Abstract
High Intensity Focused Ultrasound ablation therapy for fibroids and adenomyoma has been increasingly applied in Gynecology. It is now considered a safe surgery with effectiveness compatible to open or laparoscopic myomectomy. However, to further minimize its potential risks of skin burn to the buttocks and nerve injury, this paper studied the skin temperature changes as monitored by infrared thermography in an attempt to identify the risks during HIFU treatment. Although the infrared imaging technology is safe and feasible to monitor the skin temperature changes during HIFU ablation, there isn’t enough conclusive evidence to prove it can be used to avoid skin burn at the buttock or nerve injury.
Highlights
Introduction High Intensity FocusedUltrasound ablation therapy for fibroids and adenomyoma had been increasingly applied in Gynecology [1, 2]
High Intensity Focused Ultrasound ablation therapy for fibroids and adenomyoma had been increasingly applied in Gynecology [1, 2]
They include 1) HIFU ablation is being done with patients being awakening and arousal under monitored anesthesia care (MAC); 2) open exposure of HIFU affected skin area, e.g., the buttocks, 3) frequent palpation of the buttocks to monitor the skin temperature, and 4) cooling of the buttock skin temperature regularly or as required when patients complain of heat
Summary
Introduction High Intensity FocusedUltrasound ablation therapy for fibroids and adenomyoma had been increasingly applied in Gynecology [1, 2]. Prior to the understanding of the risks of HIFU ablation therapy in the past, heat induced complications like skin burn to the abdomen (direct burn), the buttocks (indirect burn), and pelvic nerve injuries occurred. In two retrospective studies of 27,053 patients and 9,988 patients, skin burn was reported in less than 1% of patients (26/17,402) with uterine fibroids or adenomyosis after USgHIFU treatment[3, 4]. These skin burns were first and second degree skin burn especially in patients receiving ablation treatment under general anesthesia or heavy analgesic and sedation. Despite the awareness and improved treatment protocols, superficial buttock skin scald and short term nerve injury still occurs 6, requiring a more sensitive and objective measure to reduce this complication
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