Hysteroscopic Resection Of Larger Submucous Myoma Clinical Analysis

Objective:Uterine fibroid is one of the most common seen benign tumors of the female genitaltract，with prevalence rates in literature is as high as20％～50％based on post mortemstudies．There are many different kinds of treatments of uterine fibroid, fibroid removedis the concept of minimally invasive treatment of this disease. Hysteroscopicmyomectomy (transcervical resection of myoma, TCRM) in line with this philosophy,and has been widely recognized. However, the literature on hysteroscopic removal offibroid size and fibroid type of coverage is not uniform. Retrospective analysis TCRMtreatment three types of submucosal uterine fibroids diameter from5cm to8cm fouryears clinical data in Dalian Obstetric and Gynecology Hospital. To investigate theefficacy and safety of hysteroscopic surgical treatment for larger submucous myoma．Methods:65cases larger (diameter rang from5cm to8cm) type0, type I and type IIsubmucosal uterine fibroid patients receiving treatment of TCRM in Dalian Obstetricand Gynecology Hospital affiliated to Dalian Medical University from September2008to November2012were analyzed retrospectively. All the TCRM operation done by thesame physician. Retrospective analysis the operation situation (operation time, uterinedistention fluid volume, blood loss) and therapeutic effect (myoma resction,postoperative satisfaction rate). Collate the data to build a database with Excell, using SPSS l9.0software for operation situation data and Hb changes before and after surgeryunivariate analysis of variance, the differences were statistically significant go on withLDS-t. P <0.05was considered statistically significant.Results:1. The mean age42.8(25~57) years old, menorrhagia55cases (84.6%),including40cases of anemia (29cases with mild, moderate11cases),7cases (10.8%)did not give birth,2patients without a history of pregnancy, dysmenorrhea three cases(4.6%), merger endometrial polyps in15cases (23.1%),16cases of endometrialhyperplasia (24.6%).2.6cases(9.2％)of type0uterine fibroid were found,19cases (29.3％) of type Iand40cases (61.5％) of type II, with single fibroid36cases (55.6％), with more thantwo fibroids29cases (44.6％).3. Surgical cases: three types of fibroids was no significant difference in operativetime and blood loss, uterine distention fluid volume significantly, by LDS-t, the uterinedistention fluid volume of type II and type0fibroids comparison P value <0.05.4. Evaluation:65cases of large submucosal uterine fibroids patients weresuccessfully completed surgery,36cases of single pieces of fibroids total removal ofclean and29cases more fibroids dominant fibroid were removed, secondary fibroidsresection as much as possible, in all cases without serious complications.5. Postoperative follow-up: follow-up of10months to5years, after controllingmenorrhagia success rate of90.9%, with a total satisfaction rate was92.3%, type0and type I satisfaction rate of96.0%.Conclusion:1. TCRM treatment of larger submucosal uterine fibroids (fibroids diameter of5cm or more, but8cm or less) is safe and feasible, for the larger diameter type IIsubmucosal uterine fibroids treatment also is pretty good, worthy of promotion, but theperformer to be experienced.2. The combination of type B ultrasound, diuretic and strengthen the patients’vital signs monitoring are important methods to ensure the safety of TCRM.