Gland surgery最新文献

筛选
英文 中文
Comparison of endoscopic surgical approaches for total thyroidectomy: a systematic review and Bayesian network meta-analysis.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-424
Tengjiang Long, Junlei Li, Yuquan Yuan, Zeyu Yang, Peng Xu, Bin Pan, Yiceng Sun, Supeng Yin, Chengzhi Zhao, Fan Zhang
{"title":"Comparison of endoscopic surgical approaches for total thyroidectomy: a systematic review and Bayesian network meta-analysis.","authors":"Tengjiang Long, Junlei Li, Yuquan Yuan, Zeyu Yang, Peng Xu, Bin Pan, Yiceng Sun, Supeng Yin, Chengzhi Zhao, Fan Zhang","doi":"10.21037/gs-24-424","DOIUrl":"10.21037/gs-24-424","url":null,"abstract":"<p><strong>Background: </strong>Different approaches to endoscopic total thyroidectomy are emerging for the treatment of differentiated thyroid cancer, raising clinical concerns about comprehensively evaluating the strengths and weaknesses of these approaches. In this study, we aimed to conduct a network meta-analysis to compare different endoscopic surgical approaches to total thyroidectomy, revealing their respective advantages and limitations.</p><p><strong>Methods: </strong>PubMed, Medline, Cochrane Library, Web of Science, and EMBASE databases were searched from their inception until March 2024. Pairwise meta-analysis and Bayesian network meta-analysis were performed. The surface under the cumulative ranking curve (SUCRA) was used to determine the probability that each surgical approach for the best individual outcome.</p><p><strong>Results: </strong>Twenty-one studies comprising 4,361 patients were included. Based on the SUCRA value, the endoscopic transoral approach (EOA) retrieved the highest number of lymph nodes (LNs) (SUCRA =0.59) among all endoscopic surgical approaches. The minimally invasive video-assisted approach (MIVAA) significantly shortened the operative time (SUCRA =0.77) compared to other endoscopic surgical approaches. MIVAA ranked as the most effective surgical approach for reducing the rate of permanent hypoparathyroidism (SUCRA =0.81) and controlling intraoperative bleeding (SUCRA =0.77). The endoscopic gasless transaxillary approach (EGAA) effectively shortened the hospital stay (SUCRA =0.95) and reduced the rate of transient hypoparathyroidism (SUCRA =0.74). The endoscopic bilateral areola (EBAA) approach ranked as the most effective surgical approach for preventing recurrent laryngeal nerve (RLN) palsy (SUCRA =0.92).</p><p><strong>Conclusions: </strong>The surgical outcomes of endoscopic total thyroidectomy are comparable to those of open thyroidectomy. MIVAA was superior to other endoscopic surgical approaches in terms of operative time, intraoperative bleeding volume, and permanent hypoparathyroidism rate. EOA demonstrated a significant advantage in LNs retrieval. EBAA was superior in protecting the RLN.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The evolution and clinical impact of single-port transaxillary robotic thyroidectomy: a comprehensive review.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-09 DOI: 10.21037/gs-24-409
Kwangsoon Kim
{"title":"The evolution and clinical impact of single-port transaxillary robotic thyroidectomy: a comprehensive review.","authors":"Kwangsoon Kim","doi":"10.21037/gs-24-409","DOIUrl":"10.21037/gs-24-409","url":null,"abstract":"<p><p>Single-port (SP) transaxillary robotic thyroidectomy represents a significant innovation in the field of endocrine surgery, offering a minimally invasive approach that combines oncological efficacy with enhanced cosmetic outcomes. The introduction of the SP robotic system has enabled surgeons to perform thyroidectomy and lateral neck dissection through a single axillary incision, resulting in a scarless neck and reduced postoperative morbidity. This review explores the current practices and surgical techniques associated with SP transaxillary robotic thyroidectomy, emphasizing the benefits of the SP robotic system over traditional multi-port and open approaches. The system's enhanced precision, due to its articulated instruments and high-definition three-dimensional visualization, allows for meticulous dissection, minimizing the risk of complications such as recurrent laryngeal nerve injury and hypocalcemia. The SP design simplifies the surgical process, reducing trauma to surrounding tissues and leading to faster recovery times and improved patient satisfaction. Clinical outcomes of the SP approach are promising, with studies indicating comparable oncological safety to conventional methods and superior cosmetic results. Patient satisfaction is notably high, particularly regarding the absence of visible neck scarring. However, the technique's adoption is limited by its steep learning curve and the high cost of the SP robotic system. This review also highlights the need for further long-term studies to fully assess the sustainability of the SP robotic system's benefits, especially in terms of oncological outcomes and cost-effectiveness. The potential of the SP transaxillary approach to become a standard option in thyroid surgery is discussed, alongside the importance of continued research and surgeon training to optimize its use. In conclusion, SP transaxillary robotic thyroidectomy offers a compelling alternative to traditional approaches, with the potential to significantly enhance patient outcomes and satisfaction in thyroid surgery.