Email this article Comparative evaluation of combined and isolated applications of high-intensity focused ultrasound and super-selective uterine artery embolization in treatment of patients with uterine fibroids
- Authors: Politova A.K.1, Kira E.F.1, Bolomatov N.V.1, Kitayev V.M.1, Bruslik S.V.1, Sviridova T.I.1, Slabozhankina E.A.1, Amelina Y.L.1, Politova A.A.1
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Affiliations:
- National Medical and Surgical Center named after N.I. Pirogov
- Issue: Vol 71, No 1 (2022)
- Pages: 71-78
- Section: Original Research
- URL: https://journals.eco-vector.com/jowd/article/view/71360
- DOI: https://doi.org/10.17816/JOWD71360
- ID: 71360
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Open Access
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Abstract
BACKGROUND: Uterine fibroids are a benign tumor found in two out of three women of reproductive age. The most modern methods of organ preserving treatment of uterine fibroids are uterine artery embolization, which is a minimally invasive procedure, and high intensity focused ultrasound (HIFU) ablation, which is a non-invasive procedure. According to the literature and our own experience, uterine artery embolization is ineffective in 17.1% of cases and HIFU ablation in 16% of cases, mainly due to the peculiarities of blood supply to myomatous nodes.
AIM: The aim of this study was to compare the effectiveness of the treatment of uterine fibroids using an isolated HIFU ablation technique and combined sequential application of selective embolization of uterine artery supplying the myomatous node and HIFU ablation.
MATERIALS AND METHODS: This study included two groups of patients with symptomatic uterine fibroids. Group 1 consisted of 133 patients treated using the isolated HIFU ablation, and group 2 comprised 90 patients treated sequentially using supplying the myomatous node and HIFU ablation. Age and clinical manifestations of the disease (menometrorrhagia, pain syndrome, impaired function of adjacent organs, anemia) did not differ in the both groups.
RESULTS: The following parameters were different in the study groups: the duration of ultrasound ablation (p < 0.005) and the decrease in the volume of myomatous nodes in one, six and 12 months after surgery (p < 0.001). The duration of ultrasound ablation was 610.84 (56.26) minutes in group 1 and 215.28 (70.57) minutes in group 2. In group 1, the decrease in the volume of myomatous nodes was 12.2% in one month and 58.97% in 12 months after surgery, compared to the initial value. In group 2, the decrease was 42.9% and 67.5%, respectively.
CONCLUSIONS: The combined treatment of uterine fibroids using supplying the myomatous node and FUVI ablation techniques allowed for reducing the duration of the FUVI ablation operation three times and the volume of the node by 67.5% within one year compared to group 1 (58.97%).
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About the authors
Alla K. Politova
National Medical and Surgical Center named after N.I. Pirogov
Email: al1870@mail.ru
ORCID iD: 0000-0002-5924-2616
SPIN-code: 6558-5394
Scopus Author ID: 535385
MD, Assistant Professor, Doctor of Medical Sciences, Head of the Women's Health Center, Professor of the Department of Women's Diseases and Reproductive Health
Russian Federation, 70, Nizhnyaya Pervomayskaya str., Moscow, 105203Evgeny F. Kira
National Medical and Surgical Center named after N.I. Pirogov
Author for correspondence.
Email: profkira33@gmail.com
ORCID iD: 0000-0002-1376-7361
SPIN-code: 8955-9775
Scopus Author ID: 200738
MD, Doctor of Medical Sciences, Professor, Head of the Department of Women's Diseases and Reproductive Health
Russian Federation, 65, Nizhnyaya Pervomayskaya str., Moscow, 105203Nikolay V. Bolomatov
National Medical and Surgical Center named after N.I. Pirogov
Email: n-v-bolomatov@yandex.ru
ORCID iD: 0000-0003-0590-2225
Scopus Author ID: 6506315445
ResearcherId: Z-5232-2019
MD, Doctor of Medical Sciences, Professor of the Department of Thoracic and Cardiovascular Surgery with the course of X-ray Endovascular Surgery
Russian Federation, 65, Nizhnyaya Pervomayskaya str., Moscow, 105203Vycheslav M. Kitayev
National Medical and Surgical Center named after N.I. Pirogov
Email: vm_kitaev@list.ru
ORCID iD: 0000-0002-6093-5719
Scopus Author ID: 57193996795
ResearcherId: Z-5923-2019
MD, Doctor of Medical Sciences, Professor, Head of the Department of Radiation Diagnostics with the course of Clinical Radiology
Russian Federation, 65, Nizhnyaya Pervomayskaya str., Moscow, 105203Sergey V. Bruslik
National Medical and Surgical Center named after N.I. Pirogov
Email: drbruslik@mail.ru
ORCID iD: 0000-0003-3865-3704
MD, Candidate of Medical Sciences, Head of the Department of Ultrasound and x-ray surgical methods Diagnostics and Treatment
Russian Federation, 70, Nizhnyaya Pervomayskaya str., Moscow, 105203Tatyana I. Sviridova
National Medical and Surgical Center named after N.I. Pirogov
Email: drsviridova@mail.ru
ORCID iD: 0000-0002-2984-9505
MD, candidate of Medical Sciences, doctor of ultrasound of the Department of Ultrasound and x-ray surgical methods Diagnostics and Treatment
Russian Federation, 70, Nizhnyaya Pervomayskaya str., Moscow, 105203Ekaterina A. Slabozhankina
National Medical and Surgical Center named after N.I. Pirogov
Email: elfkat@mail.ru
ORCID iD: 0000-0003-3816-293X
SPIN-code: 1615-5661
MD, candidate of Medical Sciences, doctor of ultrasound of the Department of Ultrasound and x-ray surgical methods Diagnostics and Treatment
Russian Federation, 70, Nizhnyaya Pervomayskaya str., Moscow, 105203Yulia L. Amelina
National Medical and Surgical Center named after N.I. Pirogov
Email: doctoramelina@mail.ru
ORCID iD: 0000-0001-9903-4216
SPIN-code: 3528-5618
MD, postgraduate student of the Department of Women's Diseases and Reproductive Health
Russian Federation, 65, Nizhnyaya Pervomayskaya str., Moscow, 105203Alexandra A. Politova
National Medical and Surgical Center named after N.I. Pirogov
Email: alexandra.politowa@mail.ru
ORCID iD: 0000-0002-2639-9043
Scopus Author ID: 57205459017
6th year student
Russian Federation, MoscowReferences
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