Diseases that Harm Require Therapies that Harm Less

---Sir William Osler(1849-1919)
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ISMIVS Newsletter September&October, 2021
Newsletter 2021 September & October
2021年9月及10月简报
About Us 国际微无创医学会简介
The International Society of Minimally Invasive and Virtual Surgery (ISMIVS, previously known as International Society of Minimally Invasive and Noninvasive Medicine) was founded in July 2013 at the gala of the 1st Yangtze International Summit of Minimally Invasive and Noninvasive Medicine in Chongqing, China. ISMIVS envisions to accelerating the progress in minimally invasive and noninvasive medicine by promoting research, education, communication, and international collaboration.
国际微无创医学会(ISMIVS)是在 2013 年 7 月在中国重庆召开的第一届国际微无创医学长江高峰论坛上宣布成立的,旨在通过学术研究、教育、交流以及国际合作加快微无创医学的发展。
Become a member 注册成为会员 >
The Personality in the Medical Education World 医学教育界的大人物
From the 2020 July issue of our ISMIVS Newsletter, we would like to introduce some pioneers in the field of minimally-invasive and noninvasive medicine. They are not only prestigious in their field but also willing to share their experience and ideas with younger doctors, hence making a great contribution to medical education. This issue features Professor Gail Reinette TER HAAR from Britain, who is engaged in the field of therapy ultrasound.
从 2020 年 7 月刊开始,国际微无创医学会将为大家介绍微无创医学领域的一些领军人物。他们不仅在各自的领域享负盛名,而且非常乐意与年轻医生分享他们的经验、理念和想法,从而为医学教育做出了巨大的贡献。本期月刊要介绍的是来自英国的超声治疗领域的医学专家盖尔•蕾妮特•特哈尔教授。
Professor Gail Reinette TER HAAR, DSc
Institute of Cancer Research • Division of Radiotherapy and Imaging
盖尔•蕾妮特•特哈尔教授,理学博士
英国癌症研究院医学影像与放射治疗科

Founding President of the International Society for Therapy Ultrasound (ISTU)
Honorary member of the British Medical Ultrasound Society (BMUS)
Honorary fellow of the American Institute for Ultrasound in Medicine
Deputy Editor of Ultrasound in Medicine and Biology
Editorial boards of International Journal of Hyperthermia
国际超声治疗学会(ISTU)创始主席
英国医学超声学会名誉会员
美国超声医学研究院名誉院士
《超声医学与生物学》副主编
《国际热疗杂志》编委会成员

Professor Gail ter Haar is one of the board members of International Society of Minimally Invasive and Virtual Surgery (ISMIVS), also the research team leader of Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey, UK.
盖尔•特哈尔教授是国际微无创医学会(ISMIVS)的常务理事之一,现任英国萨里郡萨顿癌症研究院(ICR)研究团队的负责人。
Gail ter Haar took her first degree in Physics from Oxford University. Following a Masters degree in Medical Physics from Aberdeen University, she studied for her PhD in Physics at Guy's hospital, in London. She also holds a D.Sc. in clinical medicine from Oxford University. In addition, she has written five books and 32 book chapters, and over 250 peer reviewed research papers.
盖尔•特哈尔教授毕业于牛津大学物理学系,随后,她在阿伯丁大学获得医学物理硕士学位,并在伦敦盖伊医院(Guy’s Hospital)攻读物理学博士学位。盖尔同时也是牛津大学临床医学博士,撰有 5 本书籍,32 篇书刊篇章,以及 250 余篇期刊论文。
Since 2007, along with a colleague from Paris (Jean Francois Aubry), Gail has organised and run a highly successful bi-annual Therapy Ultrasound School in Les Houches, France. To date, this has introduced over 400 people to the field of therapy ultrasound. In 2014,her team was recognised by being made a Centre of Excellence for HIFU physics and bone studies by the Focused Ultrasound Foundation.
