AbstractThis review compares the efficacy of Uterine Artery Embolization (UAE) and Myomectomy (MYO) in managing symptomatic Uterine Fibroids (UFs) in women who do not want hysterectomy. A meta-analysis was performed on all available studies that evaluated the relative benefits and harms of MYO and UEA for the management of patients suffering from UFs.

摘要本综述比较了子宫动脉栓塞（UAE）和子宫肌瘤切除术（MYO）在不希望子宫切除术的女性中治疗症状性子宫肌瘤（UF）的疗效。对所有可用的研究进行了荟萃分析，评估了MYO和UEA对UFs患者管理的相对益处和危害。

Outcomes evaluated reintervention, UFs scores for quality of life (QOL) and symptom severity, and other complications. To determine mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs), a random or fixed-effects model was utilized. A meta-analysis of 13 studies (9 observational and 4 randomized controlled trials) was conducted.

结果评估了再次干预，UFs评分的生活质量（QOL）和症状严重程度以及其他并发症。为了确定95%置信区间（CI）的平均差异（MD）或优势比（or），使用了随机或固定效应模型。对13项研究（9项观察性试验和4项随机对照试验）进行了荟萃分析。

The results indicated that UAE had a higher reintervention rate (OR 1.84; 95% CI 1.62–2.10; P < 0.01; I2 = 39%), hysterectomy rate (OR 4.04; 95% CI 3.45–4.72; P < 0.01; I2 = 59%), and symptom-severity score (OR − 4.02; 95% CI 0.82, 7.22; P = 0.01; I2 = 0%) compared to MYO at a four-year follow-up. However, UAE was associated with a lower rate of early complications (OR 0.44; 95% CI 0.20–0.95; P = 0.04; I2 = 25%), and readmission rate (OR 1.16; 95% CI 1.01–1.33; P = 0.04; I2 = 0%) compared to MYO.

结果表明，阿联酋的再干预率较高（OR 1.84；95%CI 1.62-2.10；P<0.01；I2=39%），子宫切除率（OR 4.04；95%CI 3.45-4.72；P<0.01；I2＝59%）和症状严重程度评分（OR＝4.02）；；P=0.01；在四年的随访中，I2=0%）与MYO相比。然而，阿联酋早期并发症发生率较低（OR 0.44；95%CI 0.20-0.95；P=0.04；I2=25%）和再入院率（OR 1.16；95%CI 1.01-1.33；P=0.04；I2=0%）与MYO相比。

Furthermore, both procedures had comparable improvement in pregnancy rates and abnormal uterine bleeding. In conclusion, UAE and MYO are effective in treating symptomatic UFs but they have different outcomes. The decision on which procedure to choose should be made based on individual preferences and the physician’s expertise..

。总之，阿联酋和MYO在治疗症状性UFs方面是有效的，但它们有不同的结果。应根据个人偏好和医生的专业知识决定选择哪种手术。。

IntroductionUterine fibroids, also known as myomas, are the most common benign tumors affecting women during their reproductive years, with prevalence increasing with age1,2. Symptoms of fibroids, such as heavy menstrual bleeding, abdominal pain, and pressure3, can have a negative impact on quality of life4,5.

引言子宫肌瘤，也称为肌瘤，是影响女性生殖期最常见的良性肿瘤，患病率随着年龄的增长而增加1,2。肌瘤的症状，如月经大量出血，腹痛和压力3，可能会对生活质量产生负面影响4,5。

Surgical treatments such as hysterectomy and myomectomy (MYO) remain the conventional choices for managing fibroids. However, a minimally invasive treatment, uterine artery embolization (UAE), has emerged as an alternative to hysterectomy, which has been in practice since 19956. UAE is now often used as an elective treatment for symptomatic UFs due to its safety and ability to improve symptoms with few major complications7.

子宫切除术和子宫肌瘤切除术（MYO）等手术治疗仍然是治疗肌瘤的常规选择。然而，一种微创治疗方法，子宫动脉栓塞（UAE）已成为子宫切除术的替代方法，自19956年以来一直在实践中。阿联酋现在经常被用作症状性UFs的选择性治疗，因为它的安全性和改善症状的能力几乎没有重大并发症7。

For those who desire to preserve their uterus, MYO is typically the standard of care, but there is uncertainty regarding the optimal treatment choice. Therefore, this paper aimed to systematically review and meta-analyze all relevant studies to compare the outcomes of UAE and MYO treatments for the management of uterine fibroids.MethodsThis meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement8, involves two independent investigators undertaking the literature search, selection, and data extraction in duplicate, ensuring the integrity of the research process.

对于那些希望保留子宫的人来说，MYO通常是护理的标准，但最佳治疗选择存在不确定性。因此，本文旨在系统地回顾和荟萃分析所有相关研究，以比较UAE和MYO治疗子宫肌瘤的结果。方法该荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）声明8进行的，涉及两名独立研究人员，一式两份进行文献检索，选择和数据提取，确保研究过程的完整性。

In the event of any discrepancy arising between these investigators, a third investigator was consulted to resolve any differences by reaching consensus, underscoring the rigorous quality control measures implemented in this study.Search strategyRelevant studies, before November 2023, were identified by searching PubMed, Embase, Medline, and the Cochrane Library for English-language studies related to uterin.

如果这些研究人员之间出现任何差异，则咨询第三位研究人员，通过达成共识来解决任何差异，强调本研究中实施的严格质量控制措施。2023年11月之前的搜索策略相关研究是通过搜索PubMed，Embase，Medline和Cochrane图书馆中与子宫素相关的英语研究来确定的。

Data availability

数据可用性

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

本研究中使用和/或分析的数据集可根据合理要求从通讯作者处获得。

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Download referencesFundingThe study was supported by a special fund for research expense of Zhejiang University (Code: 226-2022-00093 and School code: K20220023).Author informationAuthor notesThese authors contributed equally: Junwen Peng and Jian Wang.Authors and AffiliationsDepartment of General Surgery, The First People’s Hospital of Jiande, Hangzhou, 311600, Zhejiang Province, ChinaJunwen Peng & Qianjun ShuDepartment of Vascular Surgery, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, 310009, Zhejiang Province, ChinaJian Wang, Yiting Luo, Siwei Wang & Zhenjie LiuAuthorsJunwen PengView author publicationsYou can also search for this author in.

下载参考文献资助该研究得到了浙江大学研究费用专项基金（代码：226-2022-00093和学校代码：K20220023）的支持。作者信息作者注意到这些作者做出了同样的贡献：彭俊文和王健。作者和所属单位浙江省杭州市建德市第一人民医院普外科，311600，浙江省杭州市，浙江大学医学院第二附属医院血管外科，浙江省杭州市，310009，浙江省杭州市，中国王健，罗怡婷，王思伟，刘振杰作者彭俊文观点作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarJian WangView author publicationsYou can also search for this author in

PubMed Google ScholarJian WangView作者出版物您也可以在

PubMed Google ScholarQianjun ShuView author publicationsYou can also search for this author in

PubMed Google ScholarQianjun ShuView作者出版物您也可以在

PubMed Google ScholarYiting LuoView author publicationsYou can also search for this author in

PubMed Google ScholarYiting LuoView作者出版物您也可以在

PubMed Google ScholarSiwei WangView author publicationsYou can also search for this author in

PubMed Google ScholarSiwei WangView作者出版物您也可以在

PubMed Google ScholarZhenjie LiuView author publicationsYou can also search for this author in

PubMed谷歌学者刘振杰查看作者出版物您也可以在

PubMed Google ScholarContributionsJ.W.P., J.W., Z.J.L.: Conception and design. J.W., Z.J.L.: Analysis and interpretation. Q.J.S., Y.L., S.W.: Data collection. J.W.P., J.W.: Writing the article. J.W., J.W.P., Z.J.L.: Critical revision of the article. J.W., J.W.P., Q.J.S., Z.J.L., Y.L., S.W.: Final approval of the article.

PubMed谷歌学术贡献。W、 P.，J.W.，Z.J.L.：概念与设计。J、 W.，Z.J.L.：分析和解释。Q、 J.S.，Y.L.，S.W.：数据收集。J、 W.P.，J.W.：写这篇文章。J、 W.，J.W.P.，Z.J.L.：文章的关键修订。J、 W.，J.W.P.，Q.J.S.，Z.J.L.，Y.L.，S.W.：文章的最终批准。

J.W., Z.J.L.: Statistical analysis. J.W.P., J.W.: Obtained funding J.W.P., Overall responsibility.Corresponding authorCorrespondence to.

J、 W.，Z.J.L.：统计分析。J、 W.P.，J.W.：获得资金J.W.P.，全面负责。对应作者对应。

Zhenjie Liu.Ethics declarations

刘振杰。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

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Reprints and permissionsAbout this articleCite this articlePeng, J., Wang, J., Shu, Q. et al. Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids.

转载和许可本文引用本文Peng，J.，Wang，J.，Shu，Q。等人。子宫动脉栓塞与肌瘤切除术治疗症状性子宫肌瘤的现有证据的系统评价和荟萃分析。

Sci Rep 14, 19252 (2024). https://doi.org/10.1038/s41598-024-69754-0Download citationReceived: 05 February 2024Accepted: 08 August 2024Published: 20 August 2024DOI: https://doi.org/10.1038/s41598-024-69754-0Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1419252（2024）。https://doi.org/10.1038/s41598-024-69754-0Download引文接收日期：2024年2月5日接受日期：2024年8月8日发布日期：2024年8月20日OI：https://doi.org/10.1038/s41598-024-69754-0Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsUterine artery embolizationMyomectomySymptomatic uterine fibroidsMeta-analysis

关键词子宫动脉栓塞肌瘤切除术症状性子宫肌瘤Meta分析

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