Outcomes of surgical hysteroscopy: 25 years of observational study

Famada, Anna Vilà; Plans, Ramon Cos; Canals, L. Costa; Torrijos, Mireia Rojas; Vicente, Àgueda Rodríguez; Albadalejo, Albert Bainac

doi:10.1080/01443615.2021.1971176

Cited by 5 publications

(8 citation statements)

References 15 publications

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“…In our study, the absorption of normal saline under spinal anaesthesia and intravenous anaesthesia was significantly increased in the long-term group compared with the short-term group. This result indicated that the absorption of distention fluid increasedaccordingly with the extension of operation time [ 11 ]. Therefore, the absorption of uterine dilatation fluid should be monitored during long-term hysteroscopic surgery to avoid fluid overload [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal salinein patients undergoing hysteroscopic endometrial resection: an observational study

et al. 2023

BMC Women's Health

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Introduction The absorption of uterine distention fluid during hysteroscopic endometrial resection can cause volumeoverload, which can lead to coagulation dysfunction, acute left heart failure and pulmonary oedema in patients. The effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal saline as uterine distention fluid during hysteroscopic surgery remain unclear. The aim of this clinical trial was toobserve the effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal saline in patients undergoing hysteroscopic endometrial resection. Methods A total of 126 patients undergoing elective hysteroscopic endometrial resection were divided into a spinal anaesthesia group (s group) and a propofol-fentanyl intravenous anaesthesia group (PF group), with 63 cases in each group, and both groups were divided into a short-term group (S1 group and PF1 group) and a long-term group (S2 group and PF2 group) according to the operation time. The primary outcome was the absorption of normal saline, and the secondary outcomes included the perioperative SBP, DBP, HR and SpO2 and postoperative haematocrit values, and the incidence of postoperative complications. Results The volume of saline absorbed was significantly increased in the S2 and PF2 groups compared with the S1 and PF1 groups (P < 0.001). There was a significant positive correlation between the amount of normal saline absorbed and the operation time (r = 0.895, P < 0.001). The postoperative haematocrit value was slightly lower than that before the operation in all four groups (P < 0.05), and there were no differences in the incidences of urinary retention, sinus bradycardia or hypotension between groups (P > 0.05). Conclusions There was no difference in the effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal saline during hysteroscopic endometrial resection, and the absorption of normal saline increased accordingly with the extension of operation time.

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Section: Discussionmentioning

confidence: 99%

Effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal salinein patients undergoing hysteroscopic endometrial resection: an observational study

et al. 2023

BMC Women's Health

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“…Every second complication of operative hysteroscopy is mechanical (52%), including cervical lacerations, uterine perforations, and injuries to the adjacent or- As with any other surgical procedure, hysteroscopic operations can be associated with complications. Every second complication of operative hysteroscopy is mechanical (52%), including cervical lacerations, uterine perforations, and injuries to the adjacent organs such as the bowel or bladder, sometimes associated with internal bleeding and conversion to laparoscopy or laparotomy [54,55]. Further short-term complications, such as excess fluid absorption, pulmonary edema, critical electrolyte disbalance, or genital tract burns, and long-term consequences (intrauterine adhesions) should be mentioned [54][55][56].…”

Section: Operative Hysteroscopymentioning

confidence: 99%

“…Every second complication of operative hysteroscopy is mechanical (52%), including cervical lacerations, uterine perforations, and injuries to the adjacent organs such as the bowel or bladder, sometimes associated with internal bleeding and conversion to laparoscopy or laparotomy [54,55]. Further short-term complications, such as excess fluid absorption, pulmonary edema, critical electrolyte disbalance, or genital tract burns, and long-term consequences (intrauterine adhesions) should be mentioned [54][55][56]. Venous air embolism during endometrial resection/endometrial ablation (ER/EA) or hysteroscopic myomectomy, although exceedingly rare (1:1140 surgeries), is a potentially fatal complication [57,58].…”

Section: Operative Hysteroscopymentioning

confidence: 99%

Abnormal Uterine Bleeding in Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality

et al. 2022

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Abnormal uterine bleeding (AUB) is a frequent symptom in perimenopausal women. It is defined as uterine bleeding in which the duration, frequency, or amount of bleeding is considered excessive and negatively affects the woman’s quality of life (QoL) and psychological well-being. In cases of structural uterine pathology, hysterectomy (usually performed via a minimally invasive approach) offers definitive symptom relief and is associated with long-lasting improvement of QoL and sexuality. However, over the past 30 years, uterus-preserving treatments have been introduced as alternatives to hysterectomy. Hysteroscopic polypectomy, myomectomy, or endometrial resection/endometrial ablation are minimally invasive techniques that can be used as an alternative to hysterectomy to treat AUB due to benign conditions. Although associated with high patient satisfaction and short-term improvement in their QoL, hysteroscopic treatments do not eliminate the risk of AUB recurrence or the need for further intervention. Therefore, considering the impact of different treatment options on QoL and sexuality during preoperative shared decision making could help identify the most appropriate and personalized treatment options for perimenopausal women suffering from AUB.

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“…Currently, the availability of instruments for treating intrauterine conditions, both in inpatient and outpatient settings, is more than extensive, synthesizing the latest electronic technologies to the ability to miniaturize them to make them suitable for this type of endoscopic surgery [25,26]. Laser technology was adapted and integrated into hysteroscopy by experimenting with different types of lasers, such as the Nd-Yag laser [27][28][29][30], the potassium titanyl phosphate (KTP) laser [31], or the argon laser [32].…”

Section: Introduction 1backgroundmentioning

confidence: 99%

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Etrusco,

Buzzaccarini,

Laganà

et al. 2024

Diagnostics

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Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the “see and treat” approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through “see and treat” hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.

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Outcomes of surgical hysteroscopy: 25 years of observational study

Cited by 5 publications

References 15 publications

Effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal salinein patients undergoing hysteroscopic endometrial resection: an observational study

Effects of spinal anaesthesia and intravenous general anaesthesia on the absorption of normal salinein patients undergoing hysteroscopic endometrial resection: an observational study

Abnormal Uterine Bleeding in Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

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