Seul Ki You and Yong Soon Kwon
Ulsan University Hospital-University of Ulsan, Korea
Posters & Accepted Abstracts: Surgery Curr Res
Background: To introduce the safe and effective surgical technique of laparoscopic adenomyomectomy with transient occlusion of uterine arteries (TOUA) in patients with symptomatic uterine adenomyoma. Materials & Methods: In a prospective case study, we examined all cases of laparoscopic adenomyomectomy with TOUA performed by a single surgeon at Ulsan University Hospital, Ulsan, Korea, between May 2011 and February 2014. Surgical outcomes included operative time, intraoperative injury of blood vessels, nerves and pelvic organs, as well as intraoperative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia and the recurrence of adenomyomic lesions by ultrasonography at the 6-month follow-up after laparoscopic adenomyomectomy with TOUA. Results: Seventy-one women who were refractory to medical treatment or who wanted surgical treatment for preserving their uterus underwent laparoscopic adenomyomectomy with TOUA using an endoscopic vascular clip. The mean age was 42.9±5.35 years (mean age±standard deviation). The mean diameter of the adenomyomas was 3.2±2.16 cm. The mean operation time, and hospital stay were 84.09±31.48 minutes and 5.42±1.54 days, respectively. The mean estimated blood loss was 184.35±134.25 mL, and no injury to the uterine arteries or pelvic nerves occurred. No cases of conversion to a laparotomy or major complications occurred. At the 6-month follow-up, complete remission of dysmenorrhea and menorrhagia occurred in 94.5% and 86.5% of patients, respectively. The mean follow-up period was 18.7 months. During this period, recurrence rate was 5 cases (7%) and one of these 5 recurred cases was undertaken the operation (laparoscopic hysterectomy). Conclusions: Laparoscopic adenomyomectomy with TOUA could be a safe and effective surgical method for women with symptomatic uterine adenomyoma who want to preserve their fertility.