ABSTRACT
Objective:To investigate the long-term efficacy and the adverse reactions of uterine artery embolization with polyvinyl alcohol granules in the treatment of adenomyosis.Methods:Sixty patients with adenomyosis who received treatment in The Second People's Hospital of Qinzhou from January 2009 to February 2017 were retrospectively included in this study. They were divided into an observation group ( n = 31) and a control group ( n = 29) according to different treatment methods. The observation group was treated by embolization of the uterine artery with a polyvinyl alcohol granule. The control group was treated with a levonorgestrel-releasing intrauterine system. After treatment, all patients were followed up for 2-5 years. The long-term efficacy was evaluated, including the symptoms of dysmenorrhea, average menstrual fluid volume, sex hormone, and change in uterine size. Results:After 2 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 72.4% (21/29) in the control group ( χ2 = 4.81, P = 0.028). After 5 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 65.5% (19/29) in the control group ( χ2 = 7.35, P = 0.007). After treatment, the improvements in uterine size, menstrual fluid volume, and visual analogue scale score were greater in the observation group than those in the control group (all P < 0.05). After treatment, all patients were followed up for 5 years. There was no significant difference in the incidence of long-term adverse reactions between the observation and control groups [3.2% (1/31) vs. 6.9% (2/29), P > 0.05]. The recurrence rate in the observation group was 3.45% (1/29), which was significantly lower than 23.81% (5/21) in the control group ( χ2 = 4.78, P = 0.029). After 2 and 5 years of treatment, ovarian function was not affected in both groups of patients. Conclusion:Uterine artery embolization with polyvinyl alcohol granules for the treatment of adenomyosis has identified long-term curative effects, is safe, and has a low recurrence rate.
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Objective@#To compare the nature of pregnancy and deliveryin women with leiomyoma who were treated with uterine artery embolization to the outcomes in women who were treated with abdominal myomectomy. @*Material and Methods@#A prospective, clinical study was conducted in 2010-2013 at “Urguu” Maternity Hospital, Ulaanbaatar. 94 women meeting the criteria were selected for the study. Post-treatment, the patients were reviewed for a period of two years. Uterine artery embolization was performed using polyvinyl alcohol particles (300-500 µm in diameter).@*Results@#The percentage of conception in UAE group was 25.5% and 31.9% in myomectomy group (p=0.494); complication of pregnancy was 50.0% and 57.1% respectively (p=0.729); complication of delivery was 33.3% and 0.0% respectively (p=0.047). 88.9% and 90.0% (p=0.596) had Caesarean delivery. 16 (84.2%) women had uncomplicated and 3 (15.8%) women had complicated delivery due to placenta praevia, placenta acreta and uterine hypotonia. These cases all belonged to UAE group. @*Conclusion@#Pregnancy rates in women with leiomyoma who were treated by uterine artery embolization, compared with pregnancies after abdominal myomectomy, were similar.(p=0.494) In this study, there was the rate of Cesarean delivery above 80 percent in both group. There were no differences in newborn weights and Apgar scores.
ABSTRACT
Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) with polyvinyl alcohol (PVA) particles as embolic material in patients with primary hepatic cancer (PHC). Methods Twenty patients with PHC underwent TACE. The mixed emulsion of chemotherapy agents and lipiodol was given to embolize the tumor vssTranscatheter arterial chemoembolization using polyvinyl alcohol feeding artery of tumors. The tumors size, response rate and Alpha-Fetoprotein (AFP) value were monitored respectively at the end of the first month, the third month, the sixth month and the first year after TACE. The changes of liver function, including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBILI), were recorded within 1 week and 1 month after TACE. The time to progression and the overall survival were recorded. Results Compared with pre-TACE, the tumor size decreased obviously at the end of the first month, the third month, the sixth month and the first year after TACE (P<0.05), the response rate reached 80.00%, 90.00%, 95.00% and 95.00%, respectively. The AFP value decreased obviously. Serum AST, ALT and TBILI significantly increased in the first week after TACE (P<0.05), but returned to preoperative level within 1 month. The average follow-up time was (19.8±7.0) months (range 12-32 months), the time to progression was (17.0±6.8) months, and the overall survival was (19.3±7.0) months. Conclusion PVA particles are optimal embolic material for TACE of PHC. Superselective embolization is necessary in TACE to achieve effective tumor devascularization and reduce liver damage.