Laparoscopically assisted uterine fibroid cryoablation

• Published in: American journal of obstetrics and gynecology 2009-12, Vol.201 (6), p.571.e1-571.e7
• Main Authors: Pansky, Moty, MD, Cowan, Bryan D., MD, Frank, Maya, MD, Hampton, Harriette L., MD, Zimberg, Stephen, MD
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; cryo; cryoablation; Cryosurgery - instrumentation; cryotherapy; Digestive system. Abdomen; Endoscopy; Female; Female genital diseases; fibroid; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; leiomyoma; Leiomyoma - surgery; Medical sciences; Middle Aged; Needles; Obstetrics and Gynecology; Pilot Projects; Prospective Studies; quality of life; Treatment Outcome; Tumors; Uterine Neoplasms - surgery
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2009.06.028

Objective The objective of the study was to develop a safe and effective cryoablation technique for the treatment of uterine fibroids. Study Design This was a multicenter pilot case series to evaluate cryoablation of uterine fibroids using laparoscopically assisted placement of 17-gauge cryoablation needles. Patient satisfaction was documented with a validated Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire. Procedural efficacy was evaluated by assessing fibroid shrinkage. Treatment was followed by assessments at 3, 6, and 12 months. Results Median fibroid volume reduction was 43.3% (19 patients) and 66.4% (15 patients) at 6 and 12 months, respectively. Median UFS-QOL score improvement was 61.9% and 66.7% at 6 and 12 months, respectively. Additionally, patients experienced marked improvement of bleeding and fibroid bulk symptoms. The median Symptom Severity Score at baseline was 50, 25.0 (–59%) at 6 months, and 12.5 (–66.7%) at 12 months. Conclusion These pilot data indicate that uterine fibroid cryoablation is a safe and effective minimally invasive alternative to treat symptomatic uterine fibroids.