Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy

BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.

Resection of polyps involving the appendiceal orifice by combined endo-laparoscopic surgery: Two case reports

BACKGROUND The management of polyps involving the appendiceal orifice(AO)presents notable challenges.Endoscopic resection is frequently hindered by operational complexities,a heightened risk of incomplete removal,and an elevated risk of procedural complications,including appendicitis.Conversely,surgical resection may entail unnecessary excision of intestinal segments,leading to potential morbidity.CASE SUMMARY Here,we reported two patients who presented with polyps deeply situated within the AO,with indistinct boundaries making it challenging to ensure completeness using traditional endoscopic resection.To overcome these challenges,we em-ployed combined endo-laparoscopic surgery(CELS),achieving curative resection without postoperative complications.CONCLUSION The application of CELS in managing polyps involving the AO is emerging as a safe and effective treatment modality.

Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps

Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

Expression of IL-17 and Syndecan-1 in Nasal Polyps and Their Correlation with Nasal Polyps

Nasal polyp(NP) is a common chronic inflammatory disease of the nasal cavity and sinuses. Although some authors have suggested that NP is related to inflammatory factors such as interleukin(IL)-1β, IL-5, IL-8, granulocyte-macrophage colony-stimulating factor(GM-CSF), tumor necrosis factor(TNF)-α, and IL-17, the mechanisms underlying the pathogenesis and progression of NP remain obscure. This study investigated the expression and distribution of IL-17 and syndecan-1 in NP, and explored the roles of these two molecules in the pathogenesis of eosinophilic chronic rhinosinusitis with nasal polyps(Eos CRSwNP) and non-Eos CRSwNP. Real-time PCR and immunohistochemistry were used to detect the expression of IL-17 and syndecan-1 in samples [NP, unciform process(UP) from patients with CRS, and middle turbinate(MT) from healthy controls undergoing pituitary tumor surgery]. The results showed that the expression levels of IL-17 and syndecan-1 were upregulated in both NP and UP tissues, but both factors were higher in NP tissues than in UP tissues. There was no significant difference in IL-17 levels between the Eos CRSw NP and non-Eos CRSwNP samples, and syndecan-1 levels were increased in the non-Eos CRSwNP tissues as compared with those in Eos CRSwNP tissues. In all of the groups, there was a close correlation between the expression of IL-17 and syndecan-1 in nasal mucosa epithelial cells, glandular epithelial cells, and inflammatory cells, suggesting that IL-17 and syndecan-1 may play a role, and interact with each other, in the pathogenesis of non-Eos CRSwNP.

Effects of IL-17 on Expression of GRO-α and IL-8 in Fibroblasts from Nasal Polyps

Recent studies indicated that interleukin（IL）-17, growth-related oncogene（GRO）-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the production of GRO-α and IL-8 in human nasal polyp fibroblasts are not completely understood. This study aimed to determine the effects of the increased IL-17 on the changes of GRO-α and IL-8 expression in human nasal polyp fibroblasts and further investigate the mechanism of neutrophil infiltration in nasal polyps. Nasal polyp fibroblasts were isolated from six cases of human nasal polyps, and the cells were stimulated with five different concentrations of IL-17. Real-time fluorescence quantitative polymerase chain reaction（RT-PCR） was used to detect the mRNA expression of GRO-α and IL-8. The mRNA of GRO-α and IL-8 was expressed in unstimulated controls and remarkably increased by stimulation with IL-17. Moreover, the levels of GRO-α and IL-8 produced by fibroblasts were increased gradually with the increases in IL-17 concentrations. The present study showed that nasal fibroblasts can produce GRO-α and IL-8, and their production is remarkably enhanced by IL-17 stimulation, thereby clarifying the mechanism of the IL-17 mediated neutrophil infiltration in nasal polyps. These findings might provide a rationale for using IL-17 inhibitors as a treatment for nasal inflammatory diseases such as nasal polyps.

