The Clinical Efficacy Of The Thermal Balloon Endometrial Ablation With Hysteroscopic Endometrial Resection In The Treatment Of Dysfunctional Uterine Bleeding: A Meta-Aanlysis

Objective:To evaluate the curative effect of the thermal balloon endometrial ablation(TBEA) with hysteroscopic endometrial resection(TCRE) for treatment of dysfunctional uterine bleeding(DUB).Materials and method:A systematic review of the thermal balloon endometrial ablation used to treat the dysfunctional uterine bleeding was performed by searching the data bases including PUBMED, China National Knowledge Infrastructure and CBM. Literature references were checked at the same time. Languages was restricted to Chinese and English. Using the index of relative risk to express the result for the categorical variable to evaluate the curative effect,through aanlysis the dataes including the effective rate, the operation time, the blood loss of surgery, the incidence of perioperative complication and the recovery time after surgery.Results:Four cohorts of patients with dysfunctional uterine bleeding,involving 285 patients were included. Including 3 RCT and 1 CCT. None of the CCT described ran-domization or usage of double blinded method. There was no statistically significant between the TBEA and TCRE in the effective rate (RR=1.04,95%CI= [0.94,1.14], p=0.47); The incidence of perioparative complication was higher in the TCRE than in the TBEA (RR=0.30,95%CI= [0.10,0.87], p=0.03); Both the operation time and the blood loss of surgery were higher in the TCRE than in the TBEA (SMD=-2.68,95% CI=[-3.19,-2.17], p<0.05; SMD=-2.02,95%CI=[-2.57,-1.47], p<0.05respecti- vely); The recovery time was longer after operating TCRE than TBEA (SMD=-0.81, 95%CI=[-1.27,-0.35],P<0.05).Conclusion:There was no statistically significant between the TBEA and TCRE in the effective rate for the treatment of dysfunctional uterine bleeding, but that in the TBEA has shorter time of the recovery and operative,less blood loss,littler pain,lower incidence of perioparative complication than in the TCRE. In particular, some patients combined major organ dysfunction(such as blood system disorders,cardiovascular disease and renal insufficiency and so on.) can undergo surgery with TBEA.