RevoLix 2 μm激光宫腔镜子宫中隔切除术27例

Application of Revo Lix 2-μm Laser Vaporization in Uterine Septum Resection: Report of 27 Cases

目的探讨应用Revo Lix 2μm激光手术系统切除子宫中隔的安全性及疗效。方法 2011年2月-2012年2月,采用Revo Lix 2μm激光手术系统行宫腔镜子宫中隔切除术27例。激光功率40-80 W,汽化切除中隔,使宫腔形态恢复正常且内壁平整。观察手术时间、出血量、并发症,术后宫腔粘连及妊娠结果。结果手术时间（15.5±8.0）min,出血量〈5ml,未出现子宫穿孔、电切综合征、电解质紊乱、大出血等并发症。术后3个月均复查宫腔镜,提示宫腔形态恢复正常,无宫腔粘连。27例均有妊娠要求,术后随访12-25个月,（17.5±6.0）月,22例妊娠,妊娠率81.5%,妊娠距手术时间5-19个月,（10.2±5.2）月,其中自然流产4例,早产1例,足月产15例,正在妊娠2例。结论宫腔镜下应用Revo Lix 2μm手术系统治疗中隔子宫安全、有效,术中出血极少,视野清晰,且操作简单,术中对组织破坏少,术后宫腔粘连发生率低,内膜修复好,值得临床推广应用。

Objective To investigate the safety and efficacy of Revo Lix 2-μm laser surgery system in the resection of uterine septum. Methods From February 2011 to February 2012,the Revo Lix 2-μm laser surgery system was used under hysteroscopy in the treatment of 27 patients with uterine septum. The laser power was set at 40-80 W. Vaporization resection of the septum was carried out to make intrauterine cavity smooth and normally-shaped. The operation time,blood loss,complications,postoperative intrauterine adhesions,and pregnancy outcomes were observed. Results The operation time was（ 15. 5 ± 8. 0） min,and the bleeding volume was 5 ml. No intraoperative uterine perforation,intrauterine resection syndrome,electrolyte disorders,or massive bleeding happened. Reexaminations of hysteroscopy at the third postoperative month showed normal shape of uterine cavity and no adhesions. All the 27 patients had pregnancy demands. Follow-ups for 12-25 months（ mean,17. 5 ± 6. 0 months） found 22 cases of pregnancy（ 81. 5%） with time intervals from the surgery of 5-19 months（ mean,10. 2 ± 5. 2 months）. There were 4 cases of abortion,1 case of preterm delivery,15 cases of term birth,and 2 cases of ongoing pregnancy. Conclusions Application of Revo Lix 2-μm laser surgery system in the treatment of uterine septum resection is safe and effective,with advantages of little intraoperative bleeding,clear operational vision,and simple performance. The procedure has a short learning curve,less damage to tissues,lower incidence of postoperative intrauterine adhesions,and good outcomes of endometrial repair,being worthy of clinical application.