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"74-81"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perspectives on fat transfer prior to alloplastic breast reconstruction based on recent published data.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-408
Ammara Ghumman, Mitchell H Brown
{"title":"Perspectives on fat transfer prior to alloplastic breast reconstruction based on recent published data.","authors":"Ammara Ghumman, Mitchell H Brown","doi":"10.21037/gs-24-408","DOIUrl":"10.21037/gs-24-408","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"101-104"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary thyroid mucosa-associated lymphoid tissue marginal zone lymphoma in a 46-year-old female: a case report.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-353
Jing Yang, Li Jiao, Guoli Du, Sheng Jiang
{"title":"Primary thyroid mucosa-associated lymphoid tissue marginal zone lymphoma in a 46-year-old female: a case report.","authors":"Jing Yang, Li Jiao, Guoli Du, Sheng Jiang","doi":"10.21037/gs-24-353","DOIUrl":"10.21037/gs-24-353","url":null,"abstract":"<p><strong>Background: </strong>Primary thyroid lymphoma (PTL) is an extremely rare form of thyroid malignancy, merely accounting for 2-5% of all cases. Owing to its low incidence and the absence of concrete clinical manifestations, PTL is frequently misdiagnosed as thyroiditis or thyroid cancer, thereby presenting a significant hurdle to accurate diagnosis.</p><p><strong>Case description: </strong>This case study centered around a 46-year-old female patient. We meticulously detailed the diagnosis and treatment process of her primary thyroid mucosa-associated lymphoid tissue (MALT) marginal zone lymphoma. Although ultrasonography can preliminarily flag suspected cases, a histopathologic biopsy remains indispensable for a conclusive diagnosis. In terms of treatment, surgery is only recommended under specific circumstances. Radiotherapy and chemotherapy are common approaches and play a pivotal role in managing the conditions of particular PTL patients. In this instance, the patient sought medical attention due to a rapidly enlarging neck mass. Ultrasonography revealed diffuse thyroid lesions with reticular nodules, and further biopsy verified MALT lymphoma. Subsequently, an individualized radiotherapy plan was devised.</p><p><strong>Conclusions: </strong>If PTL can be diagnosed at an early stage and treatment commenced promptly, the prognosis is generally favorable. Hence, a profound understanding of the clinical and imaging characteristics of PTL and the attainment of early diagnosis are of crucial importance for effective treatment and prognosis evaluation. This can not only enhance the survival rate of patients but also furnish valuable experience for the diagnosis and treatment of subsequent similar cases, facilitating the advancement of medicine.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"90-100"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preliminary results from randomized control trial point toward the utility of neurotization in innervated breast reconstruction.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-458
Maxwell Godek, Jacquelyn Roth, Keisha E Montalmant, Bernice Z Yu, Peter W Henderson
{"title":"Preliminary results from randomized control trial point toward the utility of neurotization in innervated breast reconstruction.","authors":"Maxwell Godek, Jacquelyn Roth, Keisha E Montalmant, Bernice Z Yu, Peter W Henderson","doi":"10.21037/gs-24-458","DOIUrl":"10.21037/gs-24-458","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"105-107"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adjuvant use of CDK4/6 inhibitors, ovarian function and fertility in premenopausal women: insights from the PENELOPE-B trial.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-17 DOI: 10.21037/gs-24-418
Yael Berner-Wygoda, Eitan Amir
{"title":"Adjuvant use of CDK4/6 inhibitors, ovarian function and fertility in premenopausal women: insights from the PENELOPE-B trial.","authors":"Yael Berner-Wygoda, Eitan Amir","doi":"10.21037/gs-24-418","DOIUrl":"10.21037/gs-24-418","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"112-115"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhanced magnetic resonance imaging features and management principles of low-grade myofibroblastic sarcoma of the breast: a case report.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-347
