子宮鏡下手術中の液過負荷予防に対する自動灌流装置（Hydroflex irrigation system）の有用性

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  • Efficacy of a Mechanical Pump (Hydroflex Irrigation System) for Preventing Fluid Overload in Hysteroscopic Surgery

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Objective: To determine the efficacy of a mechanical pump (Hydroflex irrigation system) for preventing fluid overload in hysteroscopic surgery.<BR>Design: Retrospective study<BR>Patients: A total of 74 patients who had undergone hysteroscopic surgery.<BR>Intervention: We compared the surgical outcomes between the three groups (Group A: monopolar electrodes using sorbitol as irrigant and fluid is delivered to the resectoscope by means of gravity; Group B: bipolar electrodes using saline as an irrigant and adjustment of fluid pressure with pressure cuffs; Group C: bipolar electrodes using saline as an irrigant and adjustment of fluid pressure with mechanical pumps.) <BR>Main outcome measures: surgery time, amount of fluid consumption, myoma size, and complications.<BR>Results: There were no significant differences in surgery time and serum sodium levels between the three groups. Compared to Group A, fluid consumption and the diameter of the resected myomas were significantly larger in Group B and Group C. The complication rate of fluid overload was significantly higher in Group B. <BR>Conclusions: In hysteroscopic surgery, intrauterine pressure must be appropriately controlled to maintain a balance between excessive pressure, inadequate pressure, increased intravasation, and reduced visibility. Mechanical pumps appears to be useful and convenient for the prevention of fluid overload.

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