基于加速康复外科理念下一次性使用电子宫腔镜在日间手术中应用的可行性分析

Feasibility analysis of single-use digital hysteroscope in day surgery based on the concept of enhanced recovery after surgery

摘要:

目的 评估基于加速康复外科理念下一次性使用电子宫腔镜在日间手术中应用的可行性。方法 回顾性分析2023年2月－2024年4月该院295例采用一次性使用电子宫腔镜治疗的日间手术患者的临床资料。分析手术时间、手术成功率、手术并发症、疾病复发率和患者满意度等指标。结果 一次性使用电子宫腔镜治疗子宫内膜息肉的手术时间分别为：1个息肉（4.973±0.384）min，2个息肉（6.193±0.533）min，3～5个息肉（10.279±0.847）min，>5个息肉（15.938±2.008）min；治疗子宫内膜异常增生的手术时间为（4.323±0.954）min，治疗胚物残留的手术时间为（8.077±1.317）min，治疗子宫黏膜下肌瘤的手术时间为（16.750±1.541）min，治疗宫腔粘连的手术时间为（11.611±2.598）min，治疗子宫内膜炎的手术时间为（3.500±0.463）min，治疗纵隔子宫及宫腔无明显异常的手术时间为（2.214±0.636）min，治疗输卵管开口封闭的手术时间为（14.167±2.255）min，治疗宫内节育器残留的手术时间为3.5 min。检查成功率100.0%，手术成功率98.3%，患者满意度99.3%，并发症3例（人工流产综合征2例，术后发热1例，无严重并发症）。术后随访半年，失访8例，复发5例（子宫内膜息肉3例，宫腔轻度粘连2例）。结论 一次性使用电子宫腔镜能治疗妇科常见的宫腔内疾病，手术时间短，手术成功率高，患者满意度较好，并发症轻微，有利于术后快速康复，可用于日间手术。值得临床推广应用。

Abstract:

Objective To evaluate the feasibility of single-use digital hysteroscope based on enhanced recovery after surgery concept in day surgery.Methods A retrospective analysis was conducted on 295 patients who underwent treatment with single-use digital hysteroscope from February 2023 to April 2024. The study analyzed operation time, success rate, surgical complications, recurrence rate of diseases, and patient satisfaction.Results The average operation time with single-use digital hysteroscope for treating endometrial polyps: 1 polyp was (4.973 ± 0.384) min, 2 polyps was (6.193 ± 0.533) min, 3 ~ 5 polyps was (10.279 ± 0.847) min, and >5 polyps was (15.938 ± 2.008) min. The average operation time for treating endometrial hyperplasia was (4.323 ± 0.954) min, retained products of conception was (8.077 ± 1.317) min, submucosal uterine myoma was (16.750 ± 1.541) min, intrauterine adhesion was (11.611 ± 2.598) min, endometritis was (3.500 ± 0.463) min, septate uterus and uterine cavity without obvious abnormalities was (2.214 ± 0.636) min and closed tubal ostium was (14.167 ± 2.255) min, and residual intrauterine device was 3.5 min. The success rate of all cases was 100.0%, the surgical success rate was 98.3%, the patient satisfaction rate was 99.3%, and 3 cases of the complication (2 cases in induced abortion syndrome, 1 case in postoperative fever, and no serious adverse events occurred). After six-month follow-up, 8 patients were lost to follow-up, and 5 patients had disease recurrence ( 3 cases in endometrial polyps, 2 cases in mild intrauterine adhesion).Conclusion Single-use digital hysteroscope can treat common intracavitary diseases of gynecology, with short operation time, high success rate, good patient satisfaction, minor complications, and favorable conditions for rapid postoperative recovery. It can be used for day surgery. It is worthy in clinical application.