Istre O, Langebrekke A
Department of Obstetrics and Gynaecology, Ullevaal Hospital, University of Oslo, Norway.
J Am Assoc Gynecol Laparosc. 2003 May;10(2):247-51. doi: 10.1016/s1074-3804(05)60306-4.
To assess the efficacy of repeat transcervical resection of the endometrium (TCRE) in patients with dysfunctional uterine bleeding and myomas in whom primary resection failed.
Retrospective analysis (Canadian Task Force classification III).
University hospital endoscopic unit.
Six hundred sixty-eight women.
Repeat TCRE or transcervical resection of a myoma (TCRM).
Of 668 patients, 118 (17%) required repeat resection for the following reasons: pain (52, 44%), menorrhagia (39, 31%), myomas (15, 13%), perforation at the primary TCRE (6, 5%), and large fluid deficit during the procedure (6, 5%). Of 118 women undergoing repeat TCRE or TCRM, 33 (28%) eventually required hysterectomy due to pain (17, 48%), persistent bleeding (7, 27%), pain and bleeding (3, 10%), regrowth of myomas (3, 14%), and other reasons (3, 14%).
Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate.
评估对初次切除失败的功能失调性子宫出血合并肌瘤患者行重复经宫颈子宫内膜切除术（TCRE）的疗效。
回顾性分析（加拿大工作组分类III级）。
大学医院内镜科。
668名女性。
重复TCRE或经宫颈肌瘤切除术（TCRM）。
668例患者中，118例（17%）因以下原因需要重复切除：疼痛（52例，44%）、月经过多（39例，31%）、肌瘤（15例，13%）、初次TCRE时穿孔（6例，5%）以及手术过程中大量液体缺失（6例，5%）。在118例行重复TCRE或TCRM的女性中，33例（28%）最终因疼痛（17例，48%）、持续出血（7例，27%）、疼痛和出血（3例，10%）、肌瘤复发（3例，14%）及其他原因（3例，14%）而需要行子宫切除术。
初次宫腔镜手术失败后，重复切除是一种选择，且可能降低子宫切除率。