自 2007 年起,盖尔与其法国同事,让•弗朗索瓦•奥布里(Jean Francois Aubry),每两年开办一届超声治疗学习班,至今已培养 400 余人进入超声治疗领域。2014 年,盖尔带领的团队被聚焦超声基金会评为高强度聚焦超声(HIFU)物理学和骨骼研究卓越中心。
Her research interests have lain primarily in understanding the way in which medical ultrasound interacts with tissue, especially the physical mechanisms involved in producing bio-effects (primarily heating & acoustic cavitation) with a view to understanding its safety when used in diagnosis, and to harnessing these effects for therapeutic benefit. Most recently her research has concentrated on developing devices and protocols for ultrasound based treatments of cancer. Prof. Gail ter Haar is now investigating the use of high intensity focused ultrasound (HIFU) to rapidly heat and kill tumors of the liver or kidney.
盖尔主要研究医学超声与人体组织的相互作用,特别是产生生物效应(主要为加热和声空化)的物理机制,钻研其用于诊断的安全性,从而利用此类效应进行治疗。近年来,盖尔专注于研究以超声技术为基础的癌症治疗设备及方案。 目前,她正在探索应用高强度聚焦超声(HIFU)技术来快速加热并杀死肝脏或肾脏的肿瘤。
Papers and interviews of Prof. Gail ter Haar:
点击查看盖尔•特哈尔教授的相关作品和访谈:
HIFU Tissue Ablation: Concept and Devices
Developing Therapeutic Ultrasound

News 新闻
The 21st APAGE Congress
HIFU Special Seminar – The Era of Non-invasive Gynecological Surgery
2021年亚太妇产科内视镜暨微创治疗医学会(APAGE)年会
暨高强度聚焦超声(HIFU)专场研讨会——妇科手术的微无创时代
The 21st APAGE Congress (APAGE 2021) – High Intensity Focused Ultrasound (HIFU) Special Seminar brought to a successful close on September 12th, on which we invited 5 excellent speakers experienced in the field of minimally-invasive and non-invasive gynecological surgery to present clinical application and pregnancy outcome of HIFU, with two distinguished chairs Prof. Tsutsumi Osamu from Japan and Dr. Lee Keen Whye from Singapore. Let’s take a look back and enter a new era together!
2021年亚太妇产科内视镜暨微创治疗医学会(APAGE)年会暨高强度聚焦超声(HIFU)专场研讨会于 9 月 12 日圆满闭幕。本次研讨会由日本的 Osamu Tsutsumi 教授和新加坡的李健威医生担任会议主席,并邀请到了 5 位微无创妇科手术领域的顶尖专家,围绕HIFU的临床应用和生育结果展开深入交流。跟随我们的脚步回顾HIFU专场研讨会的精彩瞬间,一起迈入妇科手术的新时代吧!
Prof. David Cranston, the President of International Society of Minimally Invasive and Virtual Surgery (ISMIVS) and the Associate Professor of Surgery in the Nuffield Department of Surgical Science, shared the development of HIFU in Oxfrod for last 20 years. He first introduced clinical treatments and trials of HIFU on fibroids, liver, kidney, renal transplant and sacral chordomas. Then he gave a detailed introduction on renal and liver tumour trial in Oxford, including related papers and how HIFU works in diagnosis and surgery. Prof. David Cranston also compared the pre- and post-HIFU MRIs of a patient received renal transplant and concluded his speech with a quotes of Theodore Roosevelt to encourage clinicians who are engaged in the innovative research of HIFU to keep breaking the boundaries of knowledge.
