Clinical characteristics of patients with leiomyoma who undergo surgery after high intensity focused ultrasound (HIFU)

Yun Seo Choe, Won Moo Lee, Joong Sub Choi, Jaeman Bae, Jeong Min Eom, Eunsaem Choi

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective We evaluated the clinical characteristics of patients who underwent surgery after high intensity focused ultrasound (HIFU) to treat uterine leiomyoma. Methods From June 2016 to September 2017, patients at our hospital who underwent HIFU to treat uterine leiomyoma prior to surgery were enrolled. All patients underwent pelvic magnetic resonance imaging (MRI) before and after HIFU. If 6 months had passed since the last pelvic MRI was performed, imaging was performed again before the operation. Results A total of 12 patients were analyzed. The median age was 45 (range, 28-51) years. The median body mass index was 24.9 (range, 18.1-29.2) kg/m2. The median size of the leiomyoma was 10.1 (range, 7.8-14.0) cm before HIFU, which changed to 8.75 (range, 5.9-14.8) cm after HIFU. The median size increased to 9.1 (range, 5.9-18.0) cm before the operation. Surgery was planned for several reasons, including an increase in the leiomyoma size (n=6), persistent symptoms (n=4), and newly developed lesion (n=2). The median interval between HIFU and surgery was 7 (range, 3-32) months. Ten of the 12 patients underwent laparoscopic surgery, while the others underwent laparotomy; 6 patients also underwent laparoscopic myomectomy, and 4 underwent hysterectomy. Histopathologic findings showed infarction-type necrosis surrounded by granulation tissue with the infiltration of lymphocytes and macrophages in all patients. Conclusion Treatment of leiomyoma with operative procedures should be considered in selected patients with tumor size greater than 10 cm, multiple tumors, and persistent symptoms after HIFU treatment.

Original languageEnglish
Pages (from-to)258-263
Number of pages6
JournalObstetrics and Gynecology Science
Volume62
Issue number4
DOIs
StatePublished - 2019 Jul 1

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Leiomyoma
Uterine Myomectomy
Magnetic Resonance Imaging
Granulation Tissue
Operative Surgical Procedures
Hysterectomy
Laparoscopy
Laparotomy
Infarction
Neoplasms
Body Mass Index
Necrosis
Macrophages
Lymphocytes
Therapeutics

Keywords

  • High-intensity focused ultrasound ablation
  • Hysterectomy
  • Leiomyoma
  • Myomectomy

Cite this

@article{279c78d25dd04ffc811ca863dfd5f4fa,
title = "Clinical characteristics of patients with leiomyoma who undergo surgery after high intensity focused ultrasound (HIFU)",
abstract = "Objective We evaluated the clinical characteristics of patients who underwent surgery after high intensity focused ultrasound (HIFU) to treat uterine leiomyoma. Methods From June 2016 to September 2017, patients at our hospital who underwent HIFU to treat uterine leiomyoma prior to surgery were enrolled. All patients underwent pelvic magnetic resonance imaging (MRI) before and after HIFU. If 6 months had passed since the last pelvic MRI was performed, imaging was performed again before the operation. Results A total of 12 patients were analyzed. The median age was 45 (range, 28-51) years. The median body mass index was 24.9 (range, 18.1-29.2) kg/m2. The median size of the leiomyoma was 10.1 (range, 7.8-14.0) cm before HIFU, which changed to 8.75 (range, 5.9-14.8) cm after HIFU. The median size increased to 9.1 (range, 5.9-18.0) cm before the operation. Surgery was planned for several reasons, including an increase in the leiomyoma size (n=6), persistent symptoms (n=4), and newly developed lesion (n=2). The median interval between HIFU and surgery was 7 (range, 3-32) months. Ten of the 12 patients underwent laparoscopic surgery, while the others underwent laparotomy; 6 patients also underwent laparoscopic myomectomy, and 4 underwent hysterectomy. Histopathologic findings showed infarction-type necrosis surrounded by granulation tissue with the infiltration of lymphocytes and macrophages in all patients. Conclusion Treatment of leiomyoma with operative procedures should be considered in selected patients with tumor size greater than 10 cm, multiple tumors, and persistent symptoms after HIFU treatment.",
keywords = "High-intensity focused ultrasound ablation, Hysterectomy, Leiomyoma, Myomectomy",
author = "Choe, {Yun Seo} and Lee, {Won Moo} and Choi, {Joong Sub} and Jaeman Bae and Eom, {Jeong Min} and Eunsaem Choi",
year = "2019",
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doi = "10.5468/ogs.2019.62.4.258",
language = "English",
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pages = "258--263",
journal = "Obstetrics and Gynecology Science",
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Clinical characteristics of patients with leiomyoma who undergo surgery after high intensity focused ultrasound (HIFU). / Choe, Yun Seo; Lee, Won Moo; Choi, Joong Sub; Bae, Jaeman; Eom, Jeong Min; Choi, Eunsaem.

