Abstract：
OBJECTIVE: To present a novel technique for office resection of pedunculated endometrial polyps under ultrasound guidance.
METHODS: A prospective trial was conducted at an academic center where women with abnormal uterine bleeding (AUB) who were diagnosed an endometrial polyp following saline infusion sonogram (SIS), were offered polyp removal under ultrasound guidance using a universal grasping forceps (2.5 mm × 25 cm). The primary outcome was to evaluate the feasibility of this technique for complete removal of the polyp. The secondary outcomes were to evaluate the patients\' pain score, satisfaction score using visual analogue score (VAS), and efficacy of the technique in alleviating symptoms in patients with AUB due to polyps.
RESULTS: Thirty patients participated, with a mean age of 54.8 ± 11 years. Average polyp volume was 1.87 cm3 and mean duration for polypectomy was 11 minutes 31 seconds. The median pain score immediately post-procedure was 5 (0-9). We were unable to complete the procedure in two patients due to patient discomfort and poor visualization. Complete removal of polyp was ensured by checking for a thin endometrial echo at the end of the procedure and by performing SIS at 3-months post-procedure. Of the 22 patients who returned for follow-up, 19 (86.36%) showed no evidence of polyp on SIS and all reported resolution of AUB symptoms. The median satisfaction score at the follow-up was 10/10. Adequate pathology samples were obtained from all cases, diagnosing malignancy in one and endometrial hyperplasia in one patient.
CONCLUSIONS: This technique offers safe and effective removal of pedunculated endometrial polyps in an office setting, avoiding the need for general anesthesia. It can be offered as a therapeutic option at the initial point of contact, providing symptom relief and tissue diagnosis while reducing costs and patient visits.
METHODS: A prospective trial was conducted at an academic center where women with abnormal uterine bleeding (AUB) who were diagnosed an endometrial polyp following saline infusion sonogram (SIS), were offered polyp removal under ultrasound guidance using a universal grasping forceps (2.5 mm × 25 cm). The primary outcome was to evaluate the feasibility of this technique for complete removal of the polyp. The secondary outcomes were to evaluate the patients\' pain score, satisfaction score using visual analogue score (VAS), and efficacy of the technique in alleviating symptoms in patients with AUB due to polyps.
RESULTS: Thirty patients participated, with a mean age of 54.8 ± 11 years. Average polyp volume was 1.87 cm3 and mean duration for polypectomy was 11 minutes 31 seconds. The median pain score immediately post-procedure was 5 (0-9). We were unable to complete the procedure in two patients due to patient discomfort and poor visualization. Complete removal of polyp was ensured by checking for a thin endometrial echo at the end of the procedure and by performing SIS at 3-months post-procedure. Of the 22 patients who returned for follow-up, 19 (86.36%) showed no evidence of polyp on SIS and all reported resolution of AUB symptoms. The median satisfaction score at the follow-up was 10/10. Adequate pathology samples were obtained from all cases, diagnosing malignancy in one and endometrial hyperplasia in one patient.
CONCLUSIONS: This technique offers safe and effective removal of pedunculated endometrial polyps in an office setting, avoiding the need for general anesthesia. It can be offered as a therapeutic option at the initial point of contact, providing symptom relief and tissue diagnosis while reducing costs and patient visits.
摘要：
目的：提出一种在超声引导下对带蒂子宫内膜息肉进行办公室切除的新技术。
方法：在一个学术中心进行了一项前瞻性试验，其中患有异常子宫出血（AUB）的妇女在输注盐水超声检查（SIS）后被诊断为子宫内膜息肉，在超声引导下使用通用抓取钳（2.5mm×25cm）去除息肉。主要结果是评估该技术完全去除息肉的可行性。次要结果是评估患者的疼痛评分，满意度评分采用视觉模拟评分(VAS)，以及该技术在缓解息肉引起的AUB患者症状方面的疗效。
结果：30名患者参加，平均年龄54.8±11岁。平均息肉体积为1.87cm3，息肉切除术的平均持续时间为11分31秒。术后即刻疼痛评分中位数为5(0-9)。由于患者不适和视觉差，我们无法完成两名患者的手术。通过在手术结束时检查子宫内膜的薄回声并在手术后3个月进行SIS来确保息肉的完全去除。在返回随访的22名患者中，19（86.36％）在SIS上没有显示息肉的证据，并且所有报告的AUB症状消退。随访时的中位满意度评分为10/10。从所有病例中获得足够的病理样本，诊断1例恶性肿瘤和1例子宫内膜增生。
结论：这项技术可以在办公室环境中安全有效地去除带蒂的子宫内膜息肉，避免全身麻醉的需要。它可以作为初始接触点的治疗选择，提供症状缓解和组织诊断，同时降低成本和患者就诊。
方法：在一个学术中心进行了一项前瞻性试验，其中患有异常子宫出血（AUB）的妇女在输注盐水超声检查（SIS）后被诊断为子宫内膜息肉，在超声引导下使用通用抓取钳（2.5mm×25cm）去除息肉。主要结果是评估该技术完全去除息肉的可行性。次要结果是评估患者的疼痛评分，满意度评分采用视觉模拟评分(VAS)，以及该技术在缓解息肉引起的AUB患者症状方面的疗效。
结果：30名患者参加，平均年龄54.8±11岁。平均息肉体积为1.87cm3，息肉切除术的平均持续时间为11分31秒。术后即刻疼痛评分中位数为5(0-9)。由于患者不适和视觉差，我们无法完成两名患者的手术。通过在手术结束时检查子宫内膜的薄回声并在手术后3个月进行SIS来确保息肉的完全去除。在返回随访的22名患者中，19（86.36％）在SIS上没有显示息肉的证据，并且所有报告的AUB症状消退。随访时的中位满意度评分为10/10。从所有病例中获得足够的病理样本，诊断1例恶性肿瘤和1例子宫内膜增生。
结论：这项技术可以在办公室环境中安全有效地去除带蒂的子宫内膜息肉，避免全身麻醉的需要。它可以作为初始接触点的治疗选择，提供症状缓解和组织诊断，同时降低成本和患者就诊。
