Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids

Abstract Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US...

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Autores principales:	Florian Recker, Marcus Thudium, Holger Strunk, Tolga Tonguc, Sara Dohmen, Guido Luechters, Birgit Bette, Simone Welz, Babak Salam, Kai Wilhelm, Eva K. Egger, Ullrich Wüllner, Ulrike Attenberger, Alexander Mustea, Rupert Conrad, Milka Marinova
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/293d2960c89f47abad6dbeeda7aac583
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spelling	oai:doaj.org-article:293d2960c89f47abad6dbeeda7aac5832021-11-28T12:20:23ZMultidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids10.1038/s41598-021-02217-y2045-2322https://doaj.org/article/293d2960c89f47abad6dbeeda7aac5832021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02217-yhttps://doaj.org/toc/2045-2322Abstract Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.Florian ReckerMarcus ThudiumHolger StrunkTolga TongucSara DohmenGuido LuechtersBirgit BetteSimone WelzBabak SalamKai WilhelmEva K. EggerUllrich WüllnerUlrike AttenbergerAlexander MusteaRupert ConradMilka MarinovaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Florian Recker Marcus Thudium Holger Strunk Tolga Tonguc Sara Dohmen Guido Luechters Birgit Bette Simone Welz Babak Salam Kai Wilhelm Eva K. Egger Ullrich Wüllner Ulrike Attenberger Alexander Mustea Rupert Conrad Milka Marinova Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
description	Abstract Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.
format	article
author	Florian Recker Marcus Thudium Holger Strunk Tolga Tonguc Sara Dohmen Guido Luechters Birgit Bette Simone Welz Babak Salam Kai Wilhelm Eva K. Egger Ullrich Wüllner Ulrike Attenberger Alexander Mustea Rupert Conrad Milka Marinova
author_facet	Florian Recker Marcus Thudium Holger Strunk Tolga Tonguc Sara Dohmen Guido Luechters Birgit Bette Simone Welz Babak Salam Kai Wilhelm Eva K. Egger Ullrich Wüllner Ulrike Attenberger Alexander Mustea Rupert Conrad Milka Marinova
author_sort	Florian Recker
title	Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
title_short	Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
title_full	Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
title_fullStr	Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
title_full_unstemmed	Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids
title_sort	multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (hifu) in patients with uterine fibroids
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/293d2960c89f47abad6dbeeda7aac583
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Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids

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