The Comparison Research Between Uterine Artery Embolization And Laparoscopic Myomectomy For Uterine Fibroids

Background:Uterine fibroids,also known as uterine leiomyoma,are the most common benign tumors in women,with an incidence rate of 25%among women of reproductive age in China.Both uterine artery embolization(UAE)and laparoscopic myomectomy(LM)are effective treatments for uterine fibroids,but their relative efficacy is still controversial.Propensity score matching(PSM)can balance the intergroup confounding effects of non-randomized data by creating two groups of people with similar baseline characteristics.This study is a comparative analysis of the efficacy of UAE and LM on uterine fibroids based on PSM.Objective:To compare the efficacy of UAE and LM for uterine fibroids based on PSM and provide references for the clinical treatment of uterine fibroids.Materials&Methods:All patients who underwent UAE or LM from April 2010 to September 2019 were retrieved using the electronic medical record(EME)system.They were divided into two groups based on the surgical method:the UAE group and the LM group.PSM was used to match the two groups of patients 1:1.After successful matching,the size of surgical trauma,length of postoperative recovery time,improvement in quality of life,incidence of adverse events,recurrence rate,and re-intervention were compared between the two groups.Results:A total of 396 study subjects were included,including 153 in the UAE group and 243 in the LM group.PSM successfully matched 66 pairs of patients(132 cases),and the distribution of confounding factors between the two groups was balanced(P>0.05).The UAE group had less intraoperative bleeding(P<0.001),a lower decrease in hemoglobin levels(P<0.001),shorter surgical time(P<0.001),shorter postoperative hospital stay(P<0.001),shorter total hospital stay(P<0.001),faster postoperative ambulation(P<0.001),better ability to perform daily activities(P<0.05),faster completion of simple household chores(P<0.001),faster recovery to work or social activities(P<0.001),and lower recurrence rate(P<0.05)than the LM group.However,the hospitalization cost was higher in the UAE group(P<0.001).Both UAE and LM significantly improved symptoms(P<0.001)and quality of life(P<0.001),and there was no significant difference between the two groups(P>0.05)in terms of efficacy,incidence of adverse events,or re-intervention rate.Conclusion:Both UAE and LM can significantly improve symptoms and quality of life in patients with uterine fibroids,and the incidence of adverse events and re-intervention rate is low.Compared with LM,UAE has less surgical trauma,faster recovery,and lower recurrence rate,but the hospitalization cost is higher.