Haimovich Sergio, Tanvir Tanvir
Department of Obstetrics and Gynecology, Del Mar University Hospital, Barcelona, Spain.
Department of Obstetrics and Gynecology, Tanvir Hospital, Hyderabad, Telangana, India.
J Midlife Health. 2021 Jan-Mar;12(1):21-29. doi: 10.4103/jmh.jmh_42_21. Epub 2021 Apr 17.
Postmenopausal bleeding (PMB) is a common cause for a gynecological visit. Endometrial cancer risk varies from 3% to 25% in women with PMB. There is a significant concern of malignancy of the endometrium and the endocervical canal by a physician in postmenopausal women, and hence, most prefer operating room hysteroscopies with dilation and curettage (D & C) compared to in-office procedures. With increased availablility of miniaturized instruments such as mini- resectoscope and tissue removal systems, there is high likelihood of blind D & C being replaced by hysteroscopic- guided targetted biopsy or visual D & C. The cost-effectiveness of office hysteroscopy is also well demonstrated. In December 2020, an electronic search was performed of PubMed, MEDLINE, and Cochrane Library to look for articles on office hysteroscopic biopsy techniques in postmenopausal women from 2010 to 2020. Relevant studies were included where various office hysteroscopic techniques are used for endometrial sampling in PMB. Studies with 5 Fr scissors, biopsy forceps, crocodile forceps, cup forceps, bipolar electrode, in-office tissue removal system (morcellator), flexible hysteroscope, and mini-resectoscope were included. Standard reference was used as an adequate endometrial sample for histology. The objective of this review is to explore the current evidence on different office hysteroscopic techniques available for endometrial tissue sampling in PMB.
What are the different available in - office hysteroscopy techniques for obtaining endometrial biopsy?
Understanding the adequacy of an endometrial tissue sample obtained by different in - office hysteroscopy techniques and their accuracy by histology.
绝经后出血（PMB）是妇科就诊的常见原因。PMB女性患子宫内膜癌的风险在3%至25%之间。绝经后女性的医生对子宫内膜和子宫颈管恶性病变存在重大担忧，因此，与门诊手术相比，大多数人更倾向于在手术室进行宫腔镜检查及刮宫术（D&C）。随着微型器械如微型电切镜和组织切除系统的可用性增加，盲目刮宫术很有可能被宫腔镜引导下的靶向活检或可视化刮宫术所取代。门诊宫腔镜检查的成本效益也得到了充分证明。2020年12月，对PubMed、MEDLINE和考克兰图书馆进行了电子检索，以查找2010年至2020年关于绝经后女性门诊宫腔镜活检技术的文章。纳入了相关研究，这些研究使用了各种门诊宫腔镜技术对PMB患者进行子宫内膜取样。包括使用5F剪刀、活检钳、鳄嘴钳、杯状钳、双极电极、门诊组织切除系统（粉碎器）、软性宫腔镜和微型电切镜的研究。将标准参考样本用作足够的子宫内膜样本进行组织学检查。本综述的目的是探讨目前关于可用于PMB患者子宫内膜组织取样的不同门诊宫腔镜技术的证据。
获取子宫内膜活检的不同门诊宫腔镜技术有哪些？
了解通过不同门诊宫腔镜技术获得的子宫内膜组织样本的充分性及其组织学准确性。
