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Chongqing, China

Chen J.,Chongqing Medical University | Chen W.,Chongqing Medical University | Zhang L.,Chongqing Medical University | Li K.,Chongqing Haifu Hospital | And 3 more authors.
Ultrasonics Sonochemistry | Year: 2015

Abstract Objective To evaluate the incidence and severity of adverse reactions to ultrasound-guided ultrasound ablation of uterine fibroids through a multicenter, large-scale retrospective study. Methods Between July 2006 and June 2007, 9988 patients with uterine fibroids or adenomyosis were enrolled and received ultrasound ablation treatment under conscious sedation. Forty-two doctors administrated the treatment following a standardized clinical protocol. In-treatment and post-treatment side effects and complications were monitored and each patient was followed up for at least 6 months after the treatment. Complications were classified and graded according to the SIR classification system. The technical success and safety of the treatment were evaluated. Results The mean age of the 9988 patients was 40.4 ± 5.8 years (range, 20-56 years). Among them, 7438 had uterine fibroids and 2549 had adenomyosis. Specifically, 6545 patients had solitary uterine fibroid, 818 had multiple uterine fibroids, and 76 had fibroids complicated with adenomyosis. There were mainly three types of fibroids: submucous myoma in 89 patients (12.0%), intramural myoma in 5059 patients (68.0%) and subserosal myoma in 1478 patients (20.0%). In terms of fibroid location, 3496 fibroids were found in the anterior wall (47.0%), 2306 in the posterior wall (31.0%), 447 in the lateral wall (6.0%), and 1190 in fundus (16.0%). The length of treatment for uterine fibroids and adenomyosis averaged 84.2 ± 38.8 min (range, 30.0-240.0 min) and 93.3 ± 55.4 min (range, 15.0-240.0 min), respectively; and the lengths of sonication were 1243.8 ± 725.2 s (range, 506.0-2658.0 s) and 1169.7 ± 707.7 s (range, 185.0-3600.0 s), respectively. Of the uterine fibroids patients, 98.38% (7319/7439) underwent successful ablation with a mean volume ablation rate of 83.1% ± 15.6% (range, 25-100%). Of the adenomyosis patients, 94.59% (2411/2549) underwent successful ablation with a mean volume ablation rate of 73.2% ± 23.6% (range, 21-100%). A total of 1062 patients (10.6%) presented with 1305 events of adverse reactions. According to the SIR classification system, 1228 (94.1%) of these reactions fell under Class A; 45 (3.4%) fell under Class B; 24 (1.8%) fell under Class C; and the rest 8 (0.6%) fell under Class D. Adverse reactions included 874 cases (8.67%) of vaginal secretion, 225 cases (2.23%) of lower abdominal pain 24 h after the treatment but requiring no painkillers, 76 cases (0.76%) of melosalgia or buttock pain, 52 cases (0.52%) of odynuria, 20 cases (0.20%) of menstruation-like vaginal bleeding, 2 cases (0.2%) of temporary blurred vision, 26 cases (0.26%) of blisters or tangerine pericarp-like burns in the abdominal skin, 16 cases (0.16%) of urinary retention, 4 cases (0.4%) of fever of 38.5 C, 3 cases (0.3%) of acute renal insufficiency, 2 cases (0.2%) of intestinal perforation, and 1 case (0.01%) of long-term lateral ventral syndrome. No permanent injury or fatal complication occurred. Conclusions Based on our observations from 9988 cases, ultrasound ablation treatment for uterine fibroid and adenomyosis is highly effective and safe. Adverse reactions to ultrasound ablation under conscious sedation are slight and temporary for both conditions. Hence, this clinically effective and safe treatment is an alternative treatment for women with uterine fibroids and adenomyosis. © 2015 Elsevier B.V. Source

Xiong Y.,Chongqing Haifu Hospital | Yue Y.,Chongqing Medical University | Shui L.,Chongqing Medical University | Orsi F.,Italian National Cancer Institute | And 3 more authors.
International Journal of Hyperthermia | Year: 2015

The aim of this paper was to retrospectively compare the therapeutic efficacy and adverse effects of ultrasound-guided high-intensity focused ultrasound (USgHIFU) treatment for adenomyotic patients with or without prior abdominal surgical scars. Methods: From January 2011 to March 2014, 534 patients with adenomyosis were referred for HIFU treatment. Among them, 118 patients had prior abdominal surgical scars, 416 patients did not have prior abdominal surgical scars. Contrast-enhanced MRI was used to evaluate the treatment outcomes. All the adverse effects were recorded. Results: All patients completed USgHIFU treatment. A fractional ablation of 74.8 ± 27.8% was achieved in the group of patients without abdominal scars; the fractional ablation was 75.6 ± 22.3% in the group of patients with prior abdominal surgical scars. No significant difference in fractional ablation between the two groups was observed (p > 0.05). The rate of skin burn in the group of patients with prior abdominal surgical scars was significantly higher than that in the group without abdominal scars (2.5% vs. 0.2%, p < 0.05), but it is still acceptable. Conclusion: The prior abdominal surgical scars have no significant influence on the effectiveness of HIFU treatment for adenomyosis. The risk of skin burn is higher in patients with abdominal scars than without, but the incidence rate is still acceptable. © 2015 Taylor and Francis. Source