Meng Zhu, Wei Cheng, Xuejuan Liu, Lin Ma, Yujuan Chen
{"title":"Enhanced magnetic resonance imaging features and management principles of low-grade myofibroblastic sarcoma of the breast: a case report.","authors":"Meng Zhu, Wei Cheng, Xuejuan Liu, Lin Ma, Yujuan Chen","doi":"10.21037/gs-24-347","DOIUrl":"10.21037/gs-24-347","url":null,"abstract":"<p><strong>Background: </strong>Low-grade myofibroblastic sarcoma (LGMS) originating from breast is rare. Existing literature comprises clinical and pathological reports, with limited information on imaging characteristics. This study reports a case of LGMS of the breast and presents its imaging characteristics, with an emphasis on those observed using contrast-enhanced magnetic resonance imaging (MRI).</p><p><strong>Case description: </strong>A 50-year-old patient presented with a left breast mass for 1 year. One year before the presentation, the patient had palpated a mass of approximately 1.5 cm in size in the upper part of the left breast without any obvious cause. The mass was perceived to be growing slowly. There was no relevant family history of breast conditions. Physical examination revealed a hard, ill-defined, irregularly shaped, non-tender mass of approximately 3.5 cm × 3 cm in size, with poor mobility and a close connection to the deep skin. The mammography showed a high-density mass without microcalcifications and boundary wrapping. Ultrasonography showed an oval, ill-defined hypoechoic mass. The combination of mammography and ultrasound examination results ruled out the possibility of ductal carcinoma and benign fibroepithelial tumor. On contrast-enhanced MRI, the mass exhibited heterogeneous enhancement, high signal intensity on T2-weighted imaging (T2WI), high signal intensity on diffusion-weighted imaging (DWI), and a type I time-intensity curve (TIC). A core needle biopsy (CNB) suggested a spindle cell tumor. To confirm the diagnosis, the patient underwent surgical excision, and postoperative pathology confirmed LGMS of the breast. The patient subsequently received adjuvant radiotherapy. Seven months postoperatively, bone scintigraphy suggested possible metastases.</p><p><strong>Conclusions: </strong>LGMS of the breast exhibited a degree of malignancy on ultrasonography, mammography, and MRI, with the contrast-enhanced MRI showing a persistent enhancement pattern (type I TIC). A preoperative biopsy indicated a spindle cell tumor. Surgical excision remains the best diagnostic method. A thorough understanding of the imaging characteristics and biopsy results of this tumor type provides comprehensive information for formulating corresponding treatment plans.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"82-89"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors for postoperative respiratory complications following retroperitoneal laparoscopic adrenalectomy: a cohort study.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-433
Chunting Wu, Tianyi Qiu, Yan Huang, Jiaxin Hu, Jiahui Zhao
{"title":"Risk factors for postoperative respiratory complications following retroperitoneal laparoscopic adrenalectomy: a cohort study.","authors":"Chunting Wu, Tianyi Qiu, Yan Huang, Jiaxin Hu, Jiahui Zhao","doi":"10.21037/gs-24-433","DOIUrl":"10.21037/gs-24-433","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal laparoscopic adrenalectomy (RLA) is a minimally invasive technique known for its benefits, including reduced pain and quicker recovery. Despite these advantages, respiratory complications remain a notable concern, highlighting the importance of identifying risk factors to enhance perioperative care. This study aimed to explore the determinants of respiratory complications following RLA.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 569 patients who underwent RLA for adrenal lesions in the Department of Urology at Beijing Anzhen Hospital from January 2012 to December 2021. The data collected included age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, operative time, estimated intraoperative blood loss, tumor laterality, type of resection, lesion size, preoperative comorbidities and postoperative complications. Univariate and multivariate logistic regression models were used to identify risk factors for respiratory complications following RLA. The area under the receiver operating characteristic (ROC) curve with area under the curve (AUC) was calculated to evaluate the predictive value of relevant factors for respiratory complications.