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无麻醉下的高级手术办公室宫腔镜检查:501例使用5F双极电极治疗的病例分析。

Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode.

作者信息

Bettocchi S, Ceci O, Di Venere R, Pansini M V, Pellegrino A, Marello F, Nappi L

机构信息

Department of General and Specialist Surgical Sciences, Section of Obstetrics and Gynecology, University of Bari, Italy.

出版信息

Hum Reprod. 2002 Sep;17(9):2435-8. doi: 10.1093/humrep/17.9.2435.

Abstract

BACKGROUND

The aim of this study was to evaluate treatment efficacy and patient acceptability of a new bipolar probe used during office hysteroscopic treatment of benign intrauterine pathologies.

METHODS

In this observational clinical study, 501 women were treated for benign intrauterine pathologies using an office hysteroscopic procedure, without analgesia or anaesthesia. A Versapoint 5 Fr. bipolar electrical generator was used to treat endometrial polyps ranging between 0.5 and 4.5 cm, as well as submucosal and partially intramural myomas between 0.6 and 2.0 cm. Treatment efficacy and patient compliance were evaluated.

RESULTS

At follow-up, the uterine cavity was normal in all patients without any recurrence or persistence of the pathology. One focal adenocarcinoma was discovered at histology in an endometrial polyp of a menopausal patient. Patient acceptance was satisfactory; 47.6-79.3% of the patients underwent the procedure without discomfort.

CONCLUSIONS

The combination of a new generation small diameter hysteroscope and a new bipolar 5 Fr. electrode enables the gynaecologist to treat intrauterine pathologies in an office setting without anaesthesia. Experimentation of a special set-up of the electrical generator reduced patient discomfort during the operative part of the hysteroscopic procedure.

摘要

背景

本研究旨在评估一种新型双极探头在门诊宫腔镜治疗良性宫腔病变中的治疗效果及患者接受度。

方法

在这项观察性临床研究中,501名女性在未使用镇痛或麻醉的情况下,通过门诊宫腔镜手术治疗良性宫腔病变。使用Versapoint 5 Fr.双极电发生器治疗直径在0.5至4.5厘米之间的子宫内膜息肉,以及直径在0.6至2.0厘米之间的黏膜下和部分肌壁间肌瘤。评估治疗效果和患者依从性。

结果

随访时,所有患者宫腔正常,病变无复发或持续存在。在一名绝经患者的子宫内膜息肉组织学检查中发现一例局灶性腺癌。患者接受度令人满意;47.6%至79.3%的患者在手术过程中无不适。

结论

新一代小直径宫腔镜与新型5 Fr.双极电极的结合,使妇科医生能够在门诊环境下无需麻醉治疗宫腔病变。对电发生器特殊设置的试验减少了宫腔镜手术操作过程中患者的不适。

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