| Objective In this study,we compair preoperative use of gonadotropin releasing hormone agonist(GnRH-a)combined with laparoscopic uterine adenomyosis foci excision surgery with simple laparoscopic uterine adenomyoma resection operation to research the safety and clinical therapeutic effect of the two groups and to explore the effective method of treating uterus adenomyoma.Method A total of 51 patients with adenomyoma are treated by laparoscopic adenomayosis excision surgery in Affiliated Hospital of TaiShan Medical University and LiangZhuang Mineral Hospital from June 2009 to March 2014.We collect the patient’s general clinical data and surgical treatment,collect the data of patient’s menstrual cycle,menstrual days,menstrual flow,dysmenorrhea,hemoglobin,uterine volume,in 6 months、12months and 24 months after surgery,by outpatient appointments and telephone follow-up.Compare the indicators of change of the patients after surgery in different periods and recurrence.Result 1.We evaluated surgical-medical group and surgical-alone in age,clinical symptoms: dysmenorrhea,menstruation,classical quantity,and uterine lesion size,CA125,hemoglobin,there are no significant differences.2.In the surgical-medical group,after 3 months GnRH-a treatment the volume of uterus,lesion volume,CA125,clinical symptoms of the women are all reduced.The operation time,postoperative Hb changes and postoperative 1 month of CA125 showed similar findings for both groups,and there were no complications after operation in both groups.3.Taken together,the data suggest that both treatments effectively relieved the dysmenorrhea symptoms of the patients,in that the severity of dysmenorrhea declined during this 2-year follow-up period.However,surgical-medical treatment provid ed more effective symptom control(a lower symptom relapse rate)than surgery alone during the 2-year follow-up period.4.The preoperative CA125 level of the women who relapse was significantly higher than that of the women who did not relapse(P<0.01),and the maximum d-iameter of the lesions was higher than that of the women without recurrence(P<0.01).There was no significant relationship between age and recurrence.Conclusion 1.Using GnRH-a can significantly relieve the clinical symptoms,reduce the size of the uterus and lesions,so that the boundaries of the lesion and normal tissue surrounding is more clear,the lesion can be more complete resected.2.Preoperative use of GnRH-a combined with surgical resection of lesions provides an effective and feasible treatment option for patients with adenomyoma,and long-term control of symptoms and retaining uterine. |
