子宮鏡下手術に子宮内バルーンタンポナーデを用いた胎盤ポリープの8例-出血のコントロールと妊孕性保持の両立を目指して-

抄録

Objective: To assess the efficacy of careful surgical technique and intrauterine balloon tamponade in preventing abnormal bleeding in hysteroscopic surgery for placental polyps

Design: Retrospective study

Setting: Single-institution case series

Patients: Patients with placental polyps who underwent hysteroscopic surgery

Intervention: Hysteroscopic resection with intrauterine balloon tamponade

Main outcome: Perioperative surgical complications including abnormal bleeding

  A total of 8 patients were treated using hysteroscopy. The mean patient age was 40.1 years (range: 34-44 years), the median diameter of the placental polyp was 23 mm (range: 7-46 mm), and the median surgical time was 32 min (range: 10-65 min). Hysteroresectoscopes with 22 or 26 Fr diameters were used to carefully cauterize individual blood vessels at the base of placental polyps with a flat-type loop electrode. Two cases required temporary compression hemostasis with an intrauterine balloon during the intraoperative period because of increased bleeding. Although 2 cases experienced 100 g and 80 g of blood loss, the other 6 cases did not have abnormal bleeding during the perioperative period when treated with intrauterine balloon tamponade for a day after hysteroscopic surgery.

Conclusion: Placental polyps can be safely treated by hysteroscopic resection through careful surgical technique and intra- and/or postoperative application of intrauterine balloon tamponade.