湾曲を持つMicrowave Endometrial Ablation用アプリケーターの開発

抄録

A new curved microwave applicator was developed for microwave endometrial ablation for uteri with an enlarged and distorted cavity. The applicator was transcervically introduced into the uterine cavity of a resected specimen with a submucosal myoma node, and the endometrium was microwave-coagulated. The endometrium and neighboring myometrium 7 mm in depth were degenerated at a power of 70W with a duration of 50 sec for each coagulation site. Nitroblue tetrazolium staining revealed that coagulated areas lost activity of succinate dehydrogenase, a key enzyme in the Krebs cycle, while myometrium outside of coagulated areas maintained enzyme activity. Tissue temperature increased no more than 10 Celsius degrees at 10 mm from the surface of the applicator at the end of microwave coagulation procedure. In a case of hypermenorrhea caused by a submucosal myoma node 3.8 cm in diameter, heavy period was relieved and the submucosal node shrank by 50% three months after MEA. We concluded that this new curved applicator is useful for MEA in uteri enlarged with submucosal myoma.