Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our cen...Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.展开更多
目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内...目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内膜息肉患者为研究对象,采用随机数表法分为两组,每组51例,均接受TCRP治疗。术后,研究组放置曼月乐环,对照组给予地屈孕酮片,比较两组术前、术后6个月的子宫内膜厚度、月经量、雌孕激素代谢指标、简明女性性功能指数各维度评分,以及不良反应发生情况和复发情况。结果术后6个月,两组子宫内膜厚度、月经失血图评分及腺体、间质雌激素受体、孕激素受体较术前均降低,且研究组低于对照组,差异有统计学意义(P均<0.05)。研究组术后6个月的性生活质量高于对照组,差异有统计学意义(P<0.05)。研究组复发率(1.96%)低于对照组(13.73%),差异有统计学意义(χ^(2)=4.883,P<0.05)。结论TCRP治疗后,放置曼月乐环可减少子宫内膜厚度,改善机体的月经和雌孕激素代谢情况,提高性生活质量和预后质量。展开更多
Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:1...Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span><span>). We performed this surgery for 6 patients: 4 endometrial polyps and 2 intrauterine myoma. The average operation time was 25.7</span><span "=""> </span><span>±</span><span "=""> </span><span>13.2 minutes. Only a small amount of bleeding was noted in all cases. There were no surgical complications. Two out of four patients who desired childbearing became pregnant. Hysteroscopic surgery using IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span></span><span> can safely and reliably remove intrauterine protruding lesions under aspiration without using a heat source. Less endometrial damage may help preserve fertility.</span>展开更多
文摘Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.
文摘目的探讨宫腔镜下子宫内膜息肉切除术(Trans-Cervical Resection of Polyps,TCRP)联合曼月乐(Mirena)环放置对子宫内膜息肉术后不良反应和复发率的影响。方法方便选取2019年1月—2022年12月在福州经济技术开发区医院收治的102例子宫内膜息肉患者为研究对象,采用随机数表法分为两组,每组51例,均接受TCRP治疗。术后,研究组放置曼月乐环,对照组给予地屈孕酮片,比较两组术前、术后6个月的子宫内膜厚度、月经量、雌孕激素代谢指标、简明女性性功能指数各维度评分,以及不良反应发生情况和复发情况。结果术后6个月,两组子宫内膜厚度、月经失血图评分及腺体、间质雌激素受体、孕激素受体较术前均降低,且研究组低于对照组,差异有统计学意义(P均<0.05)。研究组术后6个月的性生活质量高于对照组,差异有统计学意义(P<0.05)。研究组复发率(1.96%)低于对照组(13.73%),差异有统计学意义(χ^(2)=4.883,P<0.05)。结论TCRP治疗后,放置曼月乐环可减少子宫内膜厚度,改善机体的月经和雌孕激素代谢情况,提高性生活质量和预后质量。
文摘Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span><span>). We performed this surgery for 6 patients: 4 endometrial polyps and 2 intrauterine myoma. The average operation time was 25.7</span><span "=""> </span><span>±</span><span "=""> </span><span>13.2 minutes. Only a small amount of bleeding was noted in all cases. There were no surgical complications. Two out of four patients who desired childbearing became pregnant. Hysteroscopic surgery using IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span></span><span> can safely and reliably remove intrauterine protruding lesions under aspiration without using a heat source. Less endometrial damage may help preserve fertility.</span>