Expression of Tenascin and Fibronectin in Nasal Polyps

To explore the role of tenascin (TN ) and fibronectin (FN ) in the pathophysiology of nasal polyps (NP) ,the expression of TN and FN in NP from 34patients and inferior turbinates from 2 0 patients with deviation of nasal septum was imm unohistochem ically studied.In patients with NP,the relations between expression and histopathological features,eosinophils(EOS) infil- tration,clinical staging and the size of NP were analyzed.Our study showed that the gray score of TN and FN expression was16 3.10± 10 .5 4 and16 3.2 4± 11.5 2 in NP respectively,whereas itwas 175 .4 9± 9.2 9and173.93± 7.92 in inferior turbinates respectively.The difference between two groups was significant (P<0 .0 1) .The expression of TN and FN in edematous type was signifi- cantly stronger than that in cystic and glandular type and fibrous type (P<0 .0 5 ) .The association between FN expression and EOS infiltration was significant (r=- 0 .6 0 ,P <0 .0 1) .The expres- sion of TN and FN did not correlate with clinical staging and size(P>0 .0 5 ) .It was suggested that abnormal ECM m ight contribute to proliferation of epithelia,accum ulation of EOS and edem a formation,thereby causing development of NP.

Dysregulation of E-cadherin in Chronic Rhinosinusitis with Nasal Polyps

E-cadherin is a key epithelial protein and adhesive molecule. This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and controls, and analyzed its possible role in the pathogenesis of CRSwNP. The expression of E-cadherin was detected by using Western blotting and immunohistochemistry in controls and patients with CRSwNP. Computed tomography (CT) scan findings were scored. The results showed that the E-cadherin expression was up-regulated in patients with CRSwNP as compared with controls (P=0.039) and the positive staining was predominantly localized on the epithelial cell membrane. E-cadherin level was correlated negatively with Lund-Mackay scores in patients with CRSwNP (r=–0.604, P=0.005). It is suggested that E-cadherin may be involved in the pathogenesis of CRSwNP and correlated with disease severity.

Endometrial Polyps:Which Patients Should Be Selected for Hysteroscopic Surgery?--A Study Using Data from the Swedish National Quality Registry of Gynecological Surgery

Objective: To illuminate the findings after hysteroscopic surgery of endometrial polyps. Method: Data were extracted from The Swedish National Quality Registry of Gynecological Surgery. Endometrial polyps were identified in 1934 cases in a total of 4512 hysteroscopic operations. Data on all hysteroscopic procedures registered as surgery of endometrial polyps between 1997 and January 2013 were analyzed with logistic regression analysis and effect size was calculated. Main outcome measure was malignancy in endometrial polyps. Results: The most frequently reported symptoms of endometrial polyps were: postmenopausal bleeding, metrorrhagia, pain, and infertility. Among the registered biopsies, there were: 30 malignancies (1.8%), and 41 dysplasias (2.5%). The remaining polyps were benign. Only 1/30 cancer patients were <52 years old (p < 0.001). Among those women with dysplasia, 12/41 (29%) were p = 0.07). All cancer patients at age ≥52 had postmenopausal bleeding. The <52-year-old cancer patient had treatment-resistant bleeding. Increasing weight was a risk factor associated with tissue alterations in endometrial polyps (p = 0.014), controlling for age as a confounding factor. Conclusion: Hysteroscopic surgery should be recommended for women with postmenopausal bleeding and presence of endometrial polyps according to the findings of this study. The results further indicate a low risk of malignancy in premenopausal women <52 years with endometrial polyps. In those cases, it seems to be safe to refrain from surgery.

Endoscopy and polyps-diagnostic and therapeutic advances in management

Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options.

Inflammatory fibroid polyps in children:A new case report and a systematic review of the pediatric literature

AIM: To study that inflammatory fibroid polyps(IFPs) in children are extremely uncommon tumors that may occur throughout the gastrointestinal tract. METHODS: A systematic review of the pediatric literature and a report of a new case of IFP is also pres-ented. The Pub Med database was searched for original studies on pediatric IFPs since 1960, according to "Preferred reporting items for systematic reviews and meta-analyses" guidelines for systematic reviews. RESULTS: Five studies were finally enclosed, encompassing 6 children with IFPs(mean age 64 mo). Tumors were located in the stomach(2 patients), in the small bowel(2 patients), in the rectum(1 patient) and in the colon(1 patient). Open surgery was performed in all patients and complete excision of the mass was achieved in all cases. All patients are alive and free of symptom. Authors described a further case of a 3-year-old boy with a large duodenal IFP, in whom the tumor was removed by "en block resection". The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose. An accurate pre-operative assessment is fundamental in order to differentiate IFP from other more aggressive gastrointestinal tumor, enabling unnecessary demolitive surgery. CONCLUSION: When complete resection of the IFP is achieved, the prognosis is excellent.

