids]] include [[Uterus|uteru]]<nowiki/>s [[resection]] ([[Hysterectomy|hysterectomy]])<nowiki/> either transabdominal or transvaginal and sometimes even [[resection]] of the [[ovaries]].<ref name="GoldmanHirshfeld-Cytron2012">{{cite journal|last1=Goldman|first1=Kara N.|last2=Hirshfeld-Cytron|first2=Jennifer E.|last3=Pavone|first3=Mary-Ellen|last4=Thomas|first4=Andrew P.|last5=Vogelzang|first5=Robert L.|last6=Milad|first6=Magdy P.|title=Uterine artery embolization immediately preceding laparoscopic myomectomy|journal=International Journal of Gynecology & Obstetrics|volume=116|issue=2|year=2012|pages=105–108|issn=00207292|doi=10.1016/j.ijgo.2011.08.022}}</ref><ref>{{Cite journal | ||
| author = [[Corina Grigoriu]], [[Mihai Dumitrascu]], [[Mirela Grigoras]], [[Irina Horhoianu]], [[V. Horhoianu]], [[R. Nechifor]], [[B. Dorobat]], [[Alina Pavel]] & [[G. Lana]] | | author = [[Corina Grigoriu]], [[Mihai Dumitrascu]], [[Mirela Grigoras]], [[Irina Horhoianu]], [[V. Horhoianu]], [[R. Nechifor]], [[B. Dorobat]], [[Alina Pavel]] & [[G. Lana]] | ||
| title = Combined endovascular and surgical therapy of uterine fibroma | | title = Combined endovascular and surgical therapy of uterine fibroma |
Revision as of 12:25, 29 July 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Template:A.E Maneesha Nandimandalam, M.B.B.S.[2]
Surgery
Benign fibromas can be removed or left alone. A physician should examine the fibroma and determine whether it may be malignant. If there is any question as to whether it may be cancer-related, it should be removed. This is usually a brief outpatient procedure. For most fibromas the definitive treatment is complete excision.
Uterine fibroma
Hysterectomy
- The standard treatment for uterine fibroids include uterus resection (hysterectomy) either transabdominal or transvaginal and sometimes even resection of the ovaries.[1][2][3][4]
- For young women who wish to preserve their fertility, hysterectomy is not a desirable therapeutical option.
- Furthermore it has lots of risks and complications like:
- Postoperative bleeding
- Hectic syndrome
- Low sexual desire
- Depression
- High risk of cardiovascular illness
Segmentary myomectomy
- It is a conservative surgical procedure that consists of resecting the tumor, with the preservation of uterus and, therefore the reproductive function.[5] [6]
- It is also associated with increased blood loss, pain and prolonged operative time.
Uterine artery embolization
- Bilateral uterine artery embolisation is used as an alternative approach to surgery.[7][8][9][10][11][1]
- Embolisation of uterine arteries causes lack of blood supply(devascularisation) of all fibroma structures in the uterus.
- The normal uterine elements remain unaffected, while the fibroma suffers an ischemia, necrosis.
- Young females with multiple fibromas who wish to have children are the appropriate ones for embolization, also patients with symptomatic uterine fibroma who refuse to have a hysterectomy, blood transfusion, or general anesthesia
- The embolisation performed a few days before surgery has numerous advantages:
- Less surgery bleeding, as a result eliminates the necessity for blood transfusion
- Reduces the duration of the surgery
- It allows resection of very large fibromas or of those inaccessible areas (the posterior side of the uterus, the inferior side close to the cervix)
- Eliminates the risk of relapse
References
- ↑ 1.0 1.1 Goldman, Kara N.; Hirshfeld-Cytron, Jennifer E.; Pavone, Mary-Ellen; Thomas, Andrew P.; Vogelzang, Robert L.; Milad, Magdy P. (2012). "Uterine artery embolization immediately preceding laparoscopic myomectomy". International Journal of Gynecology & Obstetrics. 116 (2): 105–108. doi:10.1016/j.ijgo.2011.08.022. ISSN 0020-7292.
- ↑ Corina Grigoriu, Mihai Dumitrascu, Mirela Grigoras, Irina Horhoianu, V. Horhoianu, R. Nechifor, B. Dorobat, Alina Pavel & G. Lana (2008). "Combined endovascular and surgical therapy of uterine fibroma". Journal of medicine and life. 1 (1): 60–65. PMID 20108481. Unknown parameter
|month=
ignored (help) - ↑ W. M. Ankum & J. A. Reekers (2001). "[Embolization of uterine artery: a new treatment for uterine myomas]". Nederlands tijdschrift voor geneeskunde. 145 (16): 765–769. PMID 11346912. Unknown parameter
|month=
ignored (help) - ↑ A. Hirst, S. Dutton, O. Wu, A. Briggs, C. Edwards, L. Waldenmaier, M. Maresh, A. Nicholson & K. McPherson (2008). "A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. The HOPEFUL study". Health technology assessment (Winchester, England). 12 (5): 1–248. PMID 18331704. Unknown parameter
|month=
ignored (help) - ↑ W. M. Ankum & J. A. Reekers (2001). "[Embolization of uterine artery: a new treatment for uterine myomas]". Nederlands tijdschrift voor geneeskunde. 145 (16): 765–769. PMID 11346912. Unknown parameter
|month=
ignored (help) - ↑ Corina Grigoriu, Mihai Dumitrascu, Mirela Grigoras, Irina Horhoianu, V. Horhoianu, R. Nechifor, B. Dorobat, Alina Pavel & G. Lana (2008). "Combined endovascular and surgical therapy of uterine fibroma". Journal of medicine and life. 1 (1): 60–65. PMID 20108481. Unknown parameter
|month=
ignored (help) - ↑ W. M. Ankum & J. A. Reekers (2001). "[Embolization of uterine artery: a new treatment for uterine myomas]". Nederlands tijdschrift voor geneeskunde. 145 (16): 765–769. PMID 11346912. Unknown parameter
|month=
ignored (help) - ↑ Corina Grigoriu, Mihai Dumitrascu, Mirela Grigoras, Irina Horhoianu, V. Horhoianu, R. Nechifor, B. Dorobat, Alina Pavel & G. Lana (2008). "Combined endovascular and surgical therapy of uterine fibroma". Journal of medicine and life. 1 (1): 60–65. PMID 20108481. Unknown parameter
|month=
ignored (help) - ↑ R. W. Dover, H. W. Torode & G. M. Briggs (2000). "Uterine artery embolisation for symptomatic fibroids". The Medical journal of Australia. 172 (5): 233–236. PMID 10776397. Unknown parameter
|month=
ignored (help) - ↑ Ozgur H. Harmanli & Meena Khandelwal (2003). "Transvaginal uterine artery ligation in a woman with uterine leiomyomas. A case report". The Journal of reproductive medicine. 48 (5): 384–386. PMID 12815915. Unknown parameter
|month=
ignored (help) - ↑ A. Hirst, S. Dutton, O. Wu, A. Briggs, C. Edwards, L. Waldenmaier, M. Maresh, A. Nicholson & K. McPherson (2008). "A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. The HOPEFUL study". Health technology assessment (Winchester, England). 12 (5): 1–248. PMID 18331704. Unknown parameter
|month=
ignored (help)