Roy Kallol Kumar, Anusha S M, Rai Rakhi, Das Anamika, Zangmo Rinchen, Singhal Seema
Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.
J Hum Reprod Sci. 2021 Jan-Mar;14(1):61-67. doi: 10.4103/jhrs.JHRS_12_20. Epub 2021 Mar 30.
Hysteroscopic metroplasty (HM) is the gold standard treatment for women with septate uterus with recurrent pregnancy loss. Miniresectoscope requires less cervical dilatation as compared to conventional resectoscope. Very few studies are available in the literature on use of miniresectoscope for operative purpose.
This study aimed to compare operative and postoperative outcome parameters using conventional versus mini resectoscope (MR) for hysteroscopic septal resection (HSR).
This was a prospective randomized controlled trial conducted in the Department of Obstetrics and Gynaecology from July 2017 to May 2019.
Forty patients fulfilling the inclusion criteria were recruited and randomized into two groups. In Group A (20 patients), HSR was done using conventional resectoscope (CR) and in Group B (20 patients), MR was used. The various parameters recorded were cervical dilatation time, operating time, intraoperative complications, postoperative pain, and hospital stay and reproductive outcome post surgery in both groups.
Data analysis was carried out using SPSS IBM software version 20.0. The mean operating time was comparable but cervical dilatation time was significantly more in Group A. The duration of hospital stay was significantly less in Group B. There were no differences in adequacy of vision in both the groups but area of field was less in MR group. Four out of nine patients with infertility conceived after surgery. 65% in Group A and 70% in Group B conceived during follow up.
Our study showed that hysteroscopic metroplasty with MR, has comparable efficacy to CR in terms of good vision and septal resectability with added advantages of shorter cervical dilatation time, ease of entry of resectoscope, shorter operative time and significantly reduced postoperative morbidity in terms of less pain. However, the field of vision is less and resection time is more, hence more expertise is required. Further larger randomized trials are required.
宫腔镜子宫成形术（HM）是治疗有复发性流产的纵隔子宫女性的金标准治疗方法。与传统电切镜相比，微型电切镜所需的宫颈扩张较小。文献中关于使用微型电切镜进行手术的研究非常少。
本研究旨在比较使用传统电切镜与微型电切镜（MR）进行宫腔镜纵隔切除术（HSR）的手术及术后结局参数。
这是一项于2017年7月至2019年5月在妇产科进行的前瞻性随机对照试验。
招募了40名符合纳入标准的患者并随机分为两组。A组（20名患者）使用传统电切镜（CR）进行HSR，B组（20名患者）使用MR。记录的各项参数包括宫颈扩张时间、手术时间、术中并发症、术后疼痛、住院时间以及两组术后的生殖结局。
使用SPSS IBM软件版本20.0进行数据分析。平均手术时间相当，但A组的宫颈扩张时间明显更长。B组的住院时间明显更短。两组的视野清晰度无差异，但MR组的视野范围较小。9名不孕患者中有4名术后受孕。A组65%、B组70%在随访期间受孕。
我们的研究表明，使用MR进行宫腔镜子宫成形术在视野良好和纵隔可切除性方面与CR具有相当的疗效，此外还具有宫颈扩张时间短、电切镜插入容易、手术时间短以及术后疼痛明显减轻等优势。然而，视野范围较小且切除时间较长，因此需要更多专业技能。需要进一步进行更大规模的随机试验。