Current strategies for malignant pedunculated colorectal polyps

Despite significant advances in imaging techniques, the incidence of colorectal cancer has been increasing in recent years, with many cases still being diagnosed in advanced stages. Early detection and accurate staging remain the main factors that lead to a decrease in the cost and invasiveness of the curative techniques, significantly improving the outcome. However, the diagnosis of pedunculated early colorectal malignancy remains a current challenge. Data on the management of pedunculated cancer precursors, apart from data on nonpolypoid lesions, are still limited. An adequate technique for complete resection, which provides the best long-term outcome, is mandatory for curative intent. In this context, a discussion regarding the diagnosis of malignancy of pedunculated polyps, separate from nonpedunculated variants, is necessary. The purpose of this review is to provide a critical review of the most recent literature reporting the different features of malignant pedunculated colorectal polyps, including diagnosis and management strategies.

Numerical analysis for the effcacy of nasal surgery in obstructive sleep apnea hypopnea syndrome

In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The effcacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram（PSG） test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further,provide a theoretical basis to solve relevant clinical problems.

High-flow nasal cannula oxygen therapy during anesthesia recovery for older orthopedic surgery patients: A prospective randomized controlled trial

BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.

Endoscopic surgery for inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity

Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important

Evaluation of Empty Nose Syndrome Scores in Patients Undergoing Extended Endoscopic Transnasal Sellar Surgery

Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to the sella, it entails complications such as nasal bleeding, impaired olfactory function, atrophic rhinitis, synechiae, etc. No studies have yet reported potential morbidities such as empty nose syndrome (ENS), although patients have a relatively empty nasal cavity after surgery. Therefore, we sought to verify the percentage of patients who truly met the diagnostic criteria for ENS after endoscopic transnasal sellar surgery, determine the variation between pre- and postoperative scores in each Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) item, and further evaluate the symptoms that may affect the patients the most after surgery. Methods: Between March 2015 and January 2019, eventually 11 patients who underwent extended endoscopic transnasal sellar surgery in Shin Kong Wu Ho-Su Memorial Hospital, a tertiary referral medical center in Taipei, Taiwan, were enrolled. The patients completed the recently validated ENS6Q after surgery. Results: One patient met the objective diagnostic criteria for ENS (score ≥ 11 in ENS6Q). Significant differences were observed in the pre- and postoperative total ENS6Q scores. The pre- and postoperative scores of “nose feeling too open” and nasal crusting showed statistically significant differences. Further, compared with the other items, the postoperative score of nasal crusting increased most obviously, and it may be the most apparent operation-related symptom. Conclusion: This study is the first to report the possibility of developing ENS after endoscopic transnasal sellar surgery. Although the transnasal endoscopic approach is a safe and minimally invasive procedure for the treatment of sellar lesions, possible complications such as ENS should be considered.

Aging and the primary cosmetic nasal surgery

Purpose: The main goal of this article is to review the literature of general health and nasal anatomical-physiological profile of the elderly, prior to considering them as a candidate for primary cosmetic rhinoplasty (PCR). Rhinoplasty is the cosmetic nose’s surgical alteration. Materials and Methods: We extracted the information from internet search engines and the End Note software version X7. Criteria were applied to the most appropriate clinical messages related to the elderly. We focused on their general health status and their nasal anatomicalphysiological considerations prior to consider them for undergoing PCR. Research links were mostly from the Pub Med and the Medline databases. Results: the literature review showed that as people age, their health status and anatomical-physiological components of their nose alter. Their nasal anatomical supports get weaker, and their nasal internal and external physiology undergoes modifications. Functions related to the nasal supports, normal physiology of smell, airway passage, humidification mechanism and their general appearances are affected by age. Conclusion: Cosmetic surgeons must be aware of the aforementioned changes of the patients’ past and present health. Considering performing a complete systemic evaluation and the nasal anatomical-physical examination to assess the degrees of alterations, are crucial pre-operatively.

