子宮内膜ポリープ切除後の妊娠率：レゼクトスコープとLINスネアシステムの比較

抄録

Introduction: Endometrial polyps can cause infertility and their removal is recommended. Transcervical resection (TCR), which is commonly selected, is performed using a resectoscope under anesthesia. Recently, use of the Lin snare system (Snare) has been reported for polyp removal without anesthesia. Snare uses a diagnostic flexible hysteroscope with an outer diameter of 3.1 mm. However, the effects on infertility are unclear. We investigated infertile patients with endometrial polyps at our hospital and compared pregnancy rates based on the two different methods.

Materials and Methods: Between January 2008 and April 2014, we analyzed 64 patients who were postoperatively followed-up for at least 12 months. The patient backgrounds and pregnancy rates were investigated retrospectively for both groups. TCR was performed under general anesthesia, with hospitalization. Snare was used with no anesthesia and no cervical dilatation on an outpatient basis. Since the introduction of Snare at our hospital in 2012, it has been the first choice.

Results: No significant differences were observed between both groups for patient backgrounds. Pregnancy rates were 42.9% (21/49) in the TCR group and 60.0% (9/15) in the Snare group, indicating no significant difference. Five patients underwent both procedures. The two patients treated with Snare for post-TCR recurrence were both pregnant, and two of three patients who underwent additional TCR following difficulties with Snare were pregnant.

Conclusions: Our study indicated that the pregnancy rate after using Snare was not inferior to that after TCR. Our results suggested that Snare could be useful for polyp removal in the treatment of patients with infertility.