Singer A, Almanza R, Gutierrez A, Haber G, Bolduc L R, Neuwirth R
Department of Obstetrics and Gynaecology, Whittington Hospital, London, United Kingdom.
Obstet Gynecol. 1994 May;83(5 Pt 1):732-4.
To evaluate the clinical effectiveness and safety of a thermal balloon system to ablate the endometrium.
All 18 patients were candidates for hysteroscopic endometrial ablation or hysterectomy for menorrhagia and consented to a trial of the balloon technique of ablation. All procedures were done in the operating room under general anesthesia, except in one patient who had regional and another who had local anesthesia with analgesia. Follow-up of 6-34 months is reported.
Fifteen subjects (83%) reported significant reduction in bleeding or amenorrhea. Two patients underwent subsequent hysterectomy and one a follow-up hysteroscopic examination with biopsy. Histology in these three cases showed areas of scar as well as areas of normal endometrial histology. In one uterus, the entire cavity and the endometrium were normal. The others had endometrial bands of scar and some contraction of the cavity.
Based on follow-up results, the frequency of successful reduction of bleeding and/or amenorrhea in this small series is comparable to hysteroscopic methods of endometrial ablation. There were no complications. A larger trial is warranted to compare this method to hysteroscopic endometrial ablation.
评估一种热球囊系统消融子宫内膜的临床有效性和安全性。
所有18例患者均因月经过多而成为宫腔镜子宫内膜消融术或子宫切除术的候选对象,并同意接受球囊消融技术试验。除1例采用区域麻醉和另1例采用局部麻醉加镇痛外,所有手术均在全身麻醉下于手术室进行。报告的随访时间为6至34个月。
15名受试者(83%)报告出血明显减少或出现闭经。2例患者随后接受了子宫切除术,1例接受了随访宫腔镜检查及活检。这3例的组织学检查显示有瘢痕区域以及正常子宫内膜组织学区域。在1个子宫中,整个宫腔和子宫内膜均正常。其他子宫有瘢痕性子宫内膜带和部分宫腔收缩。
根据随访结果,该小样本系列中成功减少出血和/或闭经的频率与宫腔镜子宫内膜消融术相当。未出现并发症。有必要进行更大规模的试验以将该方法与宫腔镜子宫内膜消融术进行比较。