Annales de chirurgie · 2001
[Hysteroscopic resection of submucous myomas: long term results].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Fernandez H, Kadoch O, Capella-Allouc S, Gervaise A, Taylor S, Frydman R
Аннотация
STUDY AIM: To evaluate the follow-up after operative hysteroscopic resection of submucous leiomyomas.
PATIENTS AND METHODS: Between January 1990 and December 1996, 200 patients underwent operative hysteroscopic resection of 289 uterine leiomyomas. Indications were: menometrorrhagia (n = 159), postmenopausal metrorrhagia (n = 22), infertility (n = 19) as sole etiology. Sixteen patients had infertility and menometrorrhagia.
RESULTS: The mean follow-up was 33.4 +/- 19.2 months. Twenty-three patients were lost to follow-up. Due to the large size of the leiomyomas, 35 patients had 2 or 3 resections and a total of 241 hysteroscopic resections were performed. Twelve complications (5%) occurred without death or need for intensive care. An improvement of clinical symptoms was observed in 74% of patients. The predictive factors of failure were: size (> 5 cm), number of intracavitary leiomyomas (> 3), hysterometry (> 12 cm), intramural myoma class 2 and association of leiomyomas. Eight of the 35 infertile patients subsequently became pregnant, but with only two live births (5.8%).
CONCLUSION: Hysteroscopic myomectomy appears to be safe, effective and reproducible for the treatment of menstrual disorders. Intramural class 2 and larger leiomyomas constitute the limits of the endoscopic technique.
PATIENTS AND METHODS: Between January 1990 and December 1996, 200 patients underwent operative hysteroscopic resection of 289 uterine leiomyomas. Indications were: menometrorrhagia (n = 159), postmenopausal metrorrhagia (n = 22), infertility (n = 19) as sole etiology. Sixteen patients had infertility and menometrorrhagia.
RESULTS: The mean follow-up was 33.4 +/- 19.2 months. Twenty-three patients were lost to follow-up. Due to the large size of the leiomyomas, 35 patients had 2 or 3 resections and a total of 241 hysteroscopic resections were performed. Twelve complications (5%) occurred without death or need for intensive care. An improvement of clinical symptoms was observed in 74% of patients. The predictive factors of failure were: size (> 5 cm), number of intracavitary leiomyomas (> 3), hysterometry (> 12 cm), intramural myoma class 2 and association of leiomyomas. Eight of the 35 infertile patients subsequently became pregnant, but with only two live births (5.8%).
CONCLUSION: Hysteroscopic myomectomy appears to be safe, effective and reproducible for the treatment of menstrual disorders. Intramural class 2 and larger leiomyomas constitute the limits of the endoscopic technique.