Results and Factors Influencing the Outcome of 203 Transcervical Endometrial Resections

Brun, J L; Chabalier, F. de; Marmie, S.; Hajjar, Marwan S; Gbossou, J.M.; Brun, G

doi:10.1089/gyn.1997.13.57

Cited by 12 publications

(2 citation statements)

References 19 publications

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“…Greater success in women close to menopause has also been demonstrated in a French study of up to 8 years of follow up of 203 patients. 25 Of the hysterectomies recorded in our study, most (78%) were performed within 2 years of the initial TCRE. For some of the patients concerned it was apparent within a few months that the result was unsatisfactory, but many experienced amenorrhoea or scanty periods for up to 2 years and then started to have heavier bleeds.…”

Section: Discussionmentioning

confidence: 75%

Endometrial resection: factors affecting long‐term success

1999

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Objective To identify prognostic factors for the long-term success of transcervical resection of endometrium (TCRE). Design A retrospective analysis. Subjects 301 patients, who chose endometrial resection rather than hysterectomy and who underwent their first TCRE between 17 October 1989 and 31 December 1994.Interventions Endometrial resection carried out by one surgeon (D.W.S.). Main outcome measures Patient satisfaction, degree of bleeding and degree of pain, 1-6 years following TCRE. The procedure was considered to have failed if hysterectomy was necessary later. Results 301 patients underwent a total of 329 procedures (TCRE) and were followed up for 1-6 years (mean 2.8). Complications were few and there was no death or major morbidity. About 80% of patients were satisfied with the procedure and had either amenorrhoea (34%), scanty periods (33%) or moderate/acceptable periods (14%). The incidence of hysterectomy because of the failure of this procedure was 15%. The success rate was significantly higher in the older age group (>40 years); in those without previous moderate or severe dysmenorrhoea; where histological examination of the endometrial chippings did not show any abnormality; where further surgery such as diagnostic hysteroscopy, laparoscopy or repeat resection (repeat TCRE) was not required, and with increasing operator experience. Conclusion TCRE should remain a useful option in the management of women with menorrhagia. Greater awareness of the prognostic factors identified in this study will improve preoperative counselling and the appropriate selection of patients for TCRE.

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Section: Discussionmentioning

confidence: 75%

Endometrial resection: factors affecting long‐term success

1999

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“…Moreover, in case of failure of medical therapy many, women are referred towards hysterectomy, which, although it can be performed in a minimally invasive way, remains a major surgical intervention [6]. Transcervical endo-metrial resection was introduced by Neuwirth in 1976 as a conservative surgical treatment and it is still now effective for the control of recurrent menorrhagia, with a success rate of 75-80% at five years and only 10-12% of failure managed with subsequent hysterectomy [7][8][9][10][11]. Hysteroscopic endometrial resection is a valid technique in a skilled surgeon's hand, but it requires a long learning curve and it could have some side effects and even serious complications such haemorrhage or metabolic effects [12].…”

Section: Introductionmentioning

confidence: 99%