1678 Cold Scissor Ploughing Technique in Hysteroscopic Adhesiolysis-A Comparative Study

Abstract

Study Objective To investigate the efficacy, feasibility, and safety of cold scissor ploughing technique in hysteroscopic adhesiolysis for intrauterine adhesions. Design Retrospective cohort study. Setting University-affiliated hospital. Patients or Participants A total of 179 intrauterine adhesion (IUA) patients who had undergone hysteroscopic adhesiolysis (HA) at the Third Xiangya Hospital of Central South University were enrolled in this study from January 2016 to October 2017. They were divided into three groups according to the surgical technique used. The groups were: cold scissors ploughing group (PG) (n=81); traditional group (TG:) (n=42); and, electrosurgical group (EG) (n=56). Interventions PG: use cold scissors to dissect the adhesion and cut the scar tissue using a ploughing technique; TG: use cold scissors to dissect the adhesion, but not deal with the scar tissue; and, EG: use resectoscope to dissect the adhesion with an energy L-hook electrode. Measurements and Main Results American Fertility Society (AFS) scores, along with adhesion types and areas; visible uterine horn and tubal ostia; menstrual recovery; pregnancy rates and live birth rates were evaluated to determine surgical efficacy. Feasibility was evaluated by technique replacement rates. Safety was evaluated by intra- and post- operative complication rates. Neither patient pre-operation history or adhesion rates were significant (P>0.05). There were significant differences between PG and TG, as well as PG and EG in: postoperative AFS scores; IUA reverse rates; reduced adhesion areas; pregnancy rates and live birth rates (P Conclusion Cold scissor ploughing is effective, feasible, and safe for HA, which is worth further study.