title: Hysteroscopic Endometrial Resection Versus Laparoscopic Supracervical Hysterectomy for Abnormal Uterine Bleeding: Long-term Follow-up of a Randomized Trial.
abstract: OBJECTIVE
  To compare long-term efficacy of laparoscopic supracervical hysterectomy (LSH) and hysteroscopic endometrial ablation (HEA) in treating persistent abnormal uterine bleeding.
  
  
  METHODS
  Canadian Task Force II-2.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred fifty-three women treated for abnormal uterine bleeding by LSH or HEA.
  
  
  METHODS
  Long-term follow-up assessment of reintervention rate and quality of life (QoL) using the Quality Metric's Health Survey Short Form 12.
  
  
  RESULTS
  This study is the long-term follow-up of a randomized control trial conducted in 2003 comparing LSH and HEA in terms of reoperation rate and QoL. Starting from November 2010 all patients included in the first trial were invited to participate in this study and clinically evaluated through vaginal examination and transvaginal ultrasound. After a mean follow-up of 14.4 years, 29% of patients (20/71) treated with HEA underwent further surgery, whereas no patients after LSH had symptom recurrence. The reintervention rate was significantly higher in the HEA group (p < .0001), with a relative risk of 1.39 (95% confidence interval, 1.20-1.61). The assessment of QoL demonstrated a higher score, in both physical and mental components, in the LSH group (p < .0001).
  
  
  CONCLUSIONS
  The lower reintervention rate and the better physical and mental health scores make LSH a more suitable procedure to treat recurrent abnormal uterine bleeding when compared with HEA.
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy. Electronic address: ezupi@libero.it.
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Centini
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.affiliation: Department of Biomedicine and Prevention, Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Finco
authors.affiliation: Department of Biomedicine and Prevention, Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Exacoustos
authors.affiliation: Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France.
authors.forename: Karolina
authors.initials: K
authors.lastname: Afors
authors.affiliation: Department of Obstetrics and Gynecology, University "Magna Graecia" Catanzaro, Catanzaro, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D055356:Endometrial Ablation Techniques; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015907:Hysteroscopy; D008875:Middle Aged; D011247:Pregnancy; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery*
keywords: Abnormal uterine bleeding; Hysteroscopic endometrial ablation; Laparoscopic supracervical hysterectomy; Long-term follow-up; SF-12