</p><p><strong>Results: </strong>A total of 30 patients (5.27%) developed postoperative respiratory complications following RLA, including 16 cases of respiratory infection (2.8%), 9 cases of postoperative cough requiring antitussive medication (1.6%), 3 cases of bronchial asthma (0.5%), and 2 cases of respiratory failure (0.4%). Univariate logistic regression analysis identified prolonged operative time [odds ratio (OR) =1.007, P=0.043], preoperative respiratory disease comorbidity (OR =6.005, P<0.001), and right-sided RLA (OR =3.544, P=0.002) as associated with an increased risk of postoperative respiratory complications. Multivariate logistic regression analysis showed that preoperative respiratory disease comorbidity (OR =7.243, P<0.001) and right-sided RLA (OR =4.227, P=0.001) were independent risk factors for postoperative respiratory complications. The AUC for the predictive model, which included operative time, preoperative respiratory diseases, and right-sided RLA, was 0.752 (95% CI: 0.657-0.848).</p><p><strong>Conclusions: </strong>Respiratory complications following RLA are associated with factors such as operative time, preoperative respiratory disease comorbidity, and right-sided RLA. Identifying these risk factors preoperatively may help optimize surgical planning and reduce the incidence of postoperative complications.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"28-36"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic value of preoperative systemic inflammatory markers and carcinoembryonic antigen in medullary thyroid carcinoma and the risk factors affecting its prognosis.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-397
Zhujuan Wu, Yuhan Jiang, Hao Gong, Tianyuchen Jiang, Anping Su, Liangying Yi
{"title":"Diagnostic value of preoperative systemic inflammatory markers and carcinoembryonic antigen in medullary thyroid carcinoma and the risk factors affecting its prognosis.","authors":"Zhujuan Wu, Yuhan Jiang, Hao Gong, Tianyuchen Jiang, Anping Su, Liangying Yi","doi":"10.21037/gs-24-397","DOIUrl":"10.21037/gs-24-397","url":null,"abstract":"<p><strong>Background: </strong>Medullary thyroid carcinoma (MTC) is a rare malignancy originating from aggressive parafollicular C cells that causes 8-13% of thyroid cancer-related deaths despite its low incidence. Calcitonin and carcinoembryonic antigen (CEA) are considered to be important indicators for the diagnosis of MTC, while serum inflammatory markers have been shown to be valuable in the diagnosis and evaluation of a variety of malignant tumors, but the amount of research literature on MTC is still limited. This article aims to assess the value of serum inflammatory markers, CEA and calcitonin in the differential diagnosis of MTC from papillary thyroid carcinoma (PTC), and to explore the risk factors affecting lateral zone lymph node metastasis of MTC and the clinical features that can be predictive of disease-free survival (DFS).</p><p><strong>Methods: </strong>We retrospectively analyzed 883 patients with PTC and 128 patients with MTC who received care at West China Hospital Sichuan University. The data of clinical characteristics and follow-up results were collected.</p><p><strong>Results: </strong>In our cohort, after performing propensity score matching (PSM), there were 117 patients in the MTC group and 436 in the PTC group. Compared with PTC, MTC patients had higher neutrophil-lymphocyte ratio (NLR) (P=0.008), neutrophil-monocyte-platelet-to-lymphocyte ratio (NMPLR) (P=0.03), and CEA values (P<0.001), and no significant differences were found between the remaining baseline characteristics, with CEA having the largest area under the curve (AUC) in the differential diagnosis of PTC and MTC at 0.898 [95% confidence interval (CI): 0.862-0.934, P<0.001]. Univariate and multivariate logistic regression analyses showed that the occurrence of extrathyroidal extension (ETE) [P=0.002, odds ratio (OR): 4.159, 95% CI: 2.734-5.584], calcitonin level >1,000 pg/mL (P=0.002, OR: 4.785, 95% CI: 3.220-6.350) and CEA level (P=0.04, OR: 1.005, 95% CI: 1.000-1.010) were significantly correlated with lateral zone lymph node metastasis in MTC, while platelet-to-lymphocyte ratio (PLR) was a predictor of DFS.</p><p><strong>Conclusions: </strong>Preoperative blood inflammatory indexes, CEA, and calcitonin level may be able to initially identify MTC and PTC. Meanwhile, ETE, CEA, and calcitonin levels are independent risk factors for lymph node metastasis in the lateral zone of the MTC; therefore, surgeons should consider more carefully planning surgery in conjunction with imaging in patients who have these risk factors at the initial visit.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"13-27"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review and meta-analysis comparing the use of elagolix therapy alone or in combination with add-back therapy to treat women with uterine fibroid associated heavy menstrual bleeding.
