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Re: Uterine-Artery Embolization versus Surgery for Symptomatic Uterine FibroidsFrom: William D. McIntosh, M.D (wmcintosh@premiermed.com)Tue Jan 30 13:36:29 2007
Where in the world can you have an AVERAGE length of stay post-hysterectomy of 5 days? My LSH'ers go home same day, vag hysts the next morning, and even abdominals go home on the second postop morning. WD McIntosh MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dean Huffman . Sent: Tuesday, January 30, 2007 10:36 AM To: Multiple recipients of list OB-GYN-L Subject: Uterine-Artery Embolization versus Surgery for Symptomatic Uterine Fibroids .. Uterine-Artery Embolization versus Surgery for Symptomatic Uterine Fibroids The REST Investigators ABSTRACT Background The efficacy and safety of uterine-artery embolization, as compared with standard surgical methods, for the treatment of symptomatic uterine fibroids remain uncertain. Methods We conducted a randomized trial comparing uterine-artery embolization and surgery in women with symptomatic uterine fibroids. The primary outcome was quality of life at 1 year of follow-up, as measured by the Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36). Results Patients were randomly assigned in a 2:1 ratio to undergo either uterine-artery embolization or surgery, with 106 patients undergoing embolization and 51 undergoing surgery (43 hysterectomies and 8 myomectomies). There were no significant differences between groups in any of the eight components of the SF-36 scores at 1 year. The embolization group had a shorter median duration of hospitalization than the surgical group (1 day vs. 5 days, P<0.001) and a shorter time before returning to work (P<0.001). At 1 year, symptom scores were better in the surgical group (P=0.03). During the first year of follow-up, there were 13 major adverse events in the embolization group (12%) and 10 in the surgical group (20%) (P=0.22), mostly related to the intervention. Ten patients in the embolization group (9%) required repeated embolization or hysterectomy for inadequate symptom control. After the first year of follow-up, 14 women in the embolization group (13%) required hospitalization, 3 of them for major adverse events and 11 for reintervention for treatment failure. Conclusions In women with symptomatic fibroids, the faster recovery after embolization must be weighed against the need for further treatment in a minority of patients. (ISRCTN.org number, ISRCTN23023665 [controlled-trials.com] .) N Engl J Med. 2007 Jan 25;356(4):360-70. PMID: 17251532 http://content.nejm.org/content/vol356/issue4/index.shtml Premier Medical Group's HIPAA Compliance Policy states that unencrypted Protected Health Information (PHI) will not be sent to external email recipients. If this email contains PHI, please inform both the original sender and Premier Medical Group's Security Officer (securityofficer@premiermed.com or 931-245-7044) of this policy violation. Thank you for assisting us in our commitment to safeguard our patients' personal information.
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