Department of Obstetric, Gynecology and Reproductive Biology, S. Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):449-54. doi: 10.1016/j.jmig.2011.03.017. Epub 2011 May 28.
To determine the reproductive outcome after hysteroscopic metroplasty in women with septate uterus.
Retrospective comparative single-center study (Canadian Task Force classification II-3).
University-affiliated hospital.
Two hundred forty-six patients with septate uterus undergoing hysteroscopic metroplasty between January 1998 and December 2007. The diagnosis was based on hysteroscopy and 3-dimensional ultrasonography. In the most cases laparoscopy was also available. The subjects were divided into 2 age-matched groups. Group 1 consisted of 108 women with unexplained infertility, and group 2 consisted of 138 women suffering from recurrent abortion.
Patients underwent hysteroscopic metroplasty by use of resectoscopy with an equatorial semicircular loop cutting at 0 degree with monopolar energy. All septa were completely removed without complications of bleeding, infection, risk of perforation, visceral injury, or uterine dehiscence during pregnancy.
The 2 groups were compared in terms of reproductive performance in mean ± SD follow-up of 37 ± 18 months. In group 1, 61 (56.5%) patients achieved pregnancy. Seventy-one pregnancies ensued, including 1 twin gestation. Fourteen of the 71 pregnancies (19.7%) ended in miscarriage. In group 2, 90 (65.3%) patients achieved pregnancy. One hundred twenty-nine pregnancies ensued, including 2 twin gestations. Forty-four of the 129 pregnancies (34.1%) ended in miscarriage. The 2 groups have no significant differences in terms of reproductive outcome after surgery, except for the number of abortions, which was higher in group 2 (p <.05).
This study confirms that hysteroscopic metroplasty is a simple, safe, and rapid surgical procedure with no complications for achieving normal uterine architecture, which is peculiar to a good reproductive outcome. The use of an equatorial semicircular loop may give satisfactory and similar results to those obtained with Collin's loop.
确定子宫中隔患者宫腔镜子宫整形术后的生殖结局。
回顾性比较的单中心研究（加拿大任务组分类 II-3）。
大学附属医院。
1998 年 1 月至 2007 年 12 月期间，246 例子宫中隔患者接受宫腔镜子宫整形术。该诊断基于宫腔镜和 3 维超声。在大多数情况下，还可进行腹腔镜检查。将这些患者分为 2 个年龄匹配组。第 1 组由 108 例不明原因不孕的女性组成，第 2 组由 138 例反复流产的女性组成。
患者采用经阴道宫腔镜切除术，在 0 度下使用赤道半圆形环切割，采用单极能量。所有中隔均完全切除，无出血、感染、穿孔、内脏损伤或妊娠期间子宫破裂等并发症。
两组在平均随访 37 ± 18 个月的生殖表现方面进行了比较。在第 1 组中，61 例（56.5%）患者妊娠。有 71 例妊娠，包括 1 例双胎妊娠。71 例妊娠中有 14 例（19.7%）流产。在第 2 组中，90 例（65.3%）患者妊娠。有 129 例妊娠，包括 2 例双胎妊娠。129 例妊娠中有 44 例（34.1%）流产。手术后两组的生殖结局无显著差异，但流产次数除外，第 2 组更高（p<.05）。
本研究证实，宫腔镜子宫整形术是一种简单、安全、快速的手术，无并发症，可获得正常的子宫结构，这是良好生殖结局的特点。赤道半圆形环的使用可能会产生与科林斯环相似的满意结果。