IF 1.5 3区 医学
Gland surgery Pub Date : 2025-01-24 Epub Date: 2025-01-20 DOI: 10.21037/gs-24-386
Xianying Wang, Jingxin Li, Yang Liu, Yingying Zheng, Xiaoli Wang, Guoqiang Liu
{"title":"A systematic review and meta-analysis comparing the use of elagolix therapy alone or in combination with add-back therapy to treat women with uterine fibroid associated heavy menstrual bleeding.","authors":"Xianying Wang, Jingxin Li, Yang Liu, Yingying Zheng, Xiaoli Wang, Guoqiang Liu","doi":"10.21037/gs-24-386","DOIUrl":"10.21037/gs-24-386","url":null,"abstract":"<p><strong>Background: </strong>Elagolix is an oral small molecule second-generation nonpeptide gonadotropin-releasing hormone (GnRH) antagonist drug that can quickly and reversibly inhibit female gonadotropins and ovarian sex hormones. Previous randomized controlled trials (RCTs) have evaluated the efficacy and safety of elagolix alone or in combination with add-back therapy to treat women with heavy menstrual bleeding (HMB) caused by uterine fibroids. Hence, this study sought to evaluate the safety and efficacy of elagolix alone or in combination with add-back therapy for the treatment of uterine fibroids with HMB.</p><p><strong>Methods: </strong>The Cochrane Library, PubMed, Embase and ClinicalTrials.gov databases were searched for randomized controlled studies on the application of elagolix alone or with add-back therapy in patients with uterine fibroids and HMB from databases establishment to June 15, 2021. The outcomes reference menstrual blood loss (MBL), amenorrhea, uterine fibroid symptom quality of life (UFS-QoL), hemoglobin level, bone mineral density loss, and adverse events (AEs). The primary endpoint is MBL. Fixed/random effects models were used to calculate the risk ratio (RR)/mean difference (MD) and 95% confidence interval (CI) for each outcome.</p><p><strong>Results: </strong>Two studies with four trials involving 1,217 patients were included in this meta-analysis. Compared with the placebo, when elagolix was used alone or given with additional therapy, the number of participants who satisfied the MBL was greater (MBL <80 mL and MBL was reduced by more than 50% in the last month), improved hemoglobin levels (increased by more than 2 g/dL from baseline to the final treatment month) criteria as well as triggered amenorrhea. Elagolix alone or in combination with add-back therapy improved the quality of life of patients. Compared with the elagolix treatment alone or with add-back therapy, the placebo was superior in terms of less bone mineral density change and a lower incidence of AEs.</p><p><strong>Conclusions: </strong>This study indicated that elagolix alone or in use with add-back therapy can be considered as a satisfactory treatment plan for the majority of patients who are diagnosed with uterine fibroids and HMB; however, the specific treatment plan should also consider patients' physical condition and any adverse reactions to the drug, based on existing research.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"60-73"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信