In: Obstetrics and Gynecology Science, Vol. 62, No. 4, 01.07.2019, p. 258-263.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Clinical characteristics of patients with leiomyoma who undergo surgery after high intensity focused ultrasound (HIFU)

AU - Choe, Yun Seo

AU - Lee, Won Moo

AU - Choi, Joong Sub

AU - Bae, Jaeman

AU - Eom, Jeong Min

AU - Choi, Eunsaem

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objective We evaluated the clinical characteristics of patients who underwent surgery after high intensity focused ultrasound (HIFU) to treat uterine leiomyoma. Methods From June 2016 to September 2017, patients at our hospital who underwent HIFU to treat uterine leiomyoma prior to surgery were enrolled. All patients underwent pelvic magnetic resonance imaging (MRI) before and after HIFU. If 6 months had passed since the last pelvic MRI was performed, imaging was performed again before the operation. Results A total of 12 patients were analyzed. The median age was 45 (range, 28-51) years. The median body mass index was 24.9 (range, 18.1-29.2) kg/m2. The median size of the leiomyoma was 10.1 (range, 7.8-14.0) cm before HIFU, which changed to 8.75 (range, 5.9-14.8) cm after HIFU. The median size increased to 9.1 (range, 5.9-18.0) cm before the operation. Surgery was planned for several reasons, including an increase in the leiomyoma size (n=6), persistent symptoms (n=4), and newly developed lesion (n=2). The median interval between HIFU and surgery was 7 (range, 3-32) months. Ten of the 12 patients underwent laparoscopic surgery, while the others underwent laparotomy; 6 patients also underwent laparoscopic myomectomy, and 4 underwent hysterectomy. Histopathologic findings showed infarction-type necrosis surrounded by granulation tissue with the infiltration of lymphocytes and macrophages in all patients. Conclusion Treatment of leiomyoma with operative procedures should be considered in selected patients with tumor size greater than 10 cm, multiple tumors, and persistent symptoms after HIFU treatment.

AB - Objective We evaluated the clinical characteristics of patients who underwent surgery after high intensity focused ultrasound (HIFU) to treat uterine leiomyoma. Methods From June 2016 to September 2017, patients at our hospital who underwent HIFU to treat uterine leiomyoma prior to surgery were enrolled. All patients underwent pelvic magnetic resonance imaging (MRI) before and after HIFU. If 6 months had passed since the last pelvic MRI was performed, imaging was performed again before the operation. Results A total of 12 patients were analyzed. The median age was 45 (range, 28-51) years. The median body mass index was 24.9 (range, 18.1-29.2) kg/m2. The median size of the leiomyoma was 10.1 (range, 7.8-14.0) cm before HIFU, which changed to 8.75 (range, 5.9-14.8) cm after HIFU. The median size increased to 9.1 (range, 5.9-18.0) cm before the operation. Surgery was planned for several reasons, including an increase in the leiomyoma size (n=6), persistent symptoms (n=4), and newly developed lesion (n=2). The median interval between HIFU and surgery was 7 (range, 3-32) months. Ten of the 12 patients underwent laparoscopic surgery, while the others underwent laparotomy; 6 patients also underwent laparoscopic myomectomy, and 4 underwent hysterectomy. Histopathologic findings showed infarction-type necrosis surrounded by granulation tissue with the infiltration of lymphocytes and macrophages in all patients. Conclusion Treatment of leiomyoma with operative procedures should be considered in selected patients with tumor size greater than 10 cm, multiple tumors, and persistent symptoms after HIFU treatment.

KW - High-intensity focused ultrasound ablation

KW - Hysterectomy

KW - Leiomyoma

KW - Myomectomy

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DO - 10.5468/ogs.2019.62.4.258

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