Clinical Investigation of Laparoscopic Cytoreductive Surgery Combined with Gestrinone in the Treatment of Adenomyosis_West China Medical Journal

Authors：

 WEIZeng-tao ^1,2 , CUIXiao-yan ^1,3 , WANGZhan-ying ¹ , WANGSu-qin ⁴ , WANGXiao-yan ²

1. Department of Gynecology, Central Hospital of Jinan City Affiliated to Shandong University, Jinan, Shandong 250012, P. R. China;
2. Teaching Section of Gynecology, Medical College of Shandong University, Jinan, Shandong 250012, P. R. China;
3. Teaching Section of Gynecology, Weifang Medical College, Weifang, Shandong 261053, P. R. China;
4. Department of Gynecology, the Second People's Hospital of Qihe County, Qihe, Shandong 251100, P. R. China;

Corresponding author：

Keywords：

Adenomyosis; Laparoscopy; Cytoreductive surgery; Gestrinone; Clinical effect

DOI：

10.7507/1002-0179.20140513

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Objective To explore the clinical effect and safety of laparoscopic cytoreductive surgery combined with gestrinone in the treatment of adenomyosis. Methods We retrospectively analyzed the clinical data of 82 patients with adenomyosis who accepted treatment in our hospital from January 2008 to April 2011. According to different treatment method, the patients were divided into three groups. Twenty-seven patients in the treatment group underwent laparoscopic cytoreductive surgery combined with postoperative treatment with gestrinone. For the 25 patients in the surgery group, only laparoscopic cytoreductive surgery was performed, and 30 other patients who only received oral gestrinone were designated as the medicine group. Dysmenorrhea, menstrual volume, uterine size, serum carcinoembryonic antigen 125 (CA125), anemia, and drug side effects were respectively recorded before and after surgery. Results The dysmenorrhea degree reduced significantly in all the three groups. There was no significant difference in the degree of dysmenorrhea, menstrual volume, and uterine volume between the treatment group and the surgery group (P>0.05); the dysmenorrhea degree was significantly different between the treatment group and the medicine group (P<0.05); the differences in hemoglobin levels and the serum CA125 level between the treatment group and the surgery group 12 months later were significant (P=0.019, P=0.049). Conclusion The laparoscopic cytoreductive surgery combined with gestrinone in treating adenomyosis can improve recent curative effect and provide more effective symptom control compared with surgery alone.

Citation： WEIZeng-tao, CUIXiao-yan, WANGZhan-ying, WANGSu-qin, WANGXiao-yan. Clinical Investigation of Laparoscopic Cytoreductive Surgery Combined with Gestrinone in the Treatment of Adenomyosis. West China Medical Journal, 2014, 29(9): 1682-1686. doi: 10.7507/1002-0179.20140513 Copy

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2.	艾小燕,程玉芬,张晓玲.腹腔镜病灶切除术联合戈舍瑞林治疗子宫腺肌瘤30例临床分析[J].实用妇产科杂志,2009(12):755-756.
3.	陈春林,刘萍,吕军,等.子宫动脉栓塞术在子宫腺肌病治疗中的应用[J].中华妇产科杂志,2002,37(2):77-79.
4.	Kim MD,Kim S,Kim NK,et al.Long-term results of uterine artery embolization for symptomatic adenomyosis[J].AJR Am J Roentgenol,2007,188(1):176-181.
5.	Pepas L,Deguara C,Davis C.Update on the surgical management of adenomyosis[J].Curr Opin Obstet Gynecol,2012,24(4):259-264.
6.	乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008:331-332.
7.	Wang PH,Liu WM,Fuh JL,et al.Comparison of surgery alone and combined surgical-medical treatment in the management of symptomatic uterine adenomyoma[J].Fertil Steril,2009,92(3):876-885.
8.	Katz A.Sexuality after hysterectomy[J].J Obstet Gynecol Neonatal Nurs,2002,31(3):256-262.
9.	Mobarakeh MD,Maghsudi A,Rashidi I.Adenomyosis among samples from hysterectomy due to abnormal uterine bleeding in Ahwaz,southern Iran[J].Adv Biomed Res,2012:49.
10.	李鼎恒,徐愔烨,寿坚,等.腹腔镜下腺肌瘤病灶切除联合曼月乐治疗子宫腺肌病疼痛53例观察[J].中华危重症医学杂志·电子版,2010,3(5):331-334.
11.	李娟,温泽清.子宫腺肌病的治疗进展[J].中国现代医学杂志,2012,22(11):60-65.
12.	张惜阴.实用妇产科学[M].2版.北京:人民卫生出版社,2003:746.
13.	沈宏伟,曾海涛,柯佩琪,等.CA125对子宫动脉栓塞术治疗子宫腺肌病疗效和复发的预测价值[J].中山大学学报·医学科学版,2007,28(增刊1):74-75.
14.	Huang BS,Seow KM,Tsui KH,et al.Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist:long-term follow-up in a series of nine patients[J].Taiwan J Obstet Gynecol,2012,51(2):212-216.
15.	李雷,冷金花,郎景和.子宫内膜异位症和子宫腺肌症手术治疗的经济学指标分析[J].中华医学杂志,2011,91(37):2619-2622.
16.	Wang PH,Fuh JL,Chao HT,et al.Is the surgical approach beneficial to subfertile women with symptomatic extensive adenomyosis?[J].J Obstet Gynaecol Res,2009,35(3):495-502.

1. Kim MD,Won JW,Lee DY,et al.Uterine artery embolization for adenomyosis without fibroids[J].Clin Radiol,2004,59(6):520-526.
2. 艾小燕,程玉芬,张晓玲.腹腔镜病灶切除术联合戈舍瑞林治疗子宫腺肌瘤30例临床分析[J].实用妇产科杂志,2009(12):755-756.
3. 陈春林,刘萍,吕军,等.子宫动脉栓塞术在子宫腺肌病治疗中的应用[J].中华妇产科杂志,2002,37(2):77-79.
4. Kim MD,Kim S,Kim NK,et al.Long-term results of uterine artery embolization for symptomatic adenomyosis[J].AJR Am J Roentgenol,2007,188(1):176-181.
5. Pepas L,Deguara C,Davis C.Update on the surgical management of adenomyosis[J].Curr Opin Obstet Gynecol,2012,24(4):259-264.
6. 乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008:331-332.
7. Wang PH,Liu WM,Fuh JL,et al.Comparison of surgery alone and combined surgical-medical treatment in the management of symptomatic uterine adenomyoma[J].Fertil Steril,2009,92(3):876-885.
8. Katz A.Sexuality after hysterectomy[J].J Obstet Gynecol Neonatal Nurs,2002,31(3):256-262.
9. Mobarakeh MD,Maghsudi A,Rashidi I.Adenomyosis among samples from hysterectomy due to abnormal uterine bleeding in Ahwaz,southern Iran[J].Adv Biomed Res,2012:49.
10. 李鼎恒,徐愔烨,寿坚,等.腹腔镜下腺肌瘤病灶切除联合曼月乐治疗子宫腺肌病疼痛53例观察[J].中华危重症医学杂志·电子版,2010,3(5):331-334.
11. 李娟,温泽清.子宫腺肌病的治疗进展[J].中国现代医学杂志,2012,22(11):60-65.
12. 张惜阴.实用妇产科学[M].2版.北京:人民卫生出版社,2003:746.
13. 沈宏伟,曾海涛,柯佩琪,等.CA125对子宫动脉栓塞术治疗子宫腺肌病疗效和复发的预测价值[J].中山大学学报·医学科学版,2007,28(增刊1):74-75.
14. Huang BS,Seow KM,Tsui KH,et al.Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist:long-term follow-up in a series of nine patients[J].Taiwan J Obstet Gynecol,2012,51(2):212-216.
15. 李雷,冷金花,郎景和.子宫内膜异位症和子宫腺肌症手术治疗的经济学指标分析[J].中华医学杂志,2011,91(37):2619-2622.
16. Wang PH,Fuh JL,Chao HT,et al.Is the surgical approach beneficial to subfertile women with symptomatic extensive adenomyosis?[J].J Obstet Gynaecol Res,2009,35(3):495-502.

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West China Medical Journal

Clinical Investigation of Laparoscopic Cytoreductive Surgery Combined with Gestrinone in the Treatment of Adenomyosis

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