Re: Uterine-Artery Embolization versus Surgery for Symptomatic Uterine
From: Dr Eberhard Lisse (el@lisse.NA)
Tue Jan 30 21:12:09 2007
Germany used to have 10 days, because they were paid by the day and they
had the Medical Aids in the pocket.
I got me in real trouble when, my boss went on leave and I started to
discharge them on day five, unheard off :-)-O.
I was then proposing a studay, to compare Koel-Cohen against whatever
they thought they were doing iver there and just discharge the patients
after 5 days :-)-O, didn't happen, would have bancrupted the hospital :-)-O
el
on 1/30/07 10:38 PM William D. McIntosh, M.D said the following:
> 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.
--
Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
PO Box 8421 \ / Please do NOT email to this address
Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
