Department of Gynecology, Hebei Linxi People's Hospital, Xingtai, Hebei, China (mainland).
Department of Ultrasound, The Second hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
Med Sci Monit. 2022 Jul 18;28:e936771. doi: 10.12659/MSM.936771.
BACKGROUND Hysteroscopic surgery has been widely used in clinical practice for more than 30 years due to its advantages of less trauma, less bleeding, and direct vision. The aim of this study was to compare hysteroscopic morcellation versus conventional resectoscopy for removal of endometrial lesions. MATERIAL AND METHODS For the database search, we used the keywords "morcellator," "morcellators," "morcellate," "morcellation," and "morcellated" combined with "hysteroscopy," "hysteroscopy," "uteroscope," and "transcervical". The last search was conducted on February 1, 2022. Randomized controlled trials (RCTs) were included in the meta-analysis. RESULTS According to our retrieval scheme and the inclusion and exclusion criteria, we found 6 studies including 565 patients. For enumeration data, we calculated the effect size as relative risk (RR) and 95% confidence interval (95% CI), while for quantitative data we used the weighted mean difference (WMD) and 95% confidence interval (95% CI). There was no significant difference between success rate of hysteroscopic morcellation and conventional resectoscopy (relative risk and 95% confidence interval 1.05(0.97,1.13); P=0.232). Procedure time was also shorter with hysteroscopic morcellation, the procedure time of the hysteroscopic morcellation group was 3.43 min shorter compared with the conventional resectoscopy group, and the operating time in the hysteroscopic morcellation group was 2.81 min shorter. In terms of fluid deficit, there was no statistically significant difference in fluid loss between the 2 groups (P=0.209). CONCLUSIONS Hysteroscopic morcellation is associated with a shorter procedure time and operative time among patients with endometrial lesions compared with resectoscopy.
由于创伤小、出血少、直视等优点，宫腔镜手术在临床实践中已应用 30 多年。本研究旨在比较宫腔镜切割与传统电切术切除子宫内膜病变。
为了进行数据库检索，我们使用了“切割器”“切割器”“切割”“切割术”和“切割”与“宫腔镜”“宫腔镜”“子宫镜”和“经宫颈”相结合的关键词。最后一次搜索是在 2022 年 2 月 1 日进行的。荟萃分析纳入了随机对照试验（RCT）。
根据我们的检索方案和纳入排除标准，我们发现了 6 项研究，共纳入 565 名患者。对于计数数据，我们计算了相对风险（RR）和 95%置信区间（95%CI）作为效应量，而对于定量数据，我们使用了加权均数差（WMD）和 95%置信区间（95%CI）。宫腔镜切割与传统电切术的成功率无显著差异（相对风险和 95%置信区间 1.05（0.97，1.13）；P=0.232）。宫腔镜切割的手术时间也更短，宫腔镜切割组的手术时间比传统电切组短 3.43 分钟，宫腔镜切割组的手术时间比传统电切组短 2.81 分钟。在液体不足方面，两组之间的液体丢失没有统计学差异（P=0.209）。
与电切术相比，宫腔镜切割术治疗子宫内膜病变患者的手术时间和手术时间更短。
