Results of centralized Asherman surgery, 2003-2013
Results of centralized Asherman surgery, 2003-2013
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DOI：
10.1016/j.fertnstert.2015.08.039
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发表时间：
2015-12-01
影响因子：
6.7
通讯作者：
Emanuel, Mark Hans
中科院分区：
文献类型：
--
作者：
Hanstede, Miriam M. E.;van der Meij, Eva;Emanuel, Mark Hans
目的：研究Asherman综合征患者宫腔镜粘连松解术的成功率和宫腔粘连（IUAs）的自发复发率。设计：队列研究。设置：大学附属医院。患者：共纳入638名Asherman综合征女性，均使用宫腔镜诊断，并在2003年至2013年期间进行手术。干预措施：宫腔镜粘连松解术：主要结果测量：如果月经血流量正常化，沿着宫腔解剖结构恢复、健康、无粘连，且宫腔镜可观察到R1输卵管口，则宫腔镜粘连松解术被分类为成功。复发的粘连诊断后，使用宫腔镜初步成功procedure. Results（S）：一个早期妊娠的程序之前Asherman综合征371名妇女（58.2%），并造成1-2A级粘连。在243名（38.1%）妇女中，产后手术导致3-5级IUAs。606名妇女（95%）手术成功，97.8%的妇女月经血流量恢复;其中174例（27.3%）IUAs自发复发。高级别的粘连是预测一个更高的机会自发复发的adhesions. Conclusions（S）：在95%的妇女与Asherman综合征，一个健康的子宫腔恢复宫腔镜粘连松解术，在1-3次尝试，与28.7%的复发率自发IUAs。(C)2015年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To study the success rate of hysteroscopic adhesiolysis and the spontaneous recurrence rate of intrauterine adhesions (IUAs) in patients with Asherman syndrome.Design: Cohort study.Setting: University-affiliated hospitals.Patient(s): A total of 638 women with Asherman syndrome were included, all diagnosed using hysteroscopy, and operated on between 2003 and 2013.Intervention(s): Hysteroscopic adhesiolysis.Main Outcome Measure(s): Hysteroscopic adhesiolysis was classified as successful if a normalization of menstrual blood flow occurred, along with a restored, healthy, cavity anatomy, free of adhesions, with hysteroscopic visualization of R1 tubal ostium. Recurrences of adhesions were diagnosed using hysteroscopy after an initial successful procedure.Result(s): A first-trimester procedure preceded Asherman syndrome in 371 women (58.2%) and caused adhesions of grades 1-2A. In 243 (38.1%) women, a postpartum procedure caused IUAs of grades 3-5. The procedure was successful in 606 women (95%), and restoration of menstrual blood flow occurred in 97.8%; IUAs spontaneously recurred in 174 (27.3%) of these cases. High grades of adhesions were predictive of a higher chance of spontaneous recurrence of adhesions.Conclusion(s): In 95% of women with Asherman syndrome, a healthy uterine cavity was restored with hysteroscopic adhesiolysis, in 1-3 attempts, with a 28.7% recurrence rate of spontaneous IUAs. (C) 2015 by American Society for Reproductive Medicine.