Zhang X.,Chongqing Medical University | Zou M.,Chongqing Haifu Hospital | Zhang C.,Chongqing Haifu Hospital | He J.,Suining Central Hospital | And 7 more authors.
European Journal of Radiology | Year: 2014

Objective To investigate the effects of oxytocin on high-intensity focused ultrasound (HIFU) ablation for the treatment of adenomyosis. Materials and methods Eighty-six patients with adenomyosis from three hospitals were randomly assigned to the oxytocin group or control group for HIFU treatment. During HIFU treatment, 80 units of oxytocin was added in 500 ml of 0.9% normal saline running at the rate of 2 ml/min (0.32 U/min) in the oxytocin group, while 0.9% normal saline was used in the control group. Both patients and HIFU operators were blinded to oxytocin or saline application. Treatment results, adverse effects were compared. Results When using oxytocin, the non-perfused volume (NPV) ratio was 80.7 ± 11.6%, the energy-efficiency factor (EEF) was 8.1 ± 9.9 J/mm3, and the sonication time required to ablate 1 cm3 was 30.0 ± 36.0 s/cm3. When not using oxytocin, the non-perfused volume ratio was 70.8 ± 16.7%, the EEF was 15.8 ± 19.6 J/mm3, and the sonication time required to ablate 1 cm3 was 58.2 ± 72.7 S/cm3. Significant difference in the NPV ratio, EEF, and the sonication time required to ablate 1 cm 3 between the two groups was observed. No oxytocin related adverse effects occurred. Conclusion Oxytocin could significantly decrease the energy for ablating adenomyosis with HIFU, safely enhance the treatment efficiency. © 2014 Elsevier Ireland Ltd. Source

Cheng C.-Q.,Chongqing Medical University | Zhang R.-T.,Chongqing Medical University | Xiong Y.,Chongqing Haifu Hospital | Chen L.,Chongqing Haifu Hospital | And 6 more authors.
Medicine (United States) | Year: 2015

As a noninvasive treatment technique, ultrasound-guided high-intensity focused ultrasound (HIFU) has been considered as a routine treatment for uterine fibroids and adenomyosis in China. Contrast-enhanced ultrasound (CEUS) has been proposed as another option to assess the treatment efficacy during HIFU treatment. The aim of this investigation is to evaluate the adverse effects of HIFU ablation for benign uterine diseases in a group of patients studied with ultrasound contrast agent (UCA), in comparison with a group of patients not exposed to UCA. From November 2010 to December 2013, 2604 patients with benign uterine diseases were treated with HIFU. Among them, 1300 patients were exposed to an UCA, whereas 1304 patients were not. During HIFU procedure, the incidences of leg pain, sacral/buttock pain, groin pain, treatment area pain, and the discomfort "hot" sensation on skin were higher in the patients who were exposed to SonoVue (Bracco, Milan, Italy) than those who were not (20.5% vs 11.7%, 52.5% vs 42.3%, 6.5% vs 4.5%, 68.9% vs 55.4%, and 48.1% vs 42.9%, respectively). Among the postoperative adverse effects, the incidence of lower abdominal pain was significantly higher in patients who were exposed to an UCA than those who were not (51.2% vs 39.9%, P<0.05). Two patients who were exposed to an UCA had acute renal function failure. In conclusion, UCA may increase the incidences of some common HIFU-related adverse effects during HIFU treatment for benign uterine diseases, but most of which were acceptable and self-limited. After HIFU treatment, renal function should be monitored in patients with a history of hypertension or taking nonsteroidal anti-inflammatory drugs. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

Chen L.,Chongqing Haifu Hospital | Xiao X.,Chongqing Haifu Hospital | Wang Q.,Chongqing Haifu Hospital | Wu C.,Chongqing Haifu Hospital | And 2 more authors.
Ultrasonics Sonochemistry | Year: 2015

Abstract Diffuse uterine leiomyomatosis (DUL) is a rare and unique type of uterine leiomyoma which affects women of reproductive age. While treatments like medication, uterine artery embolization (UAE) and hysteroscopic myomectomy show some effectiveness, hysterectomy is currently the only known treatment capable of eliminating the symptoms of this disease. This case report demonstrates that high intensity focused ultrasound (HIFU) ablation may offer these patients a new treatment strategy that could control the symptoms of DUL and spare the uterus from hysterectomy. © 2015 Elsevier B.V. Source

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