A new method of transvaginal ultrasound-guided polypectomy: a feasibility study
A new method of transvaginal ultrasound-guided polypectomy: a feasibility study
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DOI：
10.1002/uog.2668
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发表时间：
2006-02-01
影响因子：
7.1
通讯作者：
Jurkovic, D
中科院分区：
文献类型：
--
作者：
Lee, C;Ben-Nagi, J;Jurkovic, D
目的一种新的设备已经制造出来（安全T选择（TM）），它允许附件的经阴道超声探头到一个特别适合的宫颈抓钩。这提供了在不需要宫腔镜检查的情况下监测子宫内外科手术的能力。本研究的目的是探讨子宫内膜息肉切除术的可行性，使用该设备结合生理盐水子宫声学造影（SCSH），以监测proceeding.Methods妇女诊断与子宫内膜息肉的常规B型二维经阴道超声（TVS）被邀请参加这项研究。经阴道超声引导下息肉切除术由一名操作员进行。从应用到取出抓钩，对手术进行计时。超声视图被评定为满意或差。手术的成功是通过完全切除息肉来衡量的，而不需要求助于宫腔镜。妇女还参加了术后随访超声扫描，以检查残留diseases.Results 37名妇女被招募到这项研究。平均手术时间为8 min（95% CI，5.9-10.4）。32137例（86.5%）病例手术成功（95% CI，75.5-97.5）。在3例病例（8.1%）中，由于无法获得满意的宫腔图像，手术失败，在另外2例病例（5.4%）中，术者无法抓住并切除息肉。2例患者（5.4%）从抓钩插入部位流血的，需要缝合止血。无其他并发症发生，随访时无息肉组织残留。结论经阴道超声引导下子宫内膜息肉切除术是一种可行的子宫内膜息肉切除术。需要进一步的工作来比较这种技术与宫腔镜息肉切除术的结果和成本效益。Copyright（c）2005 ISUOG.由John Wiley & Sons有限公司出版
Objectives A new device has been manufactured (Safe T Choice(TM)), which allows attachment of a transvaginal ultrasound probe to a specially adapted cervical tenaculum. This affords the capacity to monitor intrauterine surgical procedures without the need for hysteroscopy. The purpose of this study was to investigate the feasibility of endometrial polypectomy using this device combined with saline contrast sonohysterography (SCSH) to monitor the procedure.Methods Women diagnosed with an endometrial polyp on routine B-mode two-dimensional transvaginal ultrasound (TVS) were invited to join the study. Transvaginal ultrasound-guided polypectomies were carried out by a single operator. The procedure was timed from application until removal of the tenaculum. The ultrasound views were rated as satisfactory or poor. Success of the procedure was gauged by complete removal of the polyp without recourse to hysteroscopy. Women also attended for postoperative follow-up ultrasound scans to check for residual disease.Results Thirty-seven women were recruited to the study. The mean operating time was 8 min (95% Cl, 5.9-10.4). The procedure was successful in 32137 (86.5%) cases (95% CI, 75.5-97.5). In three cases (8.1 %) the procedure failed because of an inability to obtain satisfactory images of the uterine cavity, and in two further cases (5.4%) the operator was unable to grasp and remove the polyp. Two patients (5.4%) bled from the tenaculum insertion site, necessitating suture for hemostasis. There were no other complications and none of the patients bad evidence of residual polyp tissue at the follow-up visit.Conclusion This study showed that transvaginal ultrasound-guided polypectomy is a feasible technique for the removal of endometrial polyps. Further work is required to compare outcomes and cost-effectiveness of this technique with hysteroscopic polypectomy. Copyright (c) 2005 ISUOG. Published by John Wiley & Sons, Ltd.