Laparoscopically Assisted Cryoablation Effective for Uterine Fibroids


Last Updated: 2009-12-28 12:00:14 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Uterine fibroids can be safely and effectively managed with laparoscopically assisted cryoablation, according to a report in the December issue of the American Journal of Obstetrics & Gynecology.

Unless a woman is willing to have a hysterectomy, symptomatic uterine fibroids are usually treated with uterine artery embolization and MRI-guided high-frequency ultrasound energy. "It was our goal to establish cost-efficient fibroid-specific treatments that are familiar to gynecologists," the authors said.

In a pilot study, lead author Dr. Moty Pansky from Asaf Harofe Medical Center in Zerifin, Israel and colleagues used laparoscopically assisted cryoablation to treat 20 premenopausal women with 33 symptomatic fibroids.

The cryoablation procedure took an average of 58.5 minutes. There were no intraoperative complications, none of the patients required blood transfusion, and patients reported no significant posttreatment pain. All but one patient were discharged from the hospital within 24 hours. The other patient asked to stay longer and was discharged the next day, according to the authors.

Median fibroid volume decreased from 75.0 mL at baseline to 38.9 mL at 6 months (a 43.3% reduction) and to 18.0 mL at 12 months (a 66.4% reduction).

Symptom severity scores improved from a median of 50.0 at baseline to 25.0 at 6 months and to 12.5 at 12 months, the researchers note, whereas median health-related quality of life scores improved from 50.9 at baseline to 86.2 at 6 months and to 92.2 at 12 months.

Fourteen women reported vaginal blood clots prior to treatment, and this was reduced to 5 women at 6 months and 4 women at 12 months.

"This technique is still in the early stages of study, and larger studies with long-term prospective data are required by the US Food and Drug Administration to approve the 17-gauge needles for cryoablation of uterine fibroids," the investigators say.

"We believe that laparoscopic cryoablation represents an important milestone in the search for the ideal minimally invasive technique for the management of symptomatic uterine myomas," the authors conclude.

Am J Obstet Gynecol 2009;210:571.

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