国际微无创医学会(ISMIVS)会长,牛津大学纳菲尔德临床医学院的 David Cranston 副教授分享了近20年以来 HIFU 技术在牛津的发展历程。他首先介绍了牛津大学应用 HIFU 治疗子宫肌瘤、肝肾疾病、肾移植和骶骨脊索瘤的相关经验和临床试验,并详细阐释了有关肝肾肿瘤的 HIFU 临床试验,包括相应的研究性论文,以及 HIFU 在术前诊断和治疗过程方面的工作原理。David Cranton 教授还对比了 HIFU 治疗肾移植病人术前与术后的 MRI 影像。最后,他以西奥多•罗斯福的名言录为引,鼓励所有开创性研究 HIFU 的医生学者们,砥砺前行,打破知识的边界。
Prof. Felix Wong, the Conjoint Professor of the University of New South Wales and Chairman of CA-AMIGO, shared his career path in the field of gynecological surgery and the technology development for the treatment of uterine fibroids from open surgery to laparoscopy, then to HIFU. Felix pointed out both advantages and disadvantages of hysterectomy and laparoscopic myomectomy for uterine fibroids, and introduced another alternative path of single port robotic surgery. After that, he shared his journey with HIFU, a unique and non-invasive FUS surgery which is able to improve the safety and efficacy of treatment and further reduce complications. Prof. Felix Wong concluded that he was looking forward to see more progress in this new technology, for which he believed would benefit women health.
新南威尔士大学客座教授、中国及亚太地区微创妇科肿瘤协会(CA-AMIGO)主席黄胡信教授与大家分享了他在妇科手术领域的职业生涯,以及子宫肌瘤治疗从普通手术到腹腔镜,再到HIFU的发展历程。他首先指出采用子宫切除术和腹腔镜手术治疗子宫肌瘤的利与弊,并介绍了针对子宫肌瘤的另一治疗方案,即单孔腔镜手术。随后,分享了他认识、学习并应用 HIFU 的精彩故事,并提到 HIFU 是一种无创聚焦超声(FUS)手术,能够提升治疗的安全性和效果,减少手术并发症。 黄教授认为 HIFU 对女性健康有益,他期待这一新兴技术的长足进步。
Prof. Aixingzi Aili from Shanghai First Maternity and Infant Hospital delivered a speech themed on “HIFU Treatment for Adenomyosis and the Pregnancy Outcome”. Based on her 20-year experience in endometriosis and adenomyosis treatment and research, Prof. Aili elaborated the principles of HIFU ablation and shared a three-step therapy of HIFU combined with GnRHa and LNG-IUS for patients with adenomyosis. She indicated that HIFU treatment did not affect ovarian reserve of women through a comparison figure of uterine volume and lesion volume before and post HIFU ablation in 54 cases, and concluded that HIFU ablation may improve uterine movement and uterine cavity morphology by ablating lesions, thus contributing to fertility.
上海第一妇婴保健院的艾星子•艾里教授在会上发表了“ HIFU 治疗子宫腺肌症的生育结果”的专题演讲。结合其 20 年以来研究并治疗内膜异位症和子宫腺肌症的经验,艾里教授介绍了 HIFU 消融的工作原理,并分享了 HIFU 联合 GnRHa 和 LNG-IUS 治疗子宫腺肌症病人的“三步疗法”。此外,通过对比 54 例病人接受HIFU消融前后的子宫体积和病灶体积,她提出 HIFU 手术并不会影响女性的卵巢储备功能,并总结道HIFU消融技术可通过消融病灶来改善子宫运动机能和子宫腔形态,从而提升生育能力。
Dr. Jordi Rodriguez from Mutua Terrassa University Hospital, Spain, shared his clinical experience centered on “HIFU Treatment for Uterine Fibroids and the Pregnancy Outcome”. Dr. Jordi Rodriguez first explained the effect of uterine fibroids on fertility and treatment options, then indicated two goals of HIFU treatment for fertile women with uterine fibroids, including the inactivation of fibroid tissues and shrinkage of fibroids with gradual restoration of uterus structure. He demonstrated some academic papers in terms of HIFU and fertility and a table of obstetric characteristics of 43 successful deliveries achieved after ultrasound guided HIFU (USgHIFU) treatment, and concluded that patients undergoing USgHIFU treatment of uterine fibroids can achieve full-term pregnancies with few intrapartum or postparturm complications.
