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Management of Uterine Fibroids:
A Focus on Uterine-sparing
Interventional Techniques
Autores: James E. Silberzweig, MD; Daniel K. Powell, MD; Alan H. Matsumoto, MD; James B. Spies, MD, MPH
Se analiza una serie de 6 pacientes en forma retrospectiva portadores de masas pulmonares con contacto parietal, que fueron pasibles de ser puncionados bajo método ecográfico por vía percutánea, con el objetivo de arribar a un diagnóstico anatomo-patológico.
Se enfatiza el rol de ésta técnica de imagen en pacientes seleccionados, analizando los resultados obtenidos, destacando de la misma su accesibilidad y la no utilización de radiaciones ionizantes.
El rendimiento diagnóstico obtenido fue excelente, lográndose en todos los casos arribar a una muestra de tejido suficiente para su análisis, sin un incremento de las complicaciones del procedimiento.
Palabras clave Tórax, Biopsia, Ultrasonido, Diagnóstico.
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Uterine fibroids occur in approximately 50% of women
over the age of 40 years, and an estimated 50% of those
are symptomatic. Menorrhagia is the most common
symptom and the primary indication for treatment, although
bulk symptoms often occur and can be treated.
Pharmacotherapy is typically inadequate unless it can
be expected to successfully bridge to menopause or allow
for a less-invasive intervention. However, hormonal
therapies have risks. Hysterectomy is still the most commonly
performed procedure for symptomatic fibroids
and has the lowest rate of reintervention (compared with
myomectomy or uterine artery embolization [UAE]), but
rates of more serious complications are higher and patient
satisfaction and ability to return to normal activities
may also be less favorable. Myomectomy is not necessarily
less morbid than hysterectomy and may have a greater
failure rate than UAE. Techniques and devices vary with
little standardization, and operator experience is crucial
to success. The largest studies of UAE show very low rates
of serious complications and rapid recovery. UAE significantly
improves symptoms related to uterine fibroids in
85%–90% of patients. Herein, this article will discuss the
nature of fibroids and their diagnosis, pharmacotherapy,
surgical treatment, and nonsurgical interventional treatment,
including UAE and magnetic resonance–guided focused
ultrasound.
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