How safe is the intravasation limit in hysteroscopic surgery?
J Minim Invasive Gynecol
; 18(3): 355-61, 2011.
Article
en En
| MEDLINE
| ID: mdl-21441076
BACKGROUND: Transcervical resection of myomas (TCR-M) is considered a safe hysteroscopic procedure if intravasation is limited. Complications may occur if gas formation during myoma resection leads to gaseous embolism. However, the incidence of emboli during transcervical myoma resection is unknown. Therefore in this study the occurrence of physiological changes that indicate the formation of emboli was retrospectively determined in patients undergoing hysteroscopic myoma resection. In addition, these changes were related to the amount of fluid intravasation. METHODS: The anesthesia records and operation files of 234 patients were screened for physiological changes that indicate embolism, as measured with standard intraoperative monitoring. These patients underwent surgery for intrauterine myomas with either a monopolar resectoscope with electrolyte-free distension fluid containing 3% sorbitol (limited to 1500-mL intravasation) or a bipolar resectoscope with normal saline solution (limited to 2500-mL intravasation). The patients were grouped according to the amount of fluid intravasation during the operation: Group 1: 500 mL or less, group 2: 500-1000 mL, group 3: 1000-1500 mL, and group 4: 1500-2500 mL. RESULTS: Physiological changes that could be attributed to gaseous embolism were observed in 33% to 43% of patients with 1000 to 2500 mL fluid intravasation during transcervical myoma resection. Nearly half of those patients had cardiovascular disturbances that indicated the formation of emboli. CONCLUSION: During transcervical resection of myomas, physiological changes that could be attributed to gaseous embolism frequently occurred. Therefore cardiovascular disturbances that indicate gaseous embolism during transcervical resection of myomas may occur despite the limitation of intravasation according to current view.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Sorbitol
/
Neoplasias Uterinas
/
Cloruro de Sodio
/
Histeroscopía
/
Embolia Aérea
/
Complicaciones Intraoperatorias
/
Mioma
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
/
Middle aged
Idioma:
En
Revista:
J Minim Invasive Gynecol
Asunto de la revista:
GINECOLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Países Bajos
Pais de publicación:
Estados Unidos