Fibroma surgery: Difference between revisions
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*For [[Young adult|young]] [[women]] who wish to preserve their [[fertility]], [[hysterectomy]] is not a desirable therapeutical option. | *For [[Young adult|young]] [[women]] who wish to preserve their [[fertility]], [[hysterectomy]] is not a desirable therapeutical option. | ||
*Furthermore it has lots of [[risks]] and [[complications]] like: | *Furthermore it has lots of [[risks]] and [[complications]] like: | ||
**Postoperative bleeding | **[[Postoperative haemorrhage|Postoperative bleeding]] | ||
**Hectic syndrome | **Hectic [[syndrome]] | ||
**Low sexual desire | **Low [[sexual desire]] | ||
**[[Depression]] | **[[Depression]] | ||
**High risk of [[cardiovascular]] illness | **High risk of [[cardiovascular]] illness | ||
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| pmid = 18331704 | | pmid = 18331704 | ||
}}</ref> | }}</ref> | ||
* | *[[Embolization]] of [[Uterine artery|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. | *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 | *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 | *The [[embolization]] performed a few days before [[surgery]] has numerous advantages: | ||
**Less surgery bleeding, as a result eliminates the necessity for blood transfusion | **Less [[surgery]] [[bleeding]], as a result eliminates the necessity for [[blood transfusion]] | ||
**Reduces the duration of the surgery | **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) | **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 | **Eliminates the risk of [[relapse]] | ||
[[File:Uterine artery embolization 1.jpg|500px|thumb|center|Grigoriu C, Dumitrascu M, Grigoras M, et al. Combined endovascular and surgical therapy of uterine fibroma. J Med Life. 2008;1(1):60–65.,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607786/]] | [[File:Uterine artery embolization 1.jpg|500px|thumb|center|Grigoriu C, Dumitrascu M, Grigoras M, et al. Combined endovascular and surgical therapy of uterine fibroma. J Med Life. 2008;1(1):60–65.,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607786/]] | ||
Latest revision as of 17:29, 18 September 2019
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Fibroma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Fibroma surgery On the Web |
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American Roentgen Ray Society Images of Fibroma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]
Overview
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.
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
Fibroids are removed by the following procedures
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.[1][7][8][9][10][11]
- Embolization 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 embolization performed a few days before surgery has numerous advantages:
Contraindications
There are no contraindications for surgery of uterine fibroma
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 medicinhttps://www.wikidoc.org/index.php?title=Fibroma_surgery&action=edite and life. 1 (1): 60–65. PMID 20108481. Unknown parameter
|month=ignored (help); External link in|journal=(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)