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
- 
							Affiliations: 
							- National Medical and Surgical Center named after N.I. Pirogov
 
- Issue: Vol 71, No 1 (2022)
- Pages: 71-78
- Section: Original study articles
- URL: https://journals.rcsi.science/jowd/article/view/71360
- DOI: https://doi.org/10.17816/JOWD71360
- ID: 71360
Cite item
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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##article.viewOnOriginalSite##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
- Buianova SN, Mgeliashvili MV, Petrakova SA. Current views of the etiology, pathogenesis, and morphogenesis of uterine myoma. Rossijskij vestnik akushera-ginekologa. 2008;8(6):45−51. (In Russ.)
- Radzinskij VE, Totchiev GF. Mioma matki: kurs na organosohranenie: informacionnyj bjulleten’. Moscow: StatusPraesens; 2014. (In Russ.)
- Mioma matki. Ed. by I.S. Sidorova. Moscow: MIA; 2003. (In Russ.)
- Vilos GA, Allaire C, Laberge PY, Leyland N. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015;37(2):157−178. doi: 10.1016/S1701-2163(15)30338-8
- Breusenko VG, Dobrohotova JuJe, Krasnova IA, et al. Jembolizacija matochnyh arterij: sovremennyj vzgljad na problemu. Chast’ II: metodicheskie aspekty. Diagnosticheskaja i intervencionnaja radiologija. 2007;1(2):56−70. (In Russ.)
- Kapranov SA, Breusenko VG, Dobrohotova JuJe, et al. Jembolizacija matochnyh arterij: sovremennyj vzgljad na problemu. Chast’ I: obshhie voprosy. Diagnosticheskaja i intervencionnaja radiologija. 2007;1(1):72−87. (In Russ.)
- Dobrohotova JuJe, Kapranov SA, Alieva AA, et al. Novyj organosohranjajushhij metod lechenija miomy matki − jembolizacija matochnyh arterij. Lechebnoe delo. 2005;(2):24−27. (In Russ.)
- Lubnin DM. Selektivnaja jembolizacija matochnyh arterij v algoritme organosohranjajushhego lechenija miomy matki [dissertation abstract]. Moscow; 2005. (In Russ). [cited 20 Sept 2021] Available from: https://www.dissercat.com/content/selektivnaya-embolizatsiya-matochnykh-arterii-v-algoritme-organosokhranyayushchego-lecheniya
- Nazarenko GI, Chen VSh, Dzhan L, Hitrova AN. Ul’trazvukovaja ablacija (HIFU) – vysokotehnologichnaja organosohranjajushhaja al’ternativa hirurgicheskogo lechenija opuholej. Moscow; 2008.
- Lyon PC, Rai V, Price N, et al. Ultrasound-guided high intensity focused ultrasound ablation for symptomatic uterine fibroids: Preliminary clinical experience. Ultraschall Med. 2020;41(5):550−556. (In German). doi: 10.1055/a-0891-0729
- Borah BJ, Yao X, Laughlin-Tommaso SK, et al. Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database. Obstet Gynecol. 2017;130(5):1047−1056. doi: 10.1097/AOG.0000000000002331
- Panagiotopoulou N, Nethra S, Karavolos S, et al. Uterine-sparing minimally invasive interventions in women with uterine fibroids: a systematic review and indirect treatment comparison meta-analysis. Acta Obstet Gynecol Scand. 2014;93(9):858−867. doi: 10.1111/aogs.12441
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