Valle R F
Northwestern University Medical School, Prentice Women's Hospital, Chicago, IL 60611.
Curr Opin Obstet Gynecol. 1991 Jun;3(3):422-6.
This review discusses advances in hysteroscopy in the past decade, including the introduction of small-caliber endoscopes, microhysteroscopy, the flexible steerable hysteroscope, and the use of video systems in monitoring hysteroscopic evaluations. Media for uterine distension are reviewed and possible complications of the use of dextran 70 are discussed. Hysteroscopy is superior to curettage for evaluating abnormal uterine bleeding. Hysteroscopy can be used as an adjunct to hysterosalpingography, endometrial biopsy, and laparoscopy in evaluating infertility, and in detecting and treating intrauterine adhesions. The method has also been applied to the division of uterine septa, the removal of submucous leiomyomas, and tubal cannulation both for treating tubal obstruction at the cornual areas and in conjunction with new reproductive technologies. The use of the microcolpohysteroscope to tailor the size and extension of a cervical conization is described. Finally, hysteroscopy permits evaluation of the extension and involvement of the endocervical canal in patients with endometrial neoplasia and offers an important guide in staging and planning treatment for this condition.
本综述讨论了过去十年宫腔镜检查的进展，包括小口径内窥镜的引入、微型宫腔镜检查、可弯曲可控宫腔镜以及在监测宫腔镜评估中使用视频系统。对子宫扩张介质进行了综述，并讨论了使用右旋糖酐70可能出现的并发症。在评估异常子宫出血方面，宫腔镜检查优于刮宫术。在评估不孕症以及检测和治疗宫腔粘连时，宫腔镜检查可作为子宫输卵管造影、子宫内膜活检和腹腔镜检查的辅助手段。该方法还已应用于子宫纵隔切开、黏膜下肌瘤切除以及输卵管插管，既用于治疗子宫角部的输卵管阻塞，也与新的生殖技术联合使用。描述了使用微型阴道宫腔镜来调整宫颈锥切术的大小和范围。最后，宫腔镜检查可评估子宫内膜肿瘤患者宫颈管的扩展和受累情况，并为该疾病的分期和治疗规划提供重要指导。
