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系统性子宫内切除术

Methodical intrauterine resection.

作者信息

Hallez J P, Netter A, Cartier R

出版信息

Am J Obstet Gynecol. 1987 May;156(5):1080-4. doi: 10.1016/0002-9378(87)90114-1.

Abstract

A technique using a fine intrauterine resectoscope with mobile electrical loop and continuous flow providing a thoroughly clear vision in all circumstances was used to resect 61 submucous leiomyomas. This technique allows complete resection of intrauterine benign tumours such as submucous leiomyoma sessile type partially embedded in the myometrium, old and wide marginal synechiae, or uterine septa. Under direct visual control it allows one to perform deep biopsies leading to precise histologic diagnoses with determination of possible myometrial penetration. The advantages of this technique, which may be performed eventually on outpatients with paracervical block, are: precise hemostasis; complete and controlled uterine evacuation, avoiding postoperative infections; precise histologic diagnosis; suppression of a good percentage of hysterectomies and open myomectomies; simplicity of follow-up; brevity of hospitalization and convalescence, which are sometimes nil; and conservation, or even restoration, of fertility.

摘要

采用一种使用精细的宫腔电切镜的技术,该电切镜带有可移动的电环和持续冲洗装置,能在各种情况下提供清晰视野,以此切除61例黏膜下平滑肌瘤。该技术可完整切除宫腔内良性肿瘤,如部分嵌入肌层的无蒂型黏膜下平滑肌瘤、陈旧性广泛边缘粘连或子宫纵隔。在直视控制下,可进行深部活检以获得精确的组织学诊断,并确定是否可能侵犯肌层。该技术最终可在宫颈旁阻滞麻醉下对门诊患者实施,其优点包括:精确止血;子宫排空完全且可控,避免术后感染;精确的组织学诊断;减少相当比例的子宫切除术和开腹肌瘤切除术;随访简单;住院和康复时间短,有时甚至无需住院;保留甚至恢复生育能力。

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