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首页> 外文期刊>Journal of minimally invasive gynecology >Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus: a prospective randomized study.
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Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus: a prospective randomized study.

机译：小直径宫腔镜与Versapoint对比直肠镜检查与单极刀治疗先天性子宫：一项前瞻性随机研究。

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STUDY OBJECTIVE: To compare 2 procedures for metroplasty: resectoscopy with monopolar knife versus small-diameter hysteroscopy fitted with a Versapoint device. DESIGN: Prospective randomized study (Canadian Task Force classification I). SETTING: Endoscopic gynecology units at tertiary care university hospitals. PATIENTS: One hundred-sixty patients with septate uterus and a history of recurrent abortion or primary infertility undergoing hysteroscopic metroplasty from 2001 to 2005. INTERVENTIONS: Hysteroscopic resection of the uterine septum performed with either a 26F resectoscope with unipolar knife (80 women, group A) or a 5-mm diameter hysteroscope with Versapoint device (80 women, group B). All patients were managed expectantly, with follow-up lasting 1 year. MEASUREMENTS AND MAIN RESULTS: Operative parameters (operative time, fluid absorption, complications, need for second intervention) and reproductive outcome parameters (pregnancy, abortion, term and preterm delivery, modality of delivery, cervical cerclage) were measured. Operative time and fluid absorption were significantly greater in group A than in group B (23.4 +/- 5.7 vs 16.9 +/- 4.7 minutes and 486.4 +/- 170.0 vs 222.1 +/- 104.9 mL, respectively). The cumulative complication rate was significantly lower in group B than in group A. No difference in any of the reproductive parameters was observed between the 2 groups: pregnancy and delivery rates were 70% and 81.6% in group A vs 76.9% and 84% in group B. Nine women (18.4%) from group B and 8 women (16%) from group B experienced spontaneous abortions. Most patients (54/82) delivered by cesarean section without differences according to the hysteroscopic technique used for metroplasty (65% in group A vs 67.7% in group B) or to the gestational age (65.1% of term and 68.7% of preterm deliveries). CONCLUSIONS: Small-diameter hysteroscopy with bipolar electrode for the incision of uterine septum is as effective as resectoscopy with unipolar electrode regarding reproductive outcome and is associated with shorter operating time and lower complication rate.
机译：研究目的：比较两种成形术：单极刀行直肠镜检查与装有Versapoint装置的小直径宫腔镜检查。设计：前瞻性随机研究（加拿大工作组I级）。地点：三级护理大学医院的内窥镜妇科。患者：2001年至2005年，共有166例子宫分隔并有反复流产或原发性不孕病史的患者接受宫腔镜子宫内膜成形术。 ）或配备Versapoint装置的直径5毫米的宫腔镜（80名女性，B组）。所有患者均接受了预期的治疗，随访时间为1年。测量和主要结果：测量手术参数（手术时间，液体吸收，并发症，需要第二次干预）和生殖结果参数（怀孕，流产，足月和早产，分娩方式，宫颈环扎）。 A组的手术时间和体液吸收明显高于B组（分别为23.4 +/- 5.7与16.9 +/- 4.7分钟和486.4 +/- 170.0与222.1 +/- 104.9 mL）。 B组的累积并发症发生率显着低于A组。两组之间的任何生殖参数均无差异：妊娠和分娩率分别为A组的70％和81.6％，而A组的76.9％和84％。 B组中有9名妇女（18.4％）和B组中有8名妇女（16％）经历了自然流产。根据剖宫产术使用的宫腔镜技术（A组为65％，B组为67.7％）或到胎龄（足月分娩的65.1％和早产的68.7％），大多数患者（54/82）无差异）。结论：双极电极小直径宫腔镜检查在子宫隔切开方面的效果与单极电极直肠镜检查在生殖结局方面一样有效，并且手术时间较短，并发症发生率较低。

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