ArticleFrontiers in medicine2026
Clinical efficacy and safety of subtotal resection of adenomyotic lesions based on the Kishi classification: a retrospective case series study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objective: Diagnosis and treatment strategies for adenomyosis are influenced by multiple factors, including patient preferences, adenomyosis subtype, and disease progression, with no standardized protocol currently established. In 2012, Kishi proposed four subtypes of adenomyosis based on magnetic resonance imaging (MRI) to guide clinical treatment. This study focuses on patients with severe adenomyosis who do not desire future fertility but wish to preserve their uterus. It investigates the clinical efficacy of subtotal adenomyotic lesion resection based on the Kishi classification, combined with sequential levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone agonist (GnRH-a) therapy, in the management of severe adenomyosis, and evaluates the clinical outcomes and safety of this approach. Methods: We used a descriptive case series design. A retrospective analysis was performed on 34 patients with severe adenomyosis who underwent this treatment protocol at the Department of Gynecology, the Changzhou Second People's Hospital Affiliated to Nanjing Medical University from December 2017 to October 2022. Clinical parameters, including hemoglobin concentrations, dysmenorrhea severity scores, and menstrual blood loss scores, before and after treatment, were observed and recorded. Results: All 34 patients successfully underwent surgery. Comparisons of postoperative and preoperative values showed significant improvements in dysmenorrhea severity score, menstrual blood loss score, hemoglobin concentration, serum cancer antigen-125 (CA125) level, and uterine volume (all Conclusion: In patients with severe adenomyosis who do not desire future fertility, who have a strong preference for uterine preservation, and who have failed multiple conservative treatments, this combined regimen was associated with significant improvements in dysmenorrhea severity, menstrual blood loss, anemia, CA125 levels, and uterine volume over a 12-month observation period, without any serious adverse events. This finding suggests that the regimen may be a safe and effective treatment option. However, its exact efficacy still requires validation through prospective controlled studies.
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