Morcellement hystéroscopique versus résection à l’anse bipolaire pour les polypes endométriaux

Hamidouche, A.; Vincienne, M.; Thubert, Thibault; Trichot, C.; Demoulin, G.; Rivain, A L; Deffieux, X.

doi:10.1016/j.gyobfe.2014.12.012

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…This surgical method has fewer postoperative complications and better safety. Hysteroscopic morcellation does not rely on energy equipment, and the tissue can be sucked out quickly while crushing the tissue [ 15 ], so there the surgical field is not blocked during the separation of adhesive tissue, and the sucked out crushed tissue can be directly used for subsequent pathological examination [ 18 ]. In addition, under hysteroscopy, the field of vision is clear and the intimal vessels are clearly visible, so the separation process can effectively avoid the vessels during the operation, and there is little surgical trauma.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Ren¹,

Huang

Wang

et al. 2022

Med Sci Monit

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Background Hysteroscopic surgery has been widely used in clinical practice for more than 30 years due to its advantages of less trauma, less bleeding, and direct vision. The aim of this study was to compare hysteroscopic morcellation versus conventional resectoscopy for removal of endometrial lesions. Material/Methods For the database search, we used the keywords “morcellator,” “morcellators,” “morcellate,” “morcellation,” and “morcellated” combined with “hysteroscopy,” “uteroscope,” and “transcervical”. The last search was conducted on February 1, 2022. Randomized controlled trials (RCTs) were included in the meta-analysis. Results According to our retrieval scheme and the inclusion and exclusion criteria, we found 6 studies including 565 patients. For enumeration data, we calculated the effect size as relative risk (RR) and 95% confidence interval (95% CI), while for quantitative data we used the weighted mean difference (WMD) and 95% confidence interval (95% CI). There was no significant difference between success rate of hysteroscopic morcellation and conventional resectoscopy (relative risk and 95% confidence interval 1.05(0.97,1.13); P =0.232). Procedure time was also shorter with hysteroscopic morcellation, the procedure time of the hysteroscopic morcellation group was 3.43 min shorter compared with the conventional resectoscopy group, and the operating time in the hysteroscopic morcellation group was 2.81 min shorter. In terms of fluid deficit, there was no statistically significant difference in fluid loss between the 2 groups ( P =0.209). Conclusions Hysteroscopic morcellation is associated with a shorter procedure time and operative time among patients with endometrial lesions compared with resectoscopy.

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Section: Discussionmentioning

confidence: 99%

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Ren¹,

Huang

Wang

et al. 2022

Med Sci Monit

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“…Retrospective, randomized, controlled studies and meta-analysis have reported that HTRs, in an operating theater, is significantly faster for removal of pathology compared with conventional loop resectoscopy, with equivalent removal of pathology. 1,[10][11][12][13] Four Tissue Removal Systems: TruClear (Medtronic), MyoSure (Hologic), IBS Integrated Bigatti Shaver (Karl Storz GmbH & Co.) and Symphion™ (Boston Scientific) are currently available (Table 3), and only for two of these technologies in vitro direct comparison has been performed. 14 Since the diameter of all systems are greater than 5 mm (except TruClear 5C system which reaches without the outer sheaths the figure of 5), no large body of published data exist for HTRs in an office setting with vaginoscopic approach.…”

Section: Discussionmentioning

confidence: 99%

“…19 The short procedure times required with the TruClear 5C may be explained by the simultaneous cutting and removal of tissue through the active suction blade, negating the requirement for the surgeon's maneuvers and multiple reinsertions to remove resected tissue that are needed for visualization using other technologies. 12 In an office setting, patient acceptability and procedural pain are linked to the duration of hysteroscopic surgery as well as the use of mechanical or electrical instruments that necessitate additional maneuvers to retrieve resected tissue. 4,16,17 Therefore, the reduction in the total operative time is of a high clinical significance for patient acceptability.…”

Section: Discussionmentioning

confidence: 99%

“…Retrospective, randomized, controlled studies and meta‐analysis have reported that HTRs, in an operating theater, is significantly faster for removal of pathology compared with conventional loop resectoscopy, with equivalent removal of pathology …”

Section: Discussionmentioning

confidence: 99%

“…HTRs polypectomy has been recognized as a safe and effective procedure completed in almost one third of the usual time with less reliance on the surgeon's skill . The short procedure times required with the TruClear 5C may be explained by the simultaneous cutting and removal of tissue through the active suction blade, negating the requirement for the surgeon's maneuvers and multiple reinsertions to remove resected tissue that are needed for visualization using other technologies …”

Section: Discussionmentioning

confidence: 99%

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Office treatment of large endometrial polyps using truclear 5C: Feasibility and acceptability

Ceci

Franchini

Cannone

et al. 2018

J of Obstet and Gynaecol

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Aim: This retrospective multicenter study was carried out to evaluate feasibility, effectiveness and patient acceptability of a small diameter hysteroscopic tissue removal system in the treatment of large endometrial polyps (≥20 mm), usually not removed in an office setting. Methods: Hundred and forty-six women with a single greater than 10-mm diameter polyp considered for polypectomy between April 2016 and August 2017. Sixty-five of these patients had a polyp size greater than 20 mm. All hysteroscopic polypectomy, using Hysteroscopic Tissue Removal system (TruClear 5C System Medtronic), were performed in an office setting with vaginoscopic approach. Results: Procedural success, time to complete the polypectomy and patient pain scores were evaluated. Polyps less than 20 mm were completely removed in 79/81 cases (97.53%). The completeness of greater than or equal to 20-mm polyp removal was achieved in 63/65 cases (96.92%). The median time for polypectomy was 4.19 AE 1.03 min for polyps less than 20 mm and 4.97 AE 1.30 min for polyps greater than or equal to 20 mm, respectively. Pain was minimal and brief, and the mean pain score measured on a 10-point visual analog scale at the end of polypectomy showed no significant difference between the two groups. In 4/79 (5.06%) cases with polyps less than 20 mm and in 4/63 (6.35%) cases with polyps greater than or equal to 20 mm women reported moderate pain. All specimens were adequate for pathologic measurements. Conclusion: Hysteroscopic treatment of polyps greater than or equal to 20 mm in size with TruClear 5C is feasible and well tolerated in an office setting with no significant difference regarding completeness compared to polyps less than 20 mm, but with a minimal increase in procedure times.

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A Prospective Analysis of Hysteroscopic Morcellation in the Management of Intrauterine Pathologies

Arnold

Ketheeswaran

Bhatti

et al. 2016

Journal of Minimally Invasive Gynecology

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Morcellement hystéroscopique versus résection à l’anse bipolaire pour les polypes endométriaux

Cited by 6 publications

References 13 publications

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Office treatment of large endometrial polyps using truclear 5C: Feasibility and acceptability

A Prospective Analysis of Hysteroscopic Morcellation in the Management of Intrauterine Pathologies

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