Objective:

To investigate the clinical efficacy of subtotal adenomyotic lesion resection based on the Kishi classification in patients with severe adenomyosis who do not desire future fertility but wish to preserve their uterus, highlighting the importance of the Kishi classification in guiding treatment decisions.

Key Findings:

• Significant improvements in dysmenorrhea severity score, menstrual blood loss score, hemoglobin concentration, serum CA125 level, and uterine volume (all p < 0.001), indicating substantial clinical benefits.
• Only one patient experienced a downward displacement of the intrauterine device, which was managed without complications.
• No disease progression noted in any patient, suggesting the treatment's effectiveness.

Interpretation:

The combined regimen was associated with significant improvements in clinical outcomes over a 12-month observation period, without serious adverse events, indicating its potential as a standard treatment option.

Limitations:

• Retrospective design limits the ability to establish causality and may introduce selection bias.
• Small sample size may affect the generalizability of the findings, necessitating further studies.

Conclusion:

The regimen may be a safe and effective treatment option for severe adenomyosis, but its efficacy requires validation through prospective controlled studies to confirm these findings.