Background: To systematic review the safety and effectiveness between uterine artery embolization (UAE), surgery and high intensity focused ultrasound (HIFU) in the treatment of uterine fibroids.
Methods: The PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang Data, and CNKI were electronically searched to collect relevant studies on comparing the safety and effectiveness of UAE, surgery and HIFU in the treatment of uterine fibroids from January 2000 to August 2019. After two reviewers independently screened the literature, extracted the data and evaluated the risk of bias of included studies, network meta-analysis was performed by ADDIS 1.16.8 and Stata 14 software.
Results: A total of 11 studies (22 articles) involving 3,646 patients were included. Compared with surgery, UAE and HIFU patients had higher quality of life (1-year follow-up) improvement, and UAE was higher than HIFU. Network meta-analysis show that patients treated with HIFU had the lowest incidence of major complications within 1 year, followed by UAE, and the highest surgery. Patients treated with HIFU and UAE have shorter hospital stays and quicker recovery time than surgery. The rate of further intervention after surgery treatment might be lower than that of UAE and HIFU.
Conclusions: UAE has the highest quality of life improvement (1-year follow-up) for uterine fibroids. HIFU and UAE are safer with shorter hospital stays and quicker recovery time compared with surgery. However, both UAE and HIFU have the risks of re-treatment. However, limited by the number and quality of included studies, the above conclusions need to be verified through more high-quality studies.
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http://dx.doi.org/10.21037/qims-20-1331 | DOI Listing |
Clin Oncol (R Coll Radiol)
December 2024
Faculty of Medicine and Health Sciences, University of Antwerp, Prinsstraat 13, 2000, Antwerp, Belgium; Department of Radiation Oncology, Iridium Netwerk, Oosterveldlaan 22, 2610, Antwerp, Belgium. Electronic address:
Aim: Tumour-infiltrating lymphocytes (TILs) represent a promising cancer biomarker. Different TILs, including CD8+, CD4+, CD3+, and FOXP3+, have been associated with clinical outcomes. However, data are lacking regarding the value of TILs for patients receiving radiation therapy (RT).
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Biochemistry, Republic of Turkey Ministry of Health Taksim Training and Research Hospital, İstanbul, Turkey.
This prospective observational study aimed to compare abdominal hysterectomy (AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) in terms of oxidative stress (OS) by measuring serum levels of total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI). Of the 3 groups, namely, AH, VH, and TLH, 22 patients were enrolled in each to investigate the aim of the study mentioned above. Patient demographics, clinical and surgical characteristics, and preoperative and postoperative (0th and 24th hours) serum TAS, TOS, and OSI levels were investigated.
View Article and Find Full Text PDFPLoS One
January 2025
School of Public Health, Makerere University, Kampala, Uganda.
Introduction: Cervical cancer (CC) is the leading cause of cancer-related deaths among Uganda women, yet rates of CC screening are very low. Training women who have recently screened to engage in advocacy for screening among women in their social network is a network-based strategy for promoting information dissemination and CC screening uptake.
Methods: Drawing on the Exploration, Preparation, Implementation and Sustainment (EPIS) framework for implementation science, this hybrid type 1 randomized controlled trial (RCT) of a peer-led, group advocacy training intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), will examine efficacy for increasing CC screening uptake as well as how it can be implemented and sustained in diverse clinic settings.
Asian J Endosc Surg
January 2025
VM Medicalpark Florya Hospital, İstanbul Aydın University, İstanbul, Turkey.
This study demonstrates the feasibility of performing a Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy on a patient with a complex surgical history, including two renal transplants. The case involves a 42-year-old female presenting with persistent menorrhagia and hypermenorrhea, unresponsive to standard treatments, and diagnosed with adenomyosis and CIN3. A detailed, step-by-step procedure of the vNOTES technique is provided, marking the first video article to document vNOTES hysterectomy in such a medical context.
View Article and Find Full Text PDFInt J Gynaecol Obstet
January 2025
Effective Care Research Unit, University of the Witwatersrand and Walter Sisulu University, East London, South Africa.
Objective: To compare low-cost "Suction Tube Uterine Tamponade" (STUT) treatment for refractory postpartum hemorrhage (PPH) with uterine balloon tamponade (UBT) using a randomized feasibility study.
Methods: After verbal assent, we allocated participants with refractory PPH by randomly ordered envelopes to STUT or routine UBT at 10 hospitals in South Africa and one tertiary referral center in Colombia between January 10, 2020, and May 3, 2024. In the STUT group, we inserted a 24 FG Levin stomach tube into the uterine cavity and applied suction.
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