Author/Editor		Verdnik, Branka; Tomaževič, Tomaž; Ribič-Pucelj, Martina; Kobal, Borut; Vogler, Andrej
Title		Transcervikalna resekcija endometrija in histeroskopska ablacija submukoznih miomov
Translated title		Transcervical resection of endometrium and hysteroscopic ablation of submucous myomata
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 1, št. 2
Publication year		1996
Volume		str. 100-7
Language		slo
Abstract		Background. The authors present the first experience of the Department of Gynaecology, Ljubljana, with treating dysfunctional menstrual bleeding and menorrhagia due to submucous myomata by operative hysteroscopic-transcervical resection of the endometrium (TCRE) and oblation of submucous myomata. Patients and methods. From July 1993 to November 1995, 44 women were treated by hysteroscopic operation for menorrhagia: 19 had transcervical resection of the endometrium and 25 ablation of submucous myomata. The operations were performed with a continous-flow resectoscope (Karl Storz and Olympus), 5%-dextrose for distending and irrigating the cavity, and the Vario Flow System or the Hamou Hysteromat (Karl Storz) for maintaining the intrauterine pressure. A monopolar loop electrode and a rollerball electrode were used for endometrial and myomal ablation; in endometrial ablation, the rollerball electrode was employed for areas at risk of perforation. The data on th outcome of operations were collected by means of a questionnaire which was completed on a voluntary basis by 16 patients undergoing TCRE and by 15 women treated by ablation of submucous myomata. The information of the course of operation and postoperative management was provided by the patients' medical records. Statistical analysis was done with the t-test for interdependent samples for each patient group separately. Results. The therapy produced notable improvement of irregular uterine bleeding in both groups of patinets. TCRE proved successful in 93.7% of patients; amenorrhea was attained in 12.5% of patients, hypomenorrhea or oligomenorrhea in 56.2% and normal menstrual bleeding in 25% of patients. After the operation dysmenorrhea persisted in solely 25% of patients versus 87.5% reported preoperatively. After oblation of submucous myomata, dysmenorrhea improved in 93.3% of women. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Prikaz prvih izkušenj Ginekološke klinike v Ljubljani pri zdravljenju disfunkcionalnih menstrualnih krvavitev in menoragij zaradi sumbukoznih miomov z operativno histeroskopijo in transcervikalno resekcijo endometrija (TCRE) in ablacijo submukoznih miomov. Bolnice in metode. Od julija 1993 do novembra 1995 je bilo zaradi menoragij histeroskopsko operiranih 44 bolnic: pri 19 je bila narejena TCRE, pri 25 ablacija submukoznega mioma. Operacije so bile izvedene s kontinuiranim pretočnim resektoskopom (Karl Storz in Olympus), 5-odstotno glukozo kot sredstvom za distenzijo in irigacijo kavuma ter sistemom Vario Flow ali Hamoujevim histeromatom (Karl Storz) za vzdrževanje intrauterinega tlaka. Uporabljena je bila kombinirana tehnika resekcije endometrija oz. mioma z unipolarno rezalno zanko in elektrokoagulacijo težje dostopnih in za perforacijo rizičnih predelov kavuma z elektrodo roller-ball. Podatke o uspešnosti zdravljenja smo zbrali s pomočjo ankete, na katero se je prostovoljno odzvalo 16 bolnic po TCRE in 15 bolnic po ablaciji submukoznih miomov. Podatke o poteku operacije in pooperativnem zdravljenju smo dobili iz popisov bolezni. Obdelani so s pomočjo t-testa za med seboj odvisne vzorce za vsako skupino bolnic posebej. Rezultati. Pri obeh skupinah bolnic so se simptomi nepravilnih menstrualnih krvavitev bistveno izboljšali. TCRE je bila uspešna pri 93,7% bolnic, doseženo je bilo 12,5% amenorej, 56,2% hipomenorej oz. oligohipomenorej in 25% normalnih menstruacij. Po operaciji navajajo bolnice dismenorejo le še v 25% v primerjavi s 87,5% pred njo. Po ablaciji submukoznih miomov so se menstrualni simptomi izboljšali v 93,3%. Večina bolnic ima normalne menstrualne krvavitve. Dismenoreja se po operaciji pojavlja le še pri 13,3% bolnic, pred njo pa pri 73,3%. Med- in pooperativnih zapletov nismo zasledili. (Izvleček prekinjen pri 2000 znakih).
Descriptors		UTERINE HEMORRHAGE LEIOMYOMA HYSTERECTOMY RETROSPECTIVE STUDIES HYSTERECTOMY TREATMENT OUTCOME