Department of Gynecology, Saint John of God Hospital, Vienna, Austria.
Acta Obstet Gynecol Scand. 2011 Nov;90(11):1284-6. doi: 10.1111/j.1600-0412.2011.01235.x. Epub 2011 Aug 29.
We aimed to critically review our experience with the value and risks of a diagnostic hysteroscopy performed in addition to LLETZ. We retrospectively included 442 womentients undergoing LLETZ and additional routine diagnostic hysteroscopy. Women for whom concomitant diagnostic hysteroscopy was somehow indicated were excluded. We focused on complications and intrauterine abnormalities detected by hysteroscopy that had not been seen on preoperative vaginal ultrasound. In 28/442 (6.3%), hysteroscopy and/or histological examination of the specimen removed by curettage revealed an abnormal intrauterine finding (benign endometrial polyps, n=20; benign cervical polyps, n=2; small leiomyomas inside the uterine cavity, n=1; septate/arcuate/unicornuate, n=5). A total of 38 surgical complications (8.6%) occurred. The two adverse events related to diagnostic hysteroscopy were uterine perforations (0.5%). In conclusion, only a few benign findings of questionable clinical relevance were discovered. Thus, we do not consider an additional routine diagnostic hysteroscopy during LLETZ beneficial for the patient.
我们旨在批判性地回顾我们在 LLETZ 基础上加行诊断性宫腔镜检查的价值和风险方面的经验。我们回顾性地纳入了 442 名接受 LLETZ 加常规诊断性宫腔镜检查的女性。排除了因某种原因需要同时行诊断性宫腔镜检查的女性。我们专注于宫腔镜检查发现的术前阴道超声未发现的并发症和宫腔内异常。在 28/442（6.3%）例行宫腔镜检查和/或刮宫标本的组织学检查中，发现宫腔内存在异常（良性子宫内膜息肉 20 例；良性宫颈息肉 2 例；宫腔内小子宫肌瘤 1 例；纵隔/弓形/单角子宫 5 例）。共发生 38 例手术并发症（8.6%）。与诊断性宫腔镜检查相关的 2 例不良事件为子宫穿孔（0.5%）。总之，仅发现了少数具有可疑临床意义的良性发现。因此，我们不认为在 LLETZ 期间进行额外的常规诊断性宫腔镜检查对患者有益。
