Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025
Safety and efficacy of combining transcervical fibroid ablation with operative hysteroscopy.
СтатьяНазвание и аннотация: Перевод в очереди
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Piriyev Elvin, Dieter Angelika, Schiermeier Sven, Renner Stefan, Römer Thomas
Аннотация
INTRODUCTION: Minimally-invasive, organ-preserving techniques for uterine fibroid management have gained popularity. This study assesses the safety and effectiveness of combining transcervical fibroid ablation (TFA) with operative hysteroscopy (HSC).
AIM: We aimed to evaluate whether a combined approach that involves performing TFA and operative HSC during a single session increased the intra- and postoperative risks.
MATERIALS AND METHODS: A total of 200 women were included in this retrospective study. They were divided into 2 groups: 100 underwent combined TFA and operative HSC (group 1), and 100 underwent HSC alone (group 2). Surgical procedures included fibroid / polyp resection, endometrial ablation, and septum dissection. Outcomes assessed comprised intra- and postoperative complications and symptom improvement.
RESULT: Complication rates were low and comparable in both groups. Among the patients in group 1 with available follow-up (n = 60), 83.3% reported improvement in bleeding symptoms, particularly those treated with TFA combined with myomectomy (84%). The combined approach enabled treatment of a broader range of fibroid types (International Federation of Gynecology and Obstetrics score 0-6) and intrauterine pathologies in a single session. No severe or life-threatening complications were observed. The risk of bleeding during fibroid resection was reduced when the resection was preceded by TFA (P = 0.001).
CONCLUSION: Combining TFA and HSC appears to be a safe, effective, and versatile approach for treating uterine fibroids and intrauterine pathologies. It offers procedural efficiency, broadens treatment eligibility, and may reduce the need for reintervention.
AIM: We aimed to evaluate whether a combined approach that involves performing TFA and operative HSC during a single session increased the intra- and postoperative risks.
MATERIALS AND METHODS: A total of 200 women were included in this retrospective study. They were divided into 2 groups: 100 underwent combined TFA and operative HSC (group 1), and 100 underwent HSC alone (group 2). Surgical procedures included fibroid / polyp resection, endometrial ablation, and septum dissection. Outcomes assessed comprised intra- and postoperative complications and symptom improvement.
RESULT: Complication rates were low and comparable in both groups. Among the patients in group 1 with available follow-up (n = 60), 83.3% reported improvement in bleeding symptoms, particularly those treated with TFA combined with myomectomy (84%). The combined approach enabled treatment of a broader range of fibroid types (International Federation of Gynecology and Obstetrics score 0-6) and intrauterine pathologies in a single session. No severe or life-threatening complications were observed. The risk of bleeding during fibroid resection was reduced when the resection was preceded by TFA (P = 0.001).
CONCLUSION: Combining TFA and HSC appears to be a safe, effective, and versatile approach for treating uterine fibroids and intrauterine pathologies. It offers procedural efficiency, broadens treatment eligibility, and may reduce the need for reintervention.