Document Detail


Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial.
MedLine Citation:
PMID:  16260201     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This was a randomized controlled trial to evaluate the safety of uterine artery embolization (UAE) compared with hysterectomy. STUDY DESIGN: Twenty-eight Dutch hospitals recruited 177 patients with symptomatic uterine fibroids and menorrhagia who were eligible for hysterectomy. Patients were randomized to UAE (n = 88) or hysterectomy (n = 89). In this paper we evaluate the peri- and postprocedural complications, length of hospital stay, unscheduled visits, and readmission rates up to 6 weeks' post-intervention. Analysis was by intention to treat. RESULTS: Bilateral UAE failure occurred in 4 patients (4.9%). Major complications occurred in 4.9% (UAE) and 2.7% (hysterectomy) of cases (P = .68). The minor complication rate from discharge until 6 weeks after was significantly higher in the UAE group than in the hysterectomy group (58.0% vs 40.0%; RR 1.45 [1.04-2.02]; P = .024). UAE patients were more often readmitted (11.1% vs 0%; P = .003). Total length of hospital stay was significantly shorter in UAE patients (mean [SD]: 2.5 [2.7] vs 5.1 [1.3], P < .001). CONCLUSION: UAE is a procedure similar to hysterectomy with a low major complication rate and with a reduced length of hospital stay. Higher readmission rates after UAE stress the need for careful postprocedural follow-up.
Authors:
Wouter J K Hehenkamp; Nicole A Volkers; Peter F J Donderwinkel; Sjoerd de Blok; Erwin Birnie; Willem M Ankum; Jim A Reekers
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  193     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-01     Completed Date:  2006-01-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1618-29     Citation Subset:  AIM; IM    
Affiliation:
Department of Gynecology, Academic Medical Center, Amsterdam, The Netherlands. w.j.k.hehenkamp@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteries
Embolization, Therapeutic* / adverse effects,  methods
Female
Follow-Up Studies
Hospitalization
Humans
Hysterectomy* / adverse effects,  methods
Leiomyoma / surgery*
Middle Aged
Postoperative Complications / epidemiology
Uterine Neoplasms / surgery*
Uterus / blood supply*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2006 Oct;195(4):1190; author reply 1191   [PMID:  17000261 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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