来自西班牙特拉萨大学医院的 Jordi Rodriguez 医生则围绕“ HIFU 治疗子宫肌瘤的生育结果”分享了他的临床经验。他首先介绍了子宫肌瘤对生育的影响和相应的治疗方案,随后指出 HIFU 治疗患有子宫肌瘤的育龄女性的两大目标:一是让肌瘤组织失活;二是缩小肌瘤,使子宫结构逐渐恢复正常。此外,他还介绍了数篇以 HIFU 与生育为主题的学术论文,以及 43 位接受超声引导 HIFU(UsgHIFU)治疗后成功分娩的患者的孕产特征,并以此总结道,接受 UsgHIFU 治疗的子宫肌瘤患者能够实现足月妊娠,同时分娩期及产后少有并发症。
Dr. Selva (Sevellaraja Supermaniam), former President of APAGE, a Consultant Obstetrician and Gynecologist at Mahkota Medical Center, Melaka, Malaysia, showed a surgery video of using HIFU to treat uterine fibroids and introduced lesion positioning, operation skills and therapeutic effects of the HIFU surgery. He believed HIFU can be performed to ablate and shrink fibroids in an effective and non-invasive way.
APAGE 往届年会主席、马来西亚马六甲州仁爱医院妇产科顾问医师塞尔瓦(Sevellaraja Supermaniam)医生为大家展示了应用 HIFU 治疗子宫肌瘤的手术视频,并介绍了手术过程中对病灶的定位方法、操作技巧以及术后的治疗效果。他认为 HIFU 这一无创技术可有效地消融并缩小子宫肌瘤。
Watch the playback on our Youtube:
https://youtu.be/hS2dA3YTLmk
点击观看HIFU专场研讨会:
http://live.99zigong.com/video/huikan/1160
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2021 APAGE-ISMIVS HIFU Series Webinars: HIFU and Fertility, Potential or Not? Episode 3
2021年国际微无创医学会(ISMIVS)与亚太妇产科内视镜暨微创治疗医学会(APAGE)联合会议
暨2021年高强度聚焦超声(HIFU)系列线上研讨会(AIH)——HIFU与生殖:潜力与否
第 3 期
On the cusp of autumn color, APAGE-ISMIVS HIFU Series Webinars were featured by its third episode. HIFU Series Webinars are jointly organized by International Society of Minimally Invasive and Virtual Surgery (ISMIVS) and Asia-Pacific Association for Gynecologic Ebdoscopy & Minimally Invasive Therapy (APAGE), aiming to facilitate academic interactions in the new field of noninvasive surgery and promote the technology and education exchange among doctors from different countries and regions.
时至金秋十月的末尾,高强度聚焦超声(HIFU)系列研讨会迎来了全新的第三期。本系列研讨会由国际微无创医学会(ISMIVS)与亚太妇产科内视镜暨微创治疗医学会(APAGE)联合举办,旨在促进微无创这一新兴医学领域的学术交流,为来自不同国家和地区的专家学者搭建技术研究与科学教育的一体化平台。
Episode 3 invited two eminent experts, Prof. Prashant Mangeshika, the Director of Center for Gynaecological Endoscopic Surgery and Institute for Research and Training in Minimally Invasive Surgery, Mumbai, and Prof. Amphan Chalermchokcharoenkit, the President of Thai Society of Gynecologic Endoscopists, to be in the chair, with four well-known speakers delivering in-depth insights on non-invasive therapy.
第三期 HIFU 研讨会邀请到两位顶尖专家,Prashant Mangeshika 教授(孟买妇科内窥镜手术中心和微创外科研究培训中心院长)和 Amphan Chalermchokcharoenkit 教授(泰国妇科内窥镜协会主席)担任会议主席,并由四位国际知名专家为大家分享无创治疗方面的深度洞察。
Dr. Hsin-Hong Kuo from Chang Gung Memorial Hospital at Linkou, Taiwan, mainly shared how to diagnose sarcoma through MRI before HIFU. He first introduced the classification and position of mesenchymal tumor in uterus, and said that it was hard to prognose leiomyosarcoma due to the similar symptoms with benign uterine myoma of bleeding, pelvic mass and pain. Then, he indicated that T2-weighted image of leiomyosarcoma was featured with irregular heterogenous and central hyper intense (necrosis/high cellularity), while T1 contrast image showing central necrosis with the evidence of invasion, with suspicious symptoms of rapid tumor growth (double size within 3-6 months), growing even with GnRHa and tumor growth after menopause.
来自台湾林口长庚医院的郭信宏医生重点分享了如何通过 HIFU 术前 MRI 影像诊断子宫肉瘤。他首先介绍了子宫间叶源性肿瘤的分类及位置,并提道由于子宫平滑肌肉瘤患者和良性子宫肌瘤患者均会出现流血、盆腔肿块和疼痛的相似症状,因此对子宫平滑肌肉瘤的预断较难。郭医生指出子宫平滑肌肉瘤的 T2 加权像呈现不规则异质和中央高强度(坏死或高细胞性),而 T1C 则呈现中心性坏死,表明已有侵入,同时病人具有肿瘤快速生长( 3 至 6 个月增长一倍),使用 GnRHa 治疗后仍持续增长,以及绝经后肿瘤仍在增长的可疑症状。
Dr. Yen-Ju Sung also Chang Gung Memorial Hospital presented 3 cases of adenomyosis with infertility. One of the cases was a 37-year-old female who has suffered from infertility for 5 years due to adenomyosis, she received GnRHa for a month in June 2020, yet still got persistent symptoms. So in August 2020, she underwent HIFU treatment and conception with advice for about 6 month, after that, she became pregnant via IVF in April 2021 and is expected to deliver this December.
同样来自林口长庚医院的宋医生分享了3例子宫腺肌症不孕不育患者。其中一例患者为 37 岁女性,因子宫腺肌症导致不孕不育的病史达 5 年。她于2020年6月接受了为期一个月的 GnRHa 治疗,但病症未见缓和,因此于同年8月进行 HIFU 治疗,并遵医嘱避孕 6 个月。此次治疗后,该患者于2021年4月通过辅助生殖技术成功受孕,预计在今年 12 月分娩。
Prof. Chyi-Long Lee, the chairman of APAGE, discussed the management of adenomyosis in infertile patient. He first explained the pathogenesis of adenomyosis and indicated that ultrasonic evaluation of the type and extension of adenomyosis in the myometrium seems to be important to confirm the severity of symptoms and infertility. Then, he mentioned there were 5 treatment options including medical treatments, surgical options, radiologic, HIFU and combined therapy depend on the presence of specific symptoms, such as pain, abnormal uterine bleeding and/or infertility. He also indicated the cause of infertility and two major goals of treatment: improving the chance of pregnancy and ART outcome post adenomyomectomy or HIFU ablation. After elaborating several surgery videos of different therapy, Prof. Chyi-Long Lee concluded that segmented ART for adenomyosis patients seems to be the best option, and HIFU showed a safe and effective profile as a therapeutic management option for sub-fertile patients with adenomyosis.
APAGE 现任主席李奇龙教授则在会上探讨了针对子宫腺肌症不孕不育患者的治疗方案。李奇龙教授首先阐释了子宫腺肌症的发病机理,并指出应用超声评价子宫肌层中子宫腺肌症的类型和范围对判断病症和不孕的严重程度来说极为重要。随后,他提到根据患者特定症状(如疼痛、异常子宫出血和/或不孕不育)的病征,可以选择 5 种不同的治疗方案:药物治疗、手术治疗、放射性治疗、高强度聚焦超声(HIFU),以及联合治疗。此外,他还介绍了不孕不育的成因和治疗子宫腺肌症的两大目标,即在腺肌瘤切除术或 HIFU 消融之后提高妊娠率和辅助生殖技术结果。李教授详细讲解了不同治疗方案的手术视频,并总结道对于子宫腺肌症患者来说,分段辅助生殖技术是最好的选择;而对患有子宫腺肌症的低生育力妇女来说,HIFU 是一种安全有效的治疗方案。
Dr. Selva (Sevellaraja Supermaniam), a Consultant Obstetrician and Gynecologist at Mahkota Medical Center, Melaka, Malaysia, shared a clip of surgery videos in managing uterine fibroids and adenomyosis with HIFU, and indicated the standard procedures and useful skills of operation. During the Q&A part, for the question of how to position the focal zone, Dr. Selva and Prof. Chyi-Long Lee emphasized the importance of controlling the ultrasonic power and precisely positioning center zone and explained the usage of the water balloon.
马来西亚马六甲州仁爱医院妇产科顾问医师塞尔瓦(Sevellaraja Supermaniam)医生分享了他应用 HIFU 治疗子宫肌瘤和子宫腺肌症的手术视频,并介绍了 HIFU 手术的标准流程和手术技巧。在问答环节,塞尔瓦医生和李奇龙教授针对如何定位病灶区域的问题,强调了控制超声能量、精准定位病灶中心的重要性,并阐释了超声定位球的使用方法。
Watch the playback on our Youtube:
https://youtu.be/gc3IKpWqZNI
点击观看本期线上研讨会:
http://live.99zigong.com/video/huikan/1146

Notice通知
APAGE-ISMIVS HIFU Series Webinars 2021: HIFU and Fertility, Potential or Not?
2021年国际微无创医学会(ISMIVS)与亚太妇产科内视镜暨微创治疗医学会(APAGE)联合会议
暨2021年高强度聚焦超声(HIFU)系列线上研讨会(AIH)
To foster academic exchanges in the new field of minimally invasive and noninvasive surgeries and deliver scientific and educational dialogues across continents, the Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE) and the International Society of Minimally Invasive and Virtual Surgery (ISMIVS) have been co-organizing APAGE - ISMIVS HIFU (AIH) Webinar Series 2021, which is themed on HIFU and Fertility, Potential or Not? and consists of 4 episodes starting from July to December, 2021.
为促进微无创手术领域的学术交流,国际微无创医学会(ISMIVS)联合亚太妇产科内视镜暨微创治疗医学会(APAGE)将于 2021 年 7 月至 12 月举办 4 场高强度聚焦超声(HIFU)线上系列研讨会。来自世界各地的医学专家将围绕“HIFU 与生殖:潜力与否”的主题为大家带来一场科学与教育的盛宴。

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HIFU Special Issue 高强度聚焦超声特刊
We are delighted to announce that International Journal of Hyperthermia, the HIFU Special Issue (i.e. Volume 38, 2021), which was partially supported by ISMIVS, was officially released on September. The Special Issue includes 15 articles written and reviewed by world-renowned scholars and pioneers in the minimally invasive and noninvasive medicine, elaborating the status and prospects of the clinical applications of high intensity focused ultrasound on tumors occurred in certain organs. We'll share the 15 articles included in the upcoming newsletters, stay tuned!
我们很高兴地向大家宣布,由国际微无创医学会(ISMIVS)参与并大力支持的《国际热疗杂志:高强度聚焦超声(HIFU)特刊》已于九月正式发布。本期特刊邀请到多位微无创医学领域的国际知名专家和行业先驱参与编撰及审核,共包含15篇学术文章,阐述了高强度聚焦超声(HIFU)治疗人体各器官肿瘤的临床应用现状和发展前景。我们将陆续分享HIFU特刊中的文章,敬请期待!
Pregnancy outcomes after ultrasound-guided high-intensity focused ultrasound (USgHIFU) for conservative treatment of uterine fibroids: experience of a single institution
超声引导下高强度聚焦超声(USgHIFU)保守治疗子宫肌瘤的妊娠结局:一所大学医院的经验分享
The objective of this retrospective observational study is to assess the impact of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids on fertility. There are 560 reproductive-age women with symptomatic uterine fibroids who underwent USgHIFU therapy at Mútua Terrassa University Hospital, Spain, between February 20408 and February 2018.
这项回顾性研究的目的是评估超声引导下高强度聚焦超声 (USgHIFU) 消融治疗子宫肌瘤对生育能力的影响。 2008 年 2 月至 2018 年 2 月,共有 560 名患有症状性子宫肌瘤的育龄女性在西班牙 Mútua Terrassa 大学医院接受了 USgHIFU 治疗。
After USgHIFU treatment, 71 pregnancies were obtained in 55 patients. Of these, 58 (82%) cases were natural pregnancies and 13 (18%) were in vitro fertilization (IVF) pregnancies. The median time to conception was 12 (range 1–72) months. Except for a baby born with a tetralogy of Fallot, all newborns developed well without complications during postpartum and breastfeeding.
USgHIFU 治疗后,55 名患者出现 71 次妊娠。 其中,58 例 (82%) 为自然妊娠,13 例 (18%) 为体外受精 (IVF) 妊娠。 平均受孕时间为 12(范围 1-72)个月。 除法洛四联症患儿以外,所有新生儿在产后和母乳喂养期间均发育良好,无并发症。
Patients undergoing USgHIFU treatment of uterine fibroids can achieve full-term pregnancies with few intrapartum or postpartum complications.
由此可见,接受 USgHIFU 治疗的子宫肌瘤患者可以实现足月妊娠,几乎没有产时或产后并发症。
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Tech Update in Gynaecological Endoscopy 妇科腔镜技术最新进展
Pregnancy Outcomes of Patients Undergoing Single-layer Sutured Laparoscopic Myomectomy
单层缝合腹腔镜子宫肌瘤切除术患者的妊娠结局

In this retrospective study, the author aimed to investigate the pregnancy outcomes of 102 patients who underwent laparoscopic myomectomy (LM) with single-layer suturing. Twenty-four patients and thirty-two pregnancies meeting our criteria were included in the study. The mean age of the pregnant patients was 34 ± 8.2 years. The mean myoma diameter was 7.8 ± 3.4 cm.
在这项回顾性研究中,作者旨在研究 102 名接受单层缝合腹腔镜子宫肌瘤切除术 (LM) 的患者的妊娠结局。研究对象包括 24 名患者和 32 名符合研究标准的孕妇。妊娠患者的平均年龄为 34 ± 8.2 岁。子宫肌瘤平均直径为 7.8 ± 3.4 厘米。
What's known 研究现状
One of the most important concerns about laparoscopic myomectomy is the theoretically increased risk of uterine rupture during pregnancy. The tendency is in favour of multilayer suturing in laparoscopic myomectomy. There are no prospective randomised studies comparing single and double closure.
腹腔镜子宫肌瘤切除术理论上会增加怀孕期间子宫破裂的风险,这也是该技术最令人担忧的一点。因此,腹腔镜子宫肌瘤切除术偏向于使用多层缝合,而迄今为止,没有比较腹腔镜子宫肌瘤切除术单层缝合和双层缝合的前瞻性随机对照研究。
What's new 研究进展
If there is sufficient surgical experience, the myometrium can be closed in one layer so that there is no dead space. According to pregnancy results of patients, single-layer suture is a safe technique to close the myometrium. Comprehensive randomised studies are needed in this regard. The author concluded that single-layer closure of the uterine defect in LM is safe for subsequent pregnancies, and the risk of uterine rupture is low.
如果医生的手术经验足够丰富,那么可以将子宫肌层单层缝合,这样就不会有死腔。根据患者的妊娠结果,使用单层缝合的方式对合子宫肌层的操作是安全的。这一课题还需要更加全面的随机研究。作者得出的结论是,在腹腔镜子宫肌瘤切除术中单层缝合子宫切口对患者后续的妊娠来说是安全的,并且子宫破裂的风险很低。
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+86 23 67886199

ISMIVS 2020