Efficacy Analysis Of Different Hysteroscopic Surgical Methods On Endometrial Polyps Treatment

Objective This study investigated the clinical efficacy of hysteroscopic cold knife resection and hysteroscopic electric resection for endometrial polyps.The conclusion provides a theoretical basis for the clinical selection of endometrial polyps surgery.Materials This study retrospectively analyzed the clinical data of 165 patients with endometrial polyps.These patients underwent hysteroscopic surgery in the First Affiliated Hospital of Fujian Medical University from January 2017 to December2019.Patients were divided into the cold knife group(n=61 cases)and the electric knife group(n=104 cases).The operation time,intraoperative blood loss,water load,recent postoperative complications,postoperative hospital stay,hospitalization cost,and other indicators were compared between the two groups.All the patients were followed up for one year after the surgery.The improvement of postoperative abnormal uterine bleeding,polyp recurrence,postoperative pregnancy,and long-term postoperative complications were compared between the two groups.The COX proportional hazard regression model was used to analyze the factors affecting recurrence of endometrial polyps after surgery.Results The operation for all 165 patients was successfully completed.There was no significant difference between the cold knife group and the electric knife group in the average operation time,average intraoperative blood loss,average water load,or average hospital stay(P>0.05).One case of abdominal pain occurred in the cold knife group,wheres two cases of abdominal pain occurred in the electric knife group.No significant difference existed in the incidence of recent complications between the two groups(P>0.05).The hospitalization cost of cold knife group(9272.06 ± 1390.72 yuan)was significantly lower than that of the electric knife group(10512.69± 1523.80 yuan,P=0.001).All 161 patients were followed up clinically for one year.The postoperative follow-up rate was 97.58%(161/165).Among patients with abnormal uterine bleeding,no significant difference existed in the remission rate of postoperative abnormal uterine bleeding between the two groups(P>0.05).Among patients with fertility needs,the postoperative pregnancy rate in the cold knife group(61.5%)was statistically higher than that in the electric knife group(38.1%,P=0.024).No significant difference was found in the postoperative polyp recurrence rate between the cold knife group and the electric knife group(P>0.05).The result of COX multivariate survival analysis showed that neither the age,the BMI,the diameter of polyp,the location of polyp,the type of polyp,the number of pregnancies,nor the operation methods were independent risk factors for the recurrence of endometrial polyps.Conclusion 1.Different hysteroscopy can effectively relieve abnormal uterine bleeding associated with endometrial polyps.2.Hysteroscopic endometrial polyp resection is beneficial to obtain better pregnancy rate.For the patients with endometrial polyps who have fertility needs,hysteroscopic cold knife resection can be preferred.3.Factors affecting the recurrence of endometrial polyps are complex.The operation approach is not an independent risk factor for the recurrence of endometrial polyps.