Evaluation of safety and diagnostic performance for flexible hysteroscopy in 1591 outpatient cases
| Autor: | Takuro Hirano, Kanako Nakamura, Masataka Adachi, Keiko Watanabe, Yusuke Kobayashi, Mayuka Anko, Shimpei Nagai, Daisuke Aoki, Arata Kobayashi, Kouji Banno, Haruko Kunitomi, Wataru Yamagami, Takayuki Takahashi, Yusuke Matoba, Eiichiro Tominaga, Kosuke Tsuji |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Uterine perforation Hysteroscopy Malignancy 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Pregnancy Ascites Outpatients medicine Endometrial Polyp Humans Radiology Nuclear Medicine and imaging Pliability Atypical Endometrial Hyperplasia Aged Retrospective Studies Aged 80 and over 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Endometrial cancer General Medicine Middle Aged medicine.disease Endometrial hyperplasia Endometrial Neoplasms Oncology 030220 oncology & carcinogenesis Uterine Neoplasms Female Radiology medicine.symptom business |
| Zdroj: | Japanese journal of clinical oncology. 50(10) |
| ISSN: | 1465-3621 |
| Popis: | BackgroundTo date, only few large studies are available concerning the safety and diagnostic concordance rates of outpatient flexible hysteroscopy. In our institution, outpatient hysteroscopy has been routinely and educationally applied Kosuke Tsuji to intrauterine lesions; thus, we retrospectively investigated the institution’s outpatient flexible hysteroscopy cases.MethodsA total of 1591 cases of outpatient flexible hysteroscopy conducted at our institution in 2012–2016 were retrospectively analyzed in terms of their clinical background, complications and diagnostic concordance rates.ResultsA total of 1591 cases included 546 cases of benign tumors (317 endometrial polyps, 168 myomas and 61 endometrial hyperplasia), 361 cases of atypical endometrial hyperplasia, 571 cases of endometrial cancers and 113 cases of other diagnoses. No major complications, including uterine perforation, occurred. However, one patient (0.06%) was diagnosed with septic shock caused by intrauterine infection that required prolonged immunosuppressive drug administration. Meanwhile, 335 patients diagnosed with benign tumors through outpatient flexible hysteroscopy underwent operation, and the diagnostic concordance rate was 74.6% (250 cases). However, this rate included 14 cases (4.2%) diagnosed with malignant tumors postoperatively. In preoperative endometrial cancer cases, the sensitivity and specificity for cervical invasion diagnosis were 39.4 and 90.8%, respectively. In addition, only one patient manifested positive ascites cytology intraoperatively, possibly caused by outpatient hysteroscopy.ConclusionsOutpatient flexible hysteroscopy is highly safe, with a slight negligible effect on ascites cytology. However, the diagnosis should be determined by multidisciplinary approaches, as hysteroscopy alone can miss malignancy. |
| Databáze: | OpenAIRE |
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