子宫动脉栓塞和子宫切除术在症状性子宫纤维瘤(EMMY临床试验)治疗中的比较:围手术期及术后结局的随机对照试验

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Objective: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy. Study design: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri-and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks’post-intervention. Analysis was by intention to treat. Results: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9%(UAE) and 2.7%(hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0%vs 40.0%; RR 1.45 1.04-2.02 ; P = .024). UAE patients were more often readmitted (11.1%vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean SD : 2.5 2.7 vs 5.1 1.3 , P < .001). Conclusion: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up. Objective: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy. Study design: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to In this paper we evaluate the peri-and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks’post-intervention. Analysis was by intention Results: Bilateral UAE failure occurred in 4 patients (4.9%). Minor minor disease occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 1.04-2.02; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003) . Total length of hospital stay was significan tly shorter in UAE patients (mean SD: 2.5 2.7 vs 5.1 1.3, P <.001). Conclusion: UAE is a procedure similar to hysterectomy with a low major complication rate and with reduced rate of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.
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