Imperial College London
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Professor Mohamad Hamady

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Interventional Radiology)
 
 
 
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Contact

 

+44 (0)20 3312 2282 1m.hamady

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Llewellyn:2020:10.1007/s00270-019-02359-7,
author = {Llewellyn, O and Patel, NR and Mallon, D and Quinn, SD and Hamady, M},
doi = {10.1007/s00270-019-02359-7},
journal = {Cardiovasc Intervent Radiol},
pages = {684--693},
title = {Uterine Artery Embolisation for Women with Giant Versus Non-giant Uterine Fibroids: A Systematic Review and Meta-analysis.},
url = {http://dx.doi.org/10.1007/s00270-019-02359-7},
volume = {43},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Evidence supporting uterine artery embolisation (UAE) for giant fibroids (≥ 10 cm and/or uterine volume ≥ 700 CC) remains sparse. We performed a systemic review and meta-analysis of UAE outcomes for symptomatic giant versus non-giant fibroids. METHODS: The literature was systematically reviewed. Research studies of UAE as an adjunct to surgery, and those not using peri-operative MRI were excluded. Primary outcomes were fibroid size and uterine volume reduction, procedure time, length of hospital stay, reinterventions, patient symptom improvement/satisfaction and complications. RESULTS: We identified four observational studies (839 patients; giant = 163, non-giant = 676). Both groups demonstrated reduction in fibroid size and uterine volume after UAE, with equivocal difference in uterine volume reduction (Mean difference (MD) - 0.3 95% confidence interval (CI) - 3.8 to 3.1, p = 0.86) and greater reduction in non-giant dominant fibroid size (MD - 5.9 95% CI - 10.3 to - 1.5, p < 0.01). Giant fibroids were associated with 5.6 min longer mean operative time (MD 5.6 min 95% CI 2.6-8.6, p < 0.01) and 4.8 h longer mean hospital stay (MD 4.8 h 95% CI 1.1-8.6, p = 0.01). Patient symptoms/satisfaction outcomes were summarised, but too heterogeneous for meta-analysis. Major complication and reintervention rates were low, with a statistically higher rate of major complications (Odds ratio (OR) 4.7 95% CI 1.5-14.6, p < 0.01) and reinterventions (OR 3.6 95% CI 1.7-7.5, p < 0.01) in giant fibroids. CONCLUSIONS: Current evidence shows UAE is a safe and effective option to treat giant fibroids. However, the limited available data indicate a relatively higher risk of complications and reinterventions when compared with non-giant fibroids. Patients should be selected
AU  - Llewellyn,O
AU  - Patel,NR
AU  - Mallon,D
AU  - Quinn,SD
AU  - Hamady,M
DO  - 10.1007/s00270-019-02359-7
EP  - 693
PY  - 2020///
SP  - 684
TI  - Uterine Artery Embolisation for Women with Giant Versus Non-giant Uterine Fibroids: A Systematic Review and Meta-analysis.
T2  - Cardiovasc Intervent Radiol
UR  - http://dx.doi.org/10.1007/s00270-019-02359-7
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31792586
VL  - 43
ER  -
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