Rezk Mohamed, Sayyed Tarek, Dawood Ragab
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Gynecol Obstet Invest. 2016;81(6):537-542. doi: 10.1159/000444711. Epub 2016 Mar 1.
To assess the effectiveness and acceptability of Pipelle endometrial sampling in comparison to dilatation and curettage (D&C).
This was a prospective observational study including a total of 538 patients with abnormal uterine bleeding who were allocated to be treated using 2 sampling techniques: Pipelle sampler (n = 270) and D&C (n = 268). The primary outcome was the adequacy of both methods and concordance rate with hysterectomy specimens. The secondary outcome included drawbacks and patients' acceptability.
There was no significant difference between the 2 methods regarding adequacy and concordance rate with hysterectomy (p > 0.05). There was a statistically significant difference between the 2 groups regarding the requirement of analgesia and overall discomfort (p < 0.001), which was higher in the Pipelle group. No significant statistical difference was recognized between the study groups regarding the occurrence of cervical lacerations, fever or the rate of inadequate intrauterine sampling (p > 0.05). In addition, no significant statistical difference between both procedures was recognized concerning the overall satisfaction rate and the advisability of the procedure to other women (p > 0.05).
Under the conditions of this study, Pipelle endometrial sampling is comparable to D&C biopsy in terms of adequacy and concordance rate with hysterectomy except that more pain and a higher overall discomfort rate were associated with it.
评估与刮宫术(D&C)相比, Pipelle子宫内膜取样的有效性和可接受性。
这是一项前瞻性观察性研究,共纳入538例子宫异常出血患者,采用两种取样技术进行治疗:Pipelle取样器(n = 270)和刮宫术(n = 268)。主要结局是两种方法的充分性以及与子宫切除标本的符合率。次要结局包括缺点和患者的可接受性。
两种方法在充分性和与子宫切除术的符合率方面无显著差异(p > 0.05)。两组在镇痛需求和总体不适方面存在统计学显著差异(p < 0.001),Pipelle组更高。研究组在宫颈裂伤、发热或宫内取样不足率方面无显著统计学差异(p > 0.05)。此外,两种手术在总体满意率和对其他女性手术的可取性方面无显著统计学差异(p > 0.05)。
在本研究条件下,Pipelle子宫内膜取样在充分性和与子宫切除术的符合率方面与刮宫活检相当,只是与之相关的疼痛更多,总体不适率更高。