Piriyev Elvin, Schiermeier Sven, Römer Thomas
Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, University Witten-Herdecke, Germany.
Department of Obstetrics and Gynecology, University Witten-Herdecke, Marien-Hospital, Witten, Germany.
Wideochir Inne Tech Maloinwazyjne. 2022 Jun;17(2):380-384. doi: 10.5114/wiitm.2022.113565. Epub 2022 Feb 17.
The advantage of transcervical radiofrequency ablation (TRFA) is that it is minimally invasive, incision-free, and treats a wide spectrum of fibroids, including those that are not accessible by surgical hysteroscopy (FIGO 3, 4, 5, 6, and 2-5). However, there are no publications describing a combined procedure of operative hysteroscopy and TRFA yet, so it was still unknown whether a combined procedure is associated with additional risks.
To report the combined technique of transcervical intrauterine radiofrequency ablation of fibroids and surgical hysteroscopy.
Our study was designed to show the results of our case series with 21 patients. The retrospective study included only patients who were treated with the combined procedure of surgical hysteroscopy with fibroid and/or endometrial resection and fibroid ablation using the Sonata System.
The combined procedure was performed without any complications in all cases. Two days after surgery, no increased morbidity was observed compared to only conventional surgical hysteroscopy and/or therapy with the TRFA. All patients were satisfied with the procedure. No late complications were observed within the first 6 months postoperatively. Seventeen patients with bleeding symptoms were asked about their subjective assessment of improvement. Fifteen patients reported significant improvement in symptoms and 1 patient reported only minimal improvement. Only 1 patient, who underwent TRFA and endometrial resection, did not report any improvement. No increase in symptoms was observed.
Although TRFA is an approved method, it is not yet widely used worldwide. The combined procedure has been rarely used. The aim of our work is to show through our case series that transcervical radiofrequency ablation can be combined with surgical hysteroscopy for fibroid and/or endometrial resection without any additional risk.
经宫颈射频消融术（TRFA）的优点是微创、无切口，可治疗多种类型的肌瘤，包括手术宫腔镜无法触及的肌瘤（国际妇产科联合会3、4、5、6级以及2 - 5级）。然而，目前尚无关于手术宫腔镜与TRFA联合手术的报道，因此联合手术是否会带来额外风险仍不明确。
报告经宫颈子宫肌瘤射频消融术与手术宫腔镜的联合技术。
我们的研究旨在展示21例患者的病例系列结果。这项回顾性研究仅纳入了接受手术宫腔镜联合肌瘤和/或子宫内膜切除术以及使用Sonata系统进行肌瘤消融术的患者。
所有病例的联合手术均未出现任何并发症。与单纯传统手术宫腔镜和/或TRFA治疗相比，术后两天未观察到发病率增加。所有患者对该手术均满意。术后前6个月内未观察到晚期并发症。询问了17例有出血症状的患者对症状改善的主观评估。15例患者报告症状有显著改善，1例患者报告仅有轻微改善。仅1例接受TRFA和子宫内膜切除术的患者未报告任何改善。未观察到症状加重。
尽管TRFA是一种已获批准的方法，但在全球范围内尚未广泛应用。联合手术很少使用。我们这项工作的目的是通过我们的病例系列表明，经宫颈射频消融术可与手术宫腔镜联合用于肌瘤和/或子宫内膜切除术，且无任何额外风险。
