Goldenberg M, Schiff E, Achiron R, Lipitz S, Mashiach S
Department of Obstetrics and Gynecology, Sackler School of Medicine, Tel-Aviv University, Sheba Medical Center, Tel-Hashomer, Israel.
J Reprod Med. 1997 Jan;42(1):26-8.
To describe our experience with selective removal of residual intrauterine trophoblastic tissue via hysteroscopy.
This is a descriptive report. Eighteen patients, 16 postabortion and 2 postpartum, underwent a hysteroscopic procedure for removal of residual trophoblastic tissue causing continuous bleeding. At hysteroscopy, a cutting loop was used as a curette for selective removal of the adherent residual tissue, while interference with the rest of the endometrial surface was avoided.
Complete removal of the suspected residual tissue was achieved in all patients. Histology confirmed the curettings as trophoblastic remnants. No complications were reported during or immediately after the procedure. The median operative time was 10 minutes (range, 8-20). In all cases the bleeding stopped shortly after the procedure. In each patient, postoperative ultrasonography revealed a uterine cavity free of residual tissue. Five of the patients underwent second-look hysteroscopy several weeks later, and no signs of further residual tissue were observed.
Selective curettage of residual trophoblastic tissue directed by hysteroscopy is an easy and short procedure and might be preferable to conventional, nonselective, blind curettage.
描述我们通过宫腔镜选择性清除残留宫内滋养层组织的经验。
这是一份描述性报告。18例患者，16例流产后和2例产后，因残留滋养层组织导致持续出血接受了宫腔镜手术以清除该组织。在宫腔镜检查时，使用切割环作为刮匙选择性清除附着的残留组织，同时避免干扰子宫内膜表面的其余部分。
所有患者均成功完全清除可疑残留组织。组织学证实刮出物为滋养层残留物。手术期间或术后即刻均未报告并发症。中位手术时间为10分钟（范围8 - 20分钟）。所有病例术后出血均在短时间内停止。每位患者术后超声检查均显示宫腔内无残留组织。5例患者在数周后接受了二次宫腔镜检查，未观察到进一步残留组织的迹象。
宫腔镜引导下选择性刮除残留滋养层组织是一种简单且耗时短的手术，可能优于传统的非选择性盲目刮宫术。