A Rare Case of Nasal Glial Heterotopia Presenting as Sphenochoanal Polyp

Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history of left sided nasal obstruction. Rigid endoscopy showed greyish left nasal polyp and anterior discharge. Subsequently, CT scan of the sinuses revealed sphenochoanal polyp filling the left nasal cavity, without signs of expansion, or destruction and no obvious connection with intracranial tissue. Mass was removed endoscopically and histology confirmed glial nature of the mass. Conclusion: Any mass arising from sphenoid sinus should be carefully evaluated on CT scan for existence of fibrous stalk, or connection with brain tissue and needs to be considered in the differential diagnosis of the sphenochoanal mass. Complete surgical excision is the treatment of choice, which is curative.

Role of Allergy in Sinonasal Polyposis

Objectives: The exact role of allergy in sinonasal polyposis is not yet clearly elucidated and is undoubtedly a contro-versial subject. The study focussed on the association of allergy in nasal polyposis. We aim to determine whether there was a correlation between Serum IgE, absolute eosinophil count, eosinophilic inflammation, and nasal polyps. Methods: A study group of fifty two consecutive patients of nasal polyposis were evaluated prospectively and compared with 26 controls who underwent septoplasty and mimimal FESS or Endoscopic Sphenopalatine artery ligation. Patients were evaluated for presence of allergy with regard to absolute eosinophil count, total serum IGE and tissue eosinophilia and correlations were established. All patients were categorized based on histological evidence of tissue eosinophilia. Re-sults: The incidence of asthma was 5.8% and positive history of allergy was obtained in 40.4% of patients in study group and 7.7% of patients in control group. The statistically significant association was not seen with absolute eosino-phil count, Serum IgE and tissue eosinophilia. Tissue eosinophilia was observed in more number of patients with nasal polyposis compared to controls. So clinical significance might be established. Conclusions: Allergy is parameter that is frequently associated with this disease, irrespective of the type of polyp and the age at presentation. Unrecognized and untreated allergy adds to the morbidity of the disease and generally results in poor treatment outcome.

Nasal Valve Surgery: How I do it?

One of the reasons for patients attending ENT clinic with a persistent feeling of Nasal obstruction is the presence of a narrow nasal valve. Currently, there are many surgical methods for widening narrow nasal valves. Yet, most of these methods are difficult to perform and with unpredictable results. The main purpose of this study is to describe and evalu- ate our technique of minimally invasive nasal valve surgery. Thirty three patients, who attended our clinic complaining from of nasal obstruction, were evaluated for indication for nasal valve surgery, complications, and postoperative re- sults. Thirty one out of the 33 patients (94%) who underwent the surgery reported subjective improvement. Visual ana- logue score (VAS score) was used to estimate the degree of pre and postoperative nasal obstruction, the mean preopera- tive score was 8.891 and the mean postoperative was 3.241 and the improvement was statistically significant (P = 3.174). In conclusion, it can be said that the technique of Minimal Invasive Nasal Valve Surgery was found to be safe and extremely effective for most patients having narrow nasal valve.

LiNA OperaScope^(TM) for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case report

BACKGROUND The procedure for microwave endometrial ablation(MEA)follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA.When a luminal uterine lesion is recognized,its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm.Recently,a fully disposable rigid hysteroscope(LiNA OperaScope^(TM))with a narrow diameter(4.4 mm)and forceps capable of extracting endometrial lesions has become available.CASE SUMMARY Here,we report a case of heavy menstrual bleeding(HMB)complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScope^(TM) device.A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier.The patient underwent MEA following endometrial polypectomy using LiNA OperaScope^(TM).After MEA,endometrial cauterization was again examined using the LiNA OperaScope^(TM),and the procedure was completed.No preoperative cervical dilation was performed.The patient’s clinical course was favorable,and she was discharged 3 h after surgery.One month after surgery,menstruation resumed,and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively,as assessed subjectively using the visual analog scale.The patient’s postoperative course was uneventful with no complic-ations.CONCLUSION LiNA OperaScope^(TM) can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.