Re: Uterine-Artery Embolization versus Surgery for Symptomatic Uterine Fibroids
From: Efrain Ramirez (eramirezt@coqui.net)
Tue Jan 30 18:15:00 2007
Is there any EBM for that management?
Ef
>At Tue, 30 Jan 2007, Bernard Cristalli wrote:
>
>Here, here, here (France).
>3 days post-op for TVHs and nearly seven (7) for abdominal ones.
>Everything is paid for by the social security and the culture is to
>stay in the hospital longer than elsewhere.
>
>---
>
>--
>Bernard Cristalli MD
>AIHP- ACCA
>CNGOF - AMACOG
>bcrist@club.fr
>
>Le 30 janv. 07 à 21:38, William D. McIntosh, M.D a écrit :
>
>> 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,
>
>the
>> first
>> year of follow-up, there were 13 major adverse events in the
>> embolization group
>
>> 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
>
>> 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
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--
“ The greatest obstacle to knowledge is not ignorance,
it is the illusion of knowledge.” Daniel J. Boorstin - Historian
