| Objective:Intrauterine benign lesions such as endometrial polyps,submucosal fibroids and residual embryos can cause changes in menstrual volume or menstrual cycle and abnormal intrauterine morphology,resulting in infertility,abortion or premature delivery,which pose a threat to the reproductive health in women of reproductive age.With the increasing number of patients with infertility year by year,these lesions have gradually received widespread attention.Hysteroscopic surgery has become the gold standard for the diagnosis and treatment of intrauterine benign lesions.Hysteroscopic electrotomy has always been considered to be the first choice for hysteroscopic surgery,but many technical-related problems remain unresolved,including complications such as fluid overload,peripheral organ damage,uterine perforation and intrauterine adhesions（IUA）.The Intrauterine Bigatti Shaver（IBS）system is a new mechanical cold knife cutting surgical system based on hysteroscopy.IBS system is widely recognized by reproductive gynecologists because it has no side effects such as electric injury and high liquid load,and can protect the endometrium in women of reproductive age more effectively.This study discusses the clinical safety and availability of IBS system through its clinical efficacy compared with hysteroscopic electrotomy system in the treatment of intrauterine benign lesions in women of reproductive age,so as to further provides evidence-based basis for individualized treatment of patients.Method:The research data of 210 patients with intrauterine benign lesions admitted to the Reproductive and Prenatal Genetic Center of Bethune First Hospital of Jilin University from January 2019 to March 2021 were retrospectively analyzed,including 92 patients with endometrial polyps,39 patients with submucosal fibroids and 79 patients with residual embryos.According to different surgical methods,they were divided into the experimental group（n=80）and the control group（n=130）.IBS system was applied in the experimental group（as the IBS group）,while hysteroscopic electrotomy system was applied in the control group（as the electrotomy group）.The operation duration,changes of biochemical indexes before and after operation,the incidence of IUA and pregnancy rate were analyzed and compared between the two groups,respectively.Result:（1）In this study,the general clinical data（including age,lesion size,lesion type,number of pregnancies,number of uterine operations and body mass index [BMI]）between the electrotomy group and the IBS group were compared and analyzed respectively,but without statistically significant difference（P>0.05）.（2）The average operation time of patients in the IBS group（6.00（4.00,11.00）min）was significantly shorter than that in the electrotomy group（8.00（6.00,21.00）min）（P<0.05）.Further study found that for EP patients,the average operation time in the IBS group（4.00（3.00,5.00）min）was significantly shorter than that in the electrotomy group（6.00（3.50,7.00）min）（P<0.05）.For patients with submucosal fibroids,the average operation time in the IBS group（13.37±5.94min）was significantly shorter than that in the electrotomy group（19.55 ±9.46 min）（P<0.05）.For the patients with residual embryos,the average operation time in the IBS group（11.00（5.75,27.00）min）was significantly shorter than that in the electrotomy group（21.00（11.00,26.00）min）（P<0.05）.（3）Further study found that there was no statistically significant difference in hemoglobin,WBCs count,and serum potassium between the electrotomy group and the IBS group（P>0.05）.（4）All the 210 operations in this study were successfully completed,the lesions were completely removed at one time,and no serious complications occurred during the operation.During one year of postoperative follow-up,IUA occurred in 5 cases in the electrotomy group,while no IUA occurred in the IBS group.There was no significant difference in the incidence of postoperative IUA between the IBS group and the electrotomy group（0.0% vs.3.8%）（P>0.05）.（5）It was found by one year of postoperative follow-up that the postoperative pregnancy rate in the IBS group was significantly higher than that in the electrotomy group（67.5% vs.51.5%）（P<0.05）.Conclusion:（1）Compared with the hysteroscopic electrotomy system,the operation duration using IBS system is significantly lower in the treatment of intrauterine benign lesions.（2）Compared with the hysteroscopic electrotomy system,the postoperative pregnancy rate using IBS system is significantly higher in the treatment of intrauterine benign lesions,indicating good reproductive prognosis of IBS system.（3）In conclusion,the IBS system is safer,faster,more effective and more available in the treatment of intrauterine benign lesions,especially for patients with fertility demand. |
PDF Full Text Request