title: Complications and myoma recurrence after laparoscopic uterine artery occlusion for symptomatic myomas.
abstract: OBJECTIVE
  To determine the frequency and severity of complications and the recurrence of fibroids as a result of laparoscopic occlusion of the uterine artery (LOUA) in women with symptomatic fibroids.
  
  
  METHODS
  One hundred and fourteen women with symptomatic fibroids were treated using ultrasonically activated shears, clips or electrosurgery. A retrospective evaluation of the complications and recurrence rate was carried out. For each patient, the analysis took place at least 3 months after the procedure was performed. Each complication was categorized using the complication classifications developed by the Czech Society of Gynecologic Endoscopy and a modified set of the classifications of the American College of Obstetricians and Gynecologists. All adverse events that occurred during the follow-up period were included, in addition to those that occurred after the 3 months minimum interval.
  
  
  RESULTS
  A total of eight women (7.1%, 95% confidence intervals [CI], 3.3-14.4) experienced complications; one of these women had two complications, resulting in a total of nine adverse events. There were no intraoperative complications and no permanent injuries. Two women required supracervical hysterectomy and myomectomy, respectively, as a result of fibroid necrosis. One patient had an undiagnosed endometrial stromal sarcoma after 12 months of LOUA. The rate of fibroid recurrence was 9.0% (10 patients). The recurrence-free survival interval rate (no clinical failure, no recurrence) at 23.6 months (median) follow-up was 88.3% (CI 84.9-93.5).
  
  
  CONCLUSIONS
  The rate of complications and fibroid recurrence was low in patients undergoing LOUA.
authors.affiliation: Department of Obstetrics and Gynecology, Endoscopic Training Center, Baby Friendly Hospital, Kladno, Czech Republic. holubz@seznam.cz
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Holub
authors.forename: Josef
authors.initials: J
authors.lastname: Eim
authors.forename: Antonin
authors.initials: A
authors.lastname: Jabor
authors.forename: Antonin
authors.initials: A
authors.lastname: Hendl
authors.forename: Jan
authors.initials: J
authors.lastname: Lukac
authors.forename: Lev
authors.initials: L
authors.lastname: Kliment
mesh_terms: D000328:Adult; D001158:Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000601:surgery*; D014599:Uterus / Q000098:blood supply / Q000601:surgery