High-intensity focused ultrasound (HIFU) ablation versus surgical
interventions for the treatment of symptomatic uterine fibroids: a
systematic review and meta-analysis
Abstract
Objective The purpose of this meta-analysis was to compare the
effectiveness and safety of HIFU with surgical interventions for the
treatment of symptomatic uterine fibroids in women according to the
studies available in current literature. Main results A total of 10
studies involving 4450 women were included in our meta-analysis.
Compared with surgery group, the reduction of uterine fibroid symptom
(UFS) scores at 6- and 12-month follow-up were higher in HIFU group,
with the overall MD -4.16 (95% CI, -7.39 to -0.94, P=0.01) and -2.44
(95% CI, -3.67 to -1.20, P=0.0001), respectively. The increase of
quality-of-life (QoL) scores at 6- and 12-month follow-up were also
higher in HIFU group, with the overall MD 2.13 (95% CI, 0.86 to 3.14,
P=0.001) and 2.34 (95% CI, 0.82 to 3.85, P=0.003), respectively. Both
of the duration of hospital stay and the time to return to work was
significantly shorter in HIFU group, with the overall MD -3.41 (95% CI,
-5.11 to -1.70, P<0.0001) and -11.61 (95% CI, -19.73 to
-3.50, P=0.005), respectively. The incidence of significant
complications was significantly lower in HIFU group, with the overall RR
0.33 (95% CI, 0.13 to 0.81, P=0.02). The difference of incidence of
adverse events, effective rate, symptom recurrence rate, re-intervention
rate and pregnancy rate between HIFU and surgery were not statistically
significant. Conclusion Compared with surgical interventions, HIFU
ablation therapy leads to more significant alleviation of symptoms and
improvement of QoL, quicker postoperative recovery and fewer significant
complications.