Abstract：
OBJECTIVE: To evaluate the use of dilute carboprost tromethamine injection at the endometrium/myoma junction during hysteroscopy to facilitate myoma expulsion and removal in a single procedure.
METHODS: Case series.
METHODS: Single high-volume academic medical center.
METHODS: Seven patients aged 32 to 51 years old with FIGO type 2 uterine myomas and symptoms of abnormal uterine bleeding or infertility undergoing hysteroscopic resection with a morcellation device from November 2022 to July 2023.
METHODS: Dilute injection of carboprost tromethamine (10 µg/mL) at time of hysteroscopic myomectomy.
RESULTS: The main outcome measure was ability to complete the hysteroscopic myomectomy in a single procedure using a hysteroscopic morcellator. Secondary outcomes included total operative time, fluid deficit, and postoperative pharmacologic side effects and/or surgical complications. Among our 7 patients, all had successful single procedure complete resections of myomas ranging from 0.9 to 4.6 cm in maximal diameter. Average operative time was 30 minutes, and average fluid deficit was approximately 839 mL. The carboprost dosages used ranged from 30 to 180 µg. One patient experienced prolonged postoperative nausea and vomiting that resolved with antiemetics. One patient experienced postoperative endometritis that improved with antibiotics.
CONCLUSIONS: In this pilot study, injection of dilute carboprost intraoperatively facilitated one-step hysteroscopic myomectomy of FIGO 2 myomas, via enhanced extrusion of the intramural portion of the fibroid into the uterine cavity, with both short operative times and acceptable fluid deficits.
METHODS: Case series.
METHODS: Single high-volume academic medical center.
METHODS: Seven patients aged 32 to 51 years old with FIGO type 2 uterine myomas and symptoms of abnormal uterine bleeding or infertility undergoing hysteroscopic resection with a morcellation device from November 2022 to July 2023.
METHODS: Dilute injection of carboprost tromethamine (10 µg/mL) at time of hysteroscopic myomectomy.
RESULTS: The main outcome measure was ability to complete the hysteroscopic myomectomy in a single procedure using a hysteroscopic morcellator. Secondary outcomes included total operative time, fluid deficit, and postoperative pharmacologic side effects and/or surgical complications. Among our 7 patients, all had successful single procedure complete resections of myomas ranging from 0.9 to 4.6 cm in maximal diameter. Average operative time was 30 minutes, and average fluid deficit was approximately 839 mL. The carboprost dosages used ranged from 30 to 180 µg. One patient experienced prolonged postoperative nausea and vomiting that resolved with antiemetics. One patient experienced postoperative endometritis that improved with antibiotics.
CONCLUSIONS: In this pilot study, injection of dilute carboprost intraoperatively facilitated one-step hysteroscopic myomectomy of FIGO 2 myomas, via enhanced extrusion of the intramural portion of the fibroid into the uterine cavity, with both short operative times and acceptable fluid deficits.
摘要：
目的：评估在宫腔镜检查期间在子宫内膜/肌瘤交界处使用稀释的卡前列素氨丁三醇注射液，以促进单个手术中的肌瘤排出和切除。
方法：案例系列。
方法：单一的高容量学术医疗中心。
方法：从2022年11月至2023年7月，7名年龄在32-51岁之间的FIGO2型子宫肌瘤和异常子宫出血或不孕症症状的患者接受宫腔镜切除术，使用碎裂装置。
方法：宫腔镜子宫肌瘤切除术时稀释注射卡前列素氨丁三醇（10mcg/mL）。
结果：主要结果指标是使用宫腔镜分割器在一次手术中完成宫腔镜子宫肌瘤切除术的能力。次要结果包括总手术时间，体液缺乏,和术后药理学副作用和/或手术并发症。在我们的七个病人中，所有患者均成功切除了最大直径为0.9-4.6cm的肌瘤。平均手术时间为30分钟,平均液体不足约为839mL。使用的卡前列素剂量范围为30-180mcg。一名患者经历了长时间的术后恶心和呕吐，并用止吐药解决。一名患者经历了术后子宫内膜炎，并使用抗生素改善。
结论：在这项初步研究中，术中注射稀释的卡前列素可促进FIGO2肌瘤的一步宫腔镜子宫肌瘤切除术，通过增强子宫肌瘤壁内部分进入子宫腔的挤压，手术时间短，液体不足可接受。
方法：案例系列。
方法：单一的高容量学术医疗中心。
方法：从2022年11月至2023年7月，7名年龄在32-51岁之间的FIGO2型子宫肌瘤和异常子宫出血或不孕症症状的患者接受宫腔镜切除术，使用碎裂装置。
方法：宫腔镜子宫肌瘤切除术时稀释注射卡前列素氨丁三醇（10mcg/mL）。
结果：主要结果指标是使用宫腔镜分割器在一次手术中完成宫腔镜子宫肌瘤切除术的能力。次要结果包括总手术时间，体液缺乏,和术后药理学副作用和/或手术并发症。在我们的七个病人中，所有患者均成功切除了最大直径为0.9-4.6cm的肌瘤。平均手术时间为30分钟,平均液体不足约为839mL。使用的卡前列素剂量范围为30-180mcg。一名患者经历了长时间的术后恶心和呕吐，并用止吐药解决。一名患者经历了术后子宫内膜炎，并使用抗生素改善。
结论：在这项初步研究中，术中注射稀释的卡前列素可促进FIGO2肌瘤的一步宫腔镜子宫肌瘤切除术，通过增强子宫肌瘤壁内部分进入子宫腔的挤压，手术时间短，液体不足可接受。
