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不同方法在绝经期息肉切除术的有效性:一项回顾性研究。

Effectiveness of different methods for polypectomy in the menopause: a retrospective study.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

出版信息

Climacteric. 2020 Aug;23(4):325-329. doi: 10.1080/13697137.2020.1732915.

Abstract

Most endometrial polyps represent focal hyperplasia of the endometrium. Endometrial polyps can be diagnosed by ultrasound, hysterocontrast sonography, hysterosalpingography, endometrial biopsy, and uterine curettage, but diagnostic hysteroscopy is considered the gold-standard method, with the greatest sensitivity and specificity and also with the opportunity for treatment at the same time. A retrospective study was conducted on 424 patients between 2006 and 2018. The polyps were verified during diagnostic hysteroscopy and were removed by resectoscopy or curettage. All samples underwent histological examination. The effectivity of the type of resection and the recurrence rate were evaluated. The average age of the patients was 60.2 ± 9.3 years. Polyps were excised in 62.97% by resectoscopic polypectomy and in 37.03% by curettage. Malignancy was confirmed in 4.24% of cases. Histological verification of polyps was 79.4% in the resectoscopy group and 69.04% in the curettage group; the difference was significant ( < 0.01). The recurrence rate was 20.47% after resectoscopy and 27.12% following curettage. Hysteroscopy remains the best option and the gold-standard method among diagnostic procedures of endometrial pathology. In this study, there was a significant difference in matching hysteroscopic and histological findings in the two methods of polypectomy. The recurrence rate is also lower following resectoscopy.

摘要

大多数子宫内膜息肉代表子宫内膜的局灶性增生。子宫内膜息肉可通过超声、宫腔镜超声造影、子宫输卵管造影、子宫内膜活检和子宫刮宫术诊断,但诊断性宫腔镜检查被认为是金标准方法,具有最高的敏感性和特异性,同时也有机会进行治疗。对 2006 年至 2018 年间的 424 名患者进行了回顾性研究。在诊断性宫腔镜检查中验证了息肉,并通过电切术或刮宫术切除。所有样本均进行了组织学检查。评估了切除类型的有效性和复发率。患者的平均年龄为 60.2±9.3 岁。息肉切除术切除息肉的比例为 62.97%,刮宫术切除息肉的比例为 37.03%。4.24%的病例证实为恶性肿瘤。电切术组的息肉组织学验证率为 79.4%,刮宫术组为 69.04%;差异有统计学意义( < 0.01)。电切术后的复发率为 20.47%,刮宫术后的复发率为 27.12%。宫腔镜检查仍然是诊断子宫内膜病变的最佳选择和金标准方法。在这项研究中,两种息肉切除术方法的宫腔镜检查和组织学检查结果有显著差异。电切术后的复发率也较低。

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