Interventional embolization and surgery for the treatment of symptomatic uterine fibroids：a meta-analysis of the safety and effectiveness / 介入放射学杂志

ABSTRACT

Objective To systematically evaluate the safety and effectiveness of interventional uterine artery embolization (UAE) in treating symptomatic uterine fibroids by comparing it with surgical therapy. Methods Computer retrieval of the Cochrane Library, PubMed, EMbase, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, etc. was conducted. The retrieval time was from the inception to July 2014. The academic papers that were related to the randomly controlled test (RCT) of UAE and surgical treatment for symptomatic uterine fibroids were collected, and the reference literatures were also searched for. Two reviewers screened the literatures according to the inclusion and exclusion criteria, the useful data were extracted and the qualities were evaluated. Meta-analysis was performed by using RevMan 5.2 software. Results A total of 6 RCTs were finally obtained, including 732 patients in total. Meta-analysis indicated that both the hospitalization time and recovery time in UAE group were shorter than those in surgery group. No significant differences in health -related quality of life, patient’s satisfaction, intra -operation complications, the recurrence rate and main complications within one year existed between UAE group and surgery group; while the differences in the incidence of minor complications within one year and the need of further intervention rate during 2 -5 years were statistically significant, the occurrence of these minor complications in UAE group being higher than that in the surgery group. The pregnancy rate and live-birth rate in UAE group were significantly lower than those in the surgery group. Conclusion Compared with surgery, UAE has many advantages, such as technically-safe, excellent therapeutic effect, simply-manipulated, easy-nursing, mini-invasive, quick-recovery and easily-accepted by patient, etc. although there is risk of receiving intervention treatment again. The influence of UAE on the fertility, the influence of different embolic agents on the therapeutic effect of UAE, and the effectiveness of UAE for multiple uterine fibroids need